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Premature ejaculation is one of the most common sexual disorders and the frequency is comparable with erectile dysfunction.

In the basis of previous definitions of premature ejaculation were the duration of sexual intercourse or the number of frictions incurred prior to ejaculation. Since the men were trying to establish their compliance rate with a stopwatch, or accelerate the frictions to increase their numbers, which usually bring the ejaculation of these definitions, have refused. The average duration of sexual intercourse is about 3 minutes. Reducing the duration of male foreplay to reduce the excitation can irritate the woman. Partner can both sympathize and fly into a rage. However, only 30% of women reach orgasm during vaginal sex, despite the controlling partner of the duration of sexual intercourse. Therefore, at present the standard cure of premature ejaculation does not exist. This leads to a divergence of opinions not only about treatment methods and their effectiveness, but also about the diagnosis.

Causes of premature ejaculation

Cortical reasons (related to the processes in the cerebral cortex)

Relevant psychogenic and interpersonal factors: teenage fears being caught when you have sex, dissatisfaction from family life, interpersonal conflicts, lack of trust in a partner, fear of intimacy, sex role conflicts.

Characteristics:

• Failure and other problems with the onset of sexual activity
• Rare and irregular sexual life
• Duration of sexual intercourse varies
• Duration of sexual intercourse depends on the partner
• Impossible to make a second sexual act due to lack of erection
• Premature ejaculation combined with erectile dysfunction
• Sometimes help thoughts on abstract subjects during intercourse, which, however, may reduce the erection
• Alcohol consumption prolongs the sexual act

The defeat of the higher cortical centers regulating urogenital automatisms and curing the threshold of excitability of nerve structures for ejaculation and orgasm as a result of pathogenic factors in the antenatal period, or birth trauma, less trauma in adults.
Subcortical and spinal disorders
Increased sensitivity of the glans penis

Characteristics:

• Duration of sexual intercourse varies little
• Ejaculation occurs during the whole of sexual life
• Repeated sexual acts is not much longer than the first
• Sexual intercourse with a condom and lubricant longer the artificial
• Ejaculation does not occur prior to sexual intercourse
• Alcohol consumption prolongs the sexual act

Manifestations

The problem is that if ever there spontaneous ejaculation during foreplay prior to the introduction or immediately after the introduction of the penis.

Fear of failure weakens the control of ejaculation, and the desire to control sexual arousal, trying to escape, may interfere with an erection.

The majority of men after prolonged abstinence ejaculation cure faster.

In the U.S., 15-20% of men have difficulty controlling ejaculation, but less than one fifth of them believe this is the reason for clinic visits. Others are trying to cope with the problem themselves by using condoms for blunting tactile sensations, reducing alcohol consumption or making repeated sexual intercourse in 2-3 hours.

Premature ejaculation is often provokes pronounced interpersonal problems and serious psychological experiences.

Treatment

It is important to interact with both partners as the situation may be more troublesome for women than for men.

The patient should be adjusted on the fact that the cure will take time, effort, patience and persistence, but will certainly be successful.

One of the main conditions is the presence of a constant, benevolent sex partner. Negative reaction partners (fatigue, frustration, resistance, etc.) may interfere with treatment.
The method of "compression"

A woman puts a thumb on the reins of the penis, and the index and middle fingers on the opposite side to the coronary sulcus and under it, and within 4 seconds compresses a member, and then abruptly releases it.
Compression can be performed both in erection and sluggish state, but the pressure must correspond to an erection. Method is much better to the plateau stage and is not used when ejaculation is imminent.

After the introduction of the penis into the vagina frictions are not produced, and after 15-30 seconds, a woman must remove the penis from the vagina and after compression to re-introduce it. Then maybe slow frictions.

With improved control over ejaculation, go to the compression at the base of the penis during intercourse without interruption.
In the first six months of a man should give up trying to figure out how he can get closer to the inevitability of ejaculation prior to compression.
Receiving a "stop-start"

Frictions are terminated immediately after introjection (the introduction of the penis into the vagina) to complete disappearance of sensual genital sensation, slowing the pace of frictions with the maximum muscle relaxation produce a significant effect.
Selective serotonin reuptake inhibitors (SSRIs)

SSRIs slow the onset of orgasm and increase satisfaction with sexual intercourse. Use daily or one-time fee for 2-6 hours before sexual intercourse at doses lower than those for psychotropic: clomipramine, Paroxetine (Paxil), Zoloft, fluoxetine (Prozac), citalopram.
Beta-blockers
Currently, the cure of premature ejaculation is not used.
Alpha-blockers
Prolong intercourse half of the patients, but can cause retrograde ejaculation into the bladder.
Injectable Therapy
Injections produce an erection, which allows the patient to continue to sexual intercourse and after ejaculation to satisfy his partner. However, there are complications of limiting their use in primary premature ejaculation before the full treatment.
Numerous advertised funds tend to be biologically active food additives (BAA) have a short-term success only if the psychogenic nature of premature ejaculation and, at best, harmless.
Topical therapy

Most of the sprays and creams applied to the head region and the coronary sulcus of penis mainly in the bridle for 10-15 minutes before intercourse contain the local anesthetic lidocaine. Use a condom. They reduce the sensitivity of the penis and may reduce the satisfaction of sexual intercourse.

Anesthesia glans penis persists for 2-3 months.
After 6-8 months, the sensitivity of the head and skin of the penis will usually recover, and 90% of patients the duration of intercourse grow for 2-4 minutes.
 

Premature ejaculation in men causes psychological distress and reduced quality of life. Often, premature ejaculation adversely affects sexual relationships, and directly or indirectly, is the cause of family conflicts. Generally accepted norms of the duration of sexual intercourse do not exist, and the duration of the friction period is from 1 to 10 minutes.Defined by the World Health Organization, ejaculation, whichever comes first 1 minute, may be called premature. However, more precise, in our opinion, is the definition: any duration ejaculation is considered premature if it is offensive man can not control. More...

In modern medicine is very common notion "premature ejaculation", which means the release of semen from the urethra before or immediately after intromissii. There is also the concept of "relative premature ejaculation", which implies lack of control over ejaculation, which, in turn, does not allow sexually satisfied partner. Any violation of ejaculation affects men's self-esteem, which leads to disharmony between the partners. Can not clearly identify the criteria by which we can judge whether it was a quick ejaculation or not. However, judging by the complaints of many people in the early ejaculation, rapid ejaculation, the main problem for them is In a short intercourse, and lack of orgasm in women. In other words, any slight sexual stimulation leads to premature ejaculation and is accompanied by frustration of sexual partners, and eventually gives rise to fears and neuroses. Causes of rapid ejaculation may be several. But they are divided into two groups: physiological, ie, various problems with the structure of genital organs or health, which led to a breach of ejaculation, or psychological, ie, various deviations due to some beliefs, overexcited, or early onset of sexual activity that does not allow for control over ejaculation. Treatment of disease Any treatment of premature ejaculation begin only after ascertaining the causes of early ejaculation by conducting due diligence. In the case of physiological abnormalities is assigned drug treatment for premature ejaculation or surgical intervention by denervation of the glans penis, the final stage of which is the excision of skin of the foreskin (circumcision). In the absence of control over ejaculation due to psychological problems, prescribe treatment for premature ejaculation by teaching methods of control over ejaculation. More...

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