23/02/2018
PE is the most common ejaculatory disorder. It occurs when a man ejaculates before the men or his partner want climax to happen. For some men, the problem starts with their first sexual experience (primary PE). For others, it happens after a period of normal sexual functioning (secondary PE).
PE often becomes a problem for the couple. Many men with PE feel embarrassed, anxious, depressed, and worried about pleasing a partner. Single men sometimes avoid new relationships because of the stress of PE.
Causes of PE
Psychological factors may play a role, but some believe that a chemical imbalance or receptor sensitivity changes in the brain are the cause, at least for some men.
Low testosterone level contribute in poor control of ejaculation.
Infection in urinary tract and genital glans affect ability of ejaculation control.
PE diagnosis
PE is a self reported diagnosis, and can be based on sexual history alone
Three criteria for PE diagnosis: (1) Unable control ejaculation nearly of most times intercourse, (2) time for penetration in Vaginal short less than 3 minutes, (3) personal distress and relation shipp
Diagnosis depends on the situation. What is premature to one couple may be fine for another. The key to diagnosing PE is the level of personal distress involved. Most men who think they have PE ejaculate within two minutes of sexual contact.
PE treatment
There are a number of strategies men use to handle PE. They include:
Psychosexual counseling & Behavioural techniques
‘Stop-start’ and ‘squeeze’ techniques, extended foreplay, pre-intercourse masturbation, cognitive distractions, alternate sexual positions, interval sex and increased frequency of sex
Masturbating before intercourse. Many men find they have better control if they ejaculate shortly before starting sexual activity.
Using condoms. For some men, a condom makes the penis less sensitive.
Techniques are diffcult to maintain long-term
Address the issue that has created the anxiety or psychogenic cause
Address methods to improve ejaculatory control.
Distraction. Some men think about non-sexual topics during sex.
Therapy options include meditation/relaxation, hypnotherapy and neuro-biofeedback
Oral pharmacotherapy
A common side-effect of some selective serotonin reuptake inhibitors (SSRI) and tricyclic antidepressants is delayed ejaculation. SSRIs are now commonly prescribed for PE. A number of treatment regimens have been reported, including:
Fluoxetine hydrochloride: 20 mg/day
Paroxetine hydrochloride: 20 mg/day.
Sertraline hydrochloride: 50 mg/day or 100 mg/day
Clomipramine hydrochloride 50 mg/day
Local anesthesia medicines: Creams contain these medicines can be applied to the head of the penis before sex 5-10 minutes to reduce glans sensitivity.
PE now is an easy treatable disease, if men undergo this condition, he should be sturdy & confident to go the andrology clinic for treatment soon.
By Nguyen Ba Hung
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Andrology and Fertility Hospital of Hanoi
? (+84) 1900 56 56 01
➡ https://www.facebook.com/afhanoi/
➡ 431 Tam Trinh Street, Hoang Mai District, Hanoi, Vietnam.
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