Premature ejaculation (PE) is constant or often repeated ejaculation that occurs as a result of minimal sexual stimulation, before, during, or immediately after penis penetration, and before man desires it.
Most experts believe that average sexual intercourse duration should be at least 2-3 minutes. In this precoital ejaculation (before the introduction of the penis into the vagina), of course, is premature.
Premature Ejaculation Causes
- psychological (beginning of sexual life, unsuccessful experience in past);
- neurophysiological (increased excitability of motor neurons of spinal ejaculation center);
- hormonal (increased prolactin level);
- hypersensitivity of individual areas of penis because of inflammatory and other diseases.
- After andrologist diagnoses premature ejaculation cause, treatment of premature ejaculation will be prescribed.
Premature Ejaculation Treatment
There are the following treatment methods for premature ejaculation:
- Behavioral therapy (patients are taught how to control ejaculation).
- Pharmacotherapy. This therapy is distinguished between local (topical) and systemic drug therapy. When topical therapy local anesthetics are used (often lidocaine), which are applied to balanus. It leads to decrease in balanus sensitivity and increase in sexual intercourse duration. To significant disadvantages of method can be attributed to decrease in pleasure level from sexual intercourse. For systemic therapy of premature ejaculation, selective inhibitors of serotonin uptake are used. Antidepressants are used, side effect of which is increase in sexual intercourse duration. Psychotropic action development, long-term use of drugs in large doses is necessary. At the same time to slow ejaculation it is sufficient reception of small doses of drugs, or reception “on demand” (ie before sexual intercourse). The appointment of selective inhibitors of serotonin reuptake should be performed by urologist-andrologist.
- Surgical treatment of premature ejaculation. Microsurgical denervation of balanus. Surgically, 4-5 main nerve trunks are isolated, innervating penile glans, and cross them. Within 2-3 months, complete anesthesia of penile glans is noted. Then sensitivity is gradually restored. Gradually patient gets used to new sensations, but he has already formed normal ejaculatory reflex, and patient can control sexual intercourse duration.
- Penile prosthesis. This method is used when other methods of treatment are ineffective and patient insists on having prolonged sexual intercourse.