Basic Information
Chinese name: premature ejaculation
English namePremature ejaculation
Main cause: psychological factors, etc.
Most common groups: young, middle-aged men
The main symptoms: ejaculation too fast
Department: Surgery - Urology
disease definition
Premature ejaculation is defined in various ways and refers to the ejaculation that occurs after a short period of intercourse, some can not complete sexual intercourse at all, some have not yet contacted the female, or have just touched the female vulva or vaginal opening, or have just inserted into the vagina within 2 minutes , ejaculation occurs, and the penis becomes weak after ejaculation, which is a disease that cannot maintain normal sexual life. Three elements must be included: 1) short latency of ejaculation; 2) poor ability to control ejaculation; 3) low degree of sexual satisfaction. From the perspective of evidence-based medicine, the International Society for Sexual Medicine ISSM pointed out that the definition of premature ejaculation should include the following three points: (1) ejaculation always or almost always occurs within 1 minute of penetration of the penis into the vagina; (2) not all or Almost all delayed ejaculation after entering the vagina; ③ Negative personal mental and psychological factors, such as distress, anxiety, frustration and/or avoidance of sexual activities.
Cause
Chinese medicine believes that the penis is connected to the seminal vesicles and is the gateway to the kidneys. It belongs to the Liver Meridian of Foot Jueyin. The physiological function of male ejaculation is accomplished under the mutual restraint and coordination of the liver and the kidneys. During sexual intercourse, the liver meridian of Foot Jueyin is stimulated by the senses of the penis, so that the dredging function of liver qi is continuously enhanced until it breaks through the restriction of kidney qi storage and ejaculation occurs. If the barrel is compared to kidneys, and the water in the barrel is compared to semen, the barrel can be filled with water without flowing out, indicating that the wooden board is compact and firm, and once we draw one of the wooden boards, the water inside will flow out immediately. In the same way, when the kidneys are healthy and the kidney yang is abundant, the fine gate is firm and the kidney storage is strong. When the kidney is deficient and the storage function of the kidney is dysfunctional, the yang qi in the kidney is not enough to solidify the semen, the semen is not solid, and premature ejaculation occurs naturally.
On the surface, high work pressure, mental stress, frequent sexual intercourse, and excessive masturbation can also lead to premature ejaculation. From the general personal treatment experience, these people have a common feature, that is, kidney yang deficiency, that is, kidney yang deficiency. For example, if you have a lot of work pressure, you must be depressed. Depression damages the liver. The liver and kidneys have the same origin and naturally affect the kidneys. Secondly, premature ejaculation caused by mental stress during the first sexual intercourse is normal, but after experiencing sexual experience, it is still the same premature ejaculation as a conditioned reflex, which is a problem with the sealing function of the kidneys. In addition, men who have frequent sexual intercourse, excessive masturbation, and frequent pornographic websites are often in a state of excitement because of the kidney barrier, which can easily deplete the kidney yang.
Therefore, this part of the population are potential patients with premature ejaculation. If they do not restrain themselves, the chance of suffering from premature ejaculation is almost 100%! Finally, to correct a statement, everyone has been misled into thinking that foreskin can cause premature ejaculation. In fact, the experiment of the University of Oxford, UK It is proved that the foreskin rate of the glans of eastern men is 78%, and the sensitivity threshold of the glans of the foreskin population is roughly the same as that of the non-circumcised population. Therefore, the foreskin will not cause premature ejaculation. Foreskin patients have to turn up the foreskin every time they urinate, but the glans of phimosis patients never have a chance to leak out, and they are naturally too sensitive and leak at the touch. Therefore, premature ejaculation has nothing to do with the foreskin, and phimosis may cause premature ejaculation.
Premature ejaculation degree classification:
General Premature Ejaculation: Ejaculation 2-7 minutes after entering.
Severe premature ejaculation: ejaculate within 2 minutes after entering, or ejaculate immediately after touching it, and ejaculate immediately after foreplay.
Disease classification
primary premature ejaculation
Primary premature ejaculation is rare and difficult to diagnose and is characterized by:
(1) The first sexual intercourse occurs;
(2) There is no selectivity for sexual partners;
(3) Premature ejaculation occurs with each sexual intercourse.
secondary premature ejaculation
Secondary premature ejaculation is acquired premature ejaculation with clear physical or psychological causes. feature is:
(1) Premature ejaculation occurs at a definite time;
(2) The ejaculation time is normal before premature ejaculation occurs;
(3) It may appear gradually or suddenly:
(4) May be secondary to urological diseases, thyroid diseases or psychological diseases.
Situational premature ejaculation
Some domestic scholars also call this type of premature ejaculation "naturally variable premature ejaculation". The ejaculation time of such patients varies, and premature ejaculation occurs from time to time. This premature ejaculation is not necessarily a pathological process. The specific features are:
(1) Premature ejaculation does not occur continuously, and the time of occurrence is irregular:
(2) At the time of ejaculation, the ability to control ejaculation is reduced, but sometimes normal, which is not a necessary condition for diagnosis.
premature ejaculation-like ejaculation dysfunction
The ejaculation latency of such patients is often within the normal range, and the patient subjectively believes that they have premature ejaculation. Such premature ejaculation cannot be regarded as a real pathological process, and usually hides psychological barriers or relationship problems with sexual partners. This type of premature ejaculation is characterized by:
(1) Subjectively believes that continuous or non-continuous ejaculation is too fast;
(2) The patient imagines premature ejaculation or uncontrollable ejaculation anxiety;
(3) The latency of actual vaginal ejaculation is normal or even very long;
(4) The ability to control ejaculation becomes lower when it is about to ejaculate;
(5) The patient's anxiety cannot be explained by other mental disorders.
clinical manifestations
The clinical manifestations of premature ejaculation are mainly rapid ejaculation.
