Premature ejaculation is a sexual disfunction, which is not caused by organic disorders or diseases. It consists in impossibility to control ejaculation, so that it is enough to both partners for the pleasure of sexual intercourse.
The most popular psychological reason is an overexcitation. If you feel sexual overexcitation , voltage rapidly increases in a certain section of the cerebral cortex. It leads to undesirable ejaculation. Another psychological cause is a fear about failure during intercourse. Signs of premature ejaculation are divided into 2 groups: psychological and physiological. The latter are associated with the features of functioning organs, their structure as well as general health problems. 1 of the main physiological reasons of premature ejaculation can be considered sensitivity of the head of the penis, the other, not less important reason, is considered vesicles. You can try to use 1 or2-3 condoms at the same time to minimize the sensitivity of the head of the penis.
PREMATURE EJACULATION: SYMPTOMS
As already has been identified, the name of this disorder is the answer to the question of the main symptoms present with him. That is, when ejaculation premature ejaculation occurs earlier than necessary. Dissatisfaction with both partners may be, because of what the problem is further exacerbated. In severe manifestations of the disease ejaculation occurs even before the penis has appeared in the female vagina. A similar situation can only occur only when the form of female genital mutilation, which is due to excessive overstimulation. A positive feature of premature ejaculation is that it can pass by itself, which is caused by the acquisition of some experience in sex. Meanwhile, it also happens that this problem persists for many years, because of which, as is known, difficulties arise in men.
Diagnosis of premature ejaculation is a constructive dialogue with the appropriate specialist, in which he will try to determine what are the causes of the problem. In the absence of specific reasons for selection, diagnosis, most likely, will be the implementation of the next phase of her. This stage requires the presence of the patient’s sexual partner, in particular that required to conduct test lidocaine. With lidocaine treatment is performed in the skin of the penis frenulum, and then you want to go to the sexual act, which should aim to fix the results of ongoing research. If the positive dynamics in this case was not, the test is complete, which requires a full treatment of the glans penis lidocaine, then re-invited to go to have sex. As other methods of diagnosis can identify tissues of the penis detection sensitivity with the concomitant reflex test. This requires the use of special equipment.
Treatment of Premature Ejaculation
Currently are 4 main approaches to the treatment of premature ejaculation:
- Local treatment
- Sex therapy
It should be noted that the local treatment and pharmacotherapy is only a temporary solution to this problem and require constant use of medicines.
Sex therapy, being the safest method, it also has a number of disadvantages. The main include prolonged lack of effect and mandatory participation in the treatment of sexual partner.
Surgery allows you to quickly get the desired result, which will not disappear later. A positive aspect is the ability to evaluate the effectiveness of the operation to its implementation (see. Below).
LOCAL EARLY EJACULATION THERAPY
The basis for the local treatment of premature ejaculation is the use of local anesthetics to block nerve endings located in the skin of the head and the body of the penis in order to turn off the peripheral link mechanism of ejaculation.
There are 2 variants of the local treatment of premature ejaculation:
- the use of condoms with anesthetics
- the application of gels and ointments with local anesthetics on the skin of the penis
Currently, there is a large selection of condoms, lubricant which contains a small amount of local anesthetic. When using these condoms reduces the sensitivity of the head of the penis, which causes a slight increase in the duration of sexual intercourse.
Low concentrations of the anesthetic lubricated condoms due to the fact that lidocaine irritates mucous membranes, causing burning. And if a man mucous represented only a small area around the urethral meatus, then the woman mucosa input and covered the whole inner surface of the vagina, which may lead to strong painful sensations sufficiently in contact with them, and no other anesthetic intercourse. However, the lower the content of lidocaine in the Condoms Lubricants, the weaker the blocked nerve endings, and the earlier the ejaculation.
In this regard, and it is possible to use an ordinary condom with a preliminary application to the skin of the penis ointment or gel with a concentrated anesthetic, thereby virtually eliminating the risk of contact with an irritant agent in the female genital tract, and also achieved a longer suppression of ejaculation process.
If you would not use condoms local anesthetics are used in the following manner: after treatment with the drug lidocaine sexual member must wait for absorption of the drug into the skin, then you need to thoroughly wash the penis in order to avoid contact with lidocaine in the vagina.
