Definition of Premature Ejaculation
1. Time-based: Ejaculation within less than 2 minutes of penetration is the most commonly used definition.
2. Frequency-based: Some define premature ejaculation as ejaculating under 15 thrusts.
3. Orgasm-based: Ejaculating before satisfying the sexual partner.
Causes of Premature Ejaculation
Sexual response involves a complex integration of psychological and nervous systems. Besides psychological factors, the most accepted theory is the Neuro-transmitter theory:
Ejaculation is primarily controlled by the brain and pudendal nerve. These nerve systems are interconnected, and their communication relies on “neuro-transmitters.“
Imbalances in these transmitters can lead to sexual dysfunction. Many drugs treating sexual dysfunction affect neurotransmitters.
Explanation of Male Orgasm and Ejaculation:
When sexual stimulation reaches a certain threshold, ejaculation and orgasm occur. The sympathetic nervous system controls semen production, which is ejaculated through rhythmic muscle contractions via the urethra.
These contractions are part of the male orgasm and are controlled by the bulbospongiosus and pubococcygeus muscles, innervated by the pudendal nerve.
Treatment Options for Premature Ejaculation
Treatment principles generally fall into two categories:
1. Reducing penile sensitivity to delay ejaculation.
2. Increasing serotonin levels in the brain.
1. Double-layered condoms/Topical anesthetics (Lidocaine cream):
Apply 10-15 minutes before intercourse to numb the penis and delay ejaculation.
It’s important to wear a condom after application to avoid numbing the partner’s genitalia.
2. Squeeze technique:
A method proposed by urologist James Seman in 1956.
3. Medications for Premature Ejaculation:
Currently available drugs include short-acting Priligy, long-term daily use of antidepressants, or opioid analgesics.
Priligy: a selective serotonin reuptake inhibitor (SSRI), which is taken two hours before sexual activity. Common side effects include nausea, headache, and fainting. Drinking at least 300cc of water is recommended to reduce these side effects.
Antidepressants:
These SSRIs, although the same class of drugs as Priligy, require longer to take effect, typically around two weeks.
Common side effects include headache or fatigue. They’re not widely used for this purpose.
4. Selective Penile Dorsal Neurotomy (SPDN):
According to research by the urology team at Chang Gung Memorial Hospital, SPDN involves selectively severing the dorsal nerve of the penis under magnification.
Success rates reach 72% (with reports from Russia suggesting an 88% improvement rate), with an average delay of 5.6 minutes. The process takes 30-60 minutes with minimal complications. Only one case in the sample showed poor wound healing, but there were no significant postoperative side effects such as erectile dysfunction, neuropathic pain, or numbness in the glans penis, which concerns many people.
【The information above is for reference only. If you experience any side effects or have questions regarding its use, please consult a doctor.】