There are generally several types of premature ejaculation: one is habitual premature ejaculation, the symptoms include strong sexual desire, strong penis erection, and impatient intercourse, mostly seen in young adults; the second is senile premature ejaculation, which is caused by sexual dysfunction; the third is occasional premature ejaculation. See premature ejaculation, which mostly occurs when the body and mind are exhausted and mood swings.
The degree of premature ejaculation in men can be divided into three categories, and their symptoms are as follows:
1. Mild, the penis is inserted into the vagina for 1 to 3 minutes, and it can twitch more than 15 times, but it cannot control orgasm.
2. Moderate, the penis can twitch 1 to 15 times when inserted into the vagina, the time is less than 1 minute, and the ejaculation cannot be controlled.
3. Severe, the penis cannot be inserted into the vagina, or can be inserted without twitching to ejaculate.
diagnosis
clinical examination
Physical examination and laboratory tests are as important as history in diagnosing premature ejaculation. Physical examinations and laboratory tests are usually normal in people with premature ejaculation. Nonetheless, a simple external genital examination is necessary. If the patient has erectile dysfunction in addition to premature ejaculation, necessary auxiliary examinations should be carried out according to organic erectile dysfunction, such as sex hormone examination, neuro-EMG examination and penile vascular examination, etc., in order to find erectile dysfunction. The exact cause, targeted treatment. many patients with premature ejaculation and erectile dysfunction coexist once the erectile dysfunction is effectively treated, the patient's confidence and ability to maintain an erection will be enhanced, and the problem of premature ejaculation will also be resolved. The causes of premature ejaculation can be mainly divided into two parts: psychological and physiological. From the perspective of treatment, it is difficult to treat premature ejaculation from psychological and physiological aspects alone.
Physical and Laboratory Diagnosis
Physical examination and laboratory tests are less important than medical history in diagnosing premature ejaculation. Physical examinations and laboratory tests are usually normal in people with premature ejaculation. Nonetheless, a simple external genital examination is necessary. If the patient has erectile dysfunction in addition to premature ejaculation, necessary auxiliary examinations should be carried out according to organic erectile dysfunction, such as sex hormone examination, neuro-EMG examination and penile vascular examination, etc., in order to find erectile dysfunction. The exact cause, targeted treatment. Many patients with premature ejaculation and erectile dysfunction coexist once the erectile dysfunction is effectively treated, the patient's confidence and ability to maintain an erection will be enhanced, and the problem of premature ejaculation will also be resolved.
There are many reasons for premature ejaculation, and corresponding countermeasures should be adopted for different causes. First of all, it is necessary to popularize sexual knowledge, comprehensively understand the sexual life history of different couples, put forward guiding suggestions based on the specific situation of the patient, and overcome ideological anxiety; comfort time before sexual intercourse is essential, and the man should be properly distracted and not too nervous. , The husband and wife do a good job of cooperating, using various behavioral treatments to prolong the time to initiate ejaculation, and at the same time with drug treatment, so that the husband and wife have enough time to achieve orgasm and sexual pleasure during sexual intercourse.
Inquiry about diagnosis
The content of the inquiry should include the frequency and duration of premature ejaculation, the intensity of sexual stimulation when premature ejaculation occurs, the specific external environment or even a specific sexual partner prone to premature ejaculation, and the impact of premature ejaculation on sexual behavior, etc. These are all medical history. The focus of the inquiry. In addition, the general health of the patient is also something that needs to be asked. Find out if there are other diseases that are easy to cause or cause premature ejaculation. For example, patients with coronary heart disease may have premature ejaculation because they are afraid that excessive stimulation will cause myocardial infarction. When inquiring about the medical history, it is also necessary to understand some situations in the patient's usual sexual life, including foreplay, masturbation, the relationship and interaction between sexual partners, as well as the patient's interpersonal relationship and work situation, etc., which should be inquired and evaluated separately. For patients with idiopathic premature ejaculation, the family history and growth history of the patient should be specifically inquired. The growth background in childhood and the mental trauma they have suffered often affect their sexual life in adulthood. For patients with secondary premature ejaculation, special attention should be paid to identifying whether the disease is premature ejaculation or erectile dysfunction. Of course, there are many patients with both premature ejaculation and erectile dysfunction.
How to determine premature ejaculation
According to the severity of premature ejaculation, premature ejaculation can be divided into three types.
Generally, premature ejaculation refers to the fact that more than 50% of sexual intercourse activities cannot make the woman reach orgasm.
Severe premature ejaculation means that after the penis enters the vagina, the ejaculation occurs less than 30 times in a row, or less than 3 minutes.
Severe premature ejaculation means that after the penis is erected, ejaculation occurs before entering the vagina, or ejaculation before entering the twitch.
The method of self-judging premature ejaculation includes the commonly used self-assessment scale for premature ejaculation, which can basically determine whether there is premature ejaculation by comparing with the scale, which is a relatively convenient method. You can also make a basic judgment based on the wife's satisfaction with sex. If it is always difficult to satisfy, it is basically determined that the man has premature ejaculation.