Local therapy usually increases the sexual intercourse on average 1.5-2 times. However, in case of failure of the further treatment there is complete regression of premature ejaculation. In this regard, most of patients after treatment with anesthetics surgery seeks to produce a constant result.
SEX THERAPY EARLY EJACULATION
Sex therapy as a treatment for premature ejaculation is based on the use of complex techniques that allow a certain degree of control the ejaculation. This type of therapy is quite effective and can increase during sexual intercourse up to 5-10 minutes.
The most widely used method of compression of the head of the penis and “start-stop” technique.
In the first case the partner provides a sufficiently strong compression of the head of the penis at the time immediately prior to ejaculation. This results in inhibition of ejaculation process that allows further manipulation and oral stimulation of the penis.
At the “start-stop” technique of distancing in time the moment of ejaculation is achieved by stopping the frictions at the first urge to ejaculation. After a pause is possible to continue intercourse until the next sensation upcoming ejaculation.
It should be noted that the first attempts to use the described techniques tend to be unsuccessful due to the inability to adequately control their own men sensations during intercourse and to anticipate the onset of ejaculation.
Another negative side of sex therapy is the lack of rapid simultaneous improvement (usually it takes about 4-6 months of regular exercise in order to achieve the desired results), which often causes the patient’s lack of confidence in the correctness of the choice of treatment.
However, the most serious drawback of sex therapy is mandatory participation in the treatment of an adequate sexual partner, which in most cases is impossible.
On the property of some drugs (neuroleptics, benzodiazepines, alpha blockers) to delay the onset of ejaculation is known a long time, but their use for the treatment of premature ejaculation was not possible due to the presence of significant side effects caused by the primary pharmacological action of these substances oriented.
Currently, drug therapy of premature ejaculation was extended due to the emergence of new drugs from the group of antidepressants – selective serotonin reuptake inhibitors, have the ability to slow down the process of ejaculation in patients without many side effects, available to their predecessors.
The effectiveness of drug treatment of premature ejaculation antidepressants drugs is quite high (the average duration of sexual intercourse is increased by 4-6 times).
The downside of medical treatment is the need for constant monitoring to assess the therapist’s own psycho-emotional state (receiving psychoactive drugs can cause depression).
Stopping drugs reduces the duration of sexual intercourse to the original level.
The simplest and most affordable way to cure premature ejaculation is surgery circumcision. After circumcision the glans penis coarsens due to constant contact with the underwear, and its sensitivity is reduced.
The average duration of sexual intercourse after circumcision increases by 2-3 times compared to the initial state. So, if ejaculation occurs in 4 min., After the cut-off time of sexual intercourse will increase to 10 minutes.
Microsurgical denervation of the glans penis
Today, there is provided another method of surgical treatment of premature ejaculation. The technique developed temporary denervation of the penis through the intersection, followed by surgical reduction of sensory nerve trunks can increase the duration of sexual intercourse 3-5 times.
After the operation, there is almost complete anesthesia of the penis, which makes it possible to conduct long-term sexual intercourse (30-40 minutes). This anesthesia is temporary and lasts for up to six months. At this time the patient shows frequent and regular sex.
Undoubtedly, at a reduced sensitivity of the head sexual sensations do not have full and colorful, available prior to surgery. However, during the course of processes of reinnervation and restore penis sensitivity, provided regular sexual contacts of the patient formed a clear dominant for a long intercourse which persists after the full restoration of sensitivity (at 6 months). After a complete restoration of the sensitivity of the duration of sexual intercourse decreased slightly and is ultimately at the level of 3-5 times higher than the original.
The effectiveness of this method can also be evaluated in advance using a test lidocaine.
Surgery is not traumatic and does not require the patient’s rehabilitation. Cosmetic outcome after surgery is more than acceptable: incisions are made around the head of the penis, after removal of sutures remains thin cutting line, visible only when an exposure head.
However, microsurgical denervation of the penis is relatively new and poorly understood technique. For example, at present it is not clear how the operation on the development of mature or impotence in old age can affect.Read more