On prevalence this is one of the first men's issues. This violation of sexual function respect to thirty percent of the male population of our planet. In the andrology clinic in Moscow study was conducted, during which it was found that in our country, premature ejaculation is a problem for twenty-eight percent of men.
Classification and Causes
This sexual dysfunction may be primary, that is, which takes place from the moment when the man had had sex, as well as secondary, acquired later. It may be due to the presence of any disease.
If the initial ejaculation, is responsible for the brain, those structures that are affected by serotonin. Proved premature ejaculation this form is peculiar to those men who are too active receptor apparatus, responsible this process. Thus, the concentration of serotonin is reduced, and is activated by cerebral center of the eruption seed.
The reason may be too sensitive head of the penis. On the surface of the skin head may be an excess of sensitive receptors. If we talk about the causes of secondary premature ejaculation, it is possible that chronic prostatitis. When the prostate gland is a long time in a fevered state, this process may be subject to other sites, for example, seed lobe. Namely, it has many receptors are responsible for obtaining orgasm. This factor explains why almost thirty percent of men diagnosed with - chronic prostatitis, have acquired premature ejaculation. Another reason could be called premature ejaculation erectile dysfunction. If a man is upset erection, this fact seriously injure the psyche, and the sympathetic division is activated, and in fact in the nervous system is it responsible for the reflex of ejaculation. This is caused by premature ejaculation.
If the hormonal activity of the thyroid gland is increased, this can also cause premature ejaculation. With Ray about fifty percent of men suffer from rapid ejaculation. If the penis has a short frenulum, this contributes to premature ejaculation, because during sex may have micro-tears, and strive to complete the man reflectively rather painful process.
Diagnosis
Diagnosis of rapid ejaculation is defined by the existing condition. In order to determine correctly, you need to know how long it takes the sexual act. Normally, it should be longer than two minutes. Premature ejaculation can be diagnosed if the sexual act is completed earlier than the above over time, or the penis does not penetrate into the vagina. The second condition can be attributed feature such as the inability to control the eruption seed. In the normal state of ejaculation should occur not randomly, but only if this man wants. The third indicator of premature ejaculation can be regarded as discontent woman sexual contact, as well as himself and men. In fourth place are the problems that occur in pairs, if the intercourse was too short.
The man should go to the doctor, when all of these symptoms. At a reception at andrologist will consider all complaints of the patient, for this there is a special form. According to this principle is working in clinics in Europe.
There is a special device bioteziometre. With the help of his penis being tested for sensitivity. Using this technique, you can determine whether the increased sensitivity of the glans penis, and how the state, when carried out appropriate treatment.
Before making bioteziometriyu requires carefully examine the sexual organ, and if there is a shortened frenulum, this should be revealed. Make sure that there is no chronic prostatitis. For this finger held diagnostics, simple groping through the rectum. Widely used in the diagnosis of ultrasound, as well as various types of studies are conducted to identify possible infections or diseases of the sexual sphere.
Every man who suffers from premature ejaculation, is required to assess erectile function. This is simply done by applying questionnaires and IIEF-5 scale. When erection is impaired, conducted a more thorough examination, detailed discussion of what causes erectile dysfunction, which caused rapid ejaculation. Last but not least is the hormonal activity of the thyroid gland. Subjected to scrutiny concentration of hormones such as thyroxine, triiodothyronine, thyroid-stimulating hormone. A blood test is carried out on an empty stomach in the morning. Experts consider such an aspect, the genetic predisposition to premature ejaculation.
Treatment
Treatment of the primary form of rapid ejaculation can be both medically and surgically. To conservative treatment may include local anesthetics. In the modern category includes tools such as special formulations that have the form of gel. Their basis is lidocaine, so the sensitivity of the glans becomes less, and therefore - as long as the sexual act. In this method does not require a significant investment, and there are no questions to the application. But there is one feature. If you do not use a condom, the partner can not get an orgasm, because her reproductive tract and subjected to the action of anesthesia, and largely disappear sensitivity.
There is some discomfort in that, at the head of the local anesthetic is applied in advance, about ten minutes before sexual activity. In addition, we must note that those patients in whom ejaculation occurs before contact with the vagina, the anesthetic will not work.
Some time ago there was a popular group of drugs that are selective inhibitors of serotonin reuptake. These tools provide an increase of this substance in the brain, which promotes the suppression of ejaculatory reflex and prolonged sexual intercourse. But the fact that these drugs are primarily used to treat nervous disorders, depression. Therefore, no formal recommendations for the treatment of premature ejaculation. If you keep using them, it appears obvious psychotropic effect.
First, it is the only selective serotonin reuptake inhibitor - is dapoxetine. They were treated with premature ejaculation.Dapoxetine pills are absolutely devoid of psychotropic effect, and at the same time the drug to the relatively little time to its concentration in the blood become effective. The recommendations on the application stated that the pills are taken when the alleged sexual contact before the remains of one to three hours. The use of one-off. With this drug, sexual intercourse becomes longer than three and a half times compared with the usual result. It should be noted that dapoxetine may be taken and the men who ejaculate comes before the penis sheath concerns. In our country, the manufacturer of the drug is not going to until his record.
If we talk about surgical remedies, rapid ejaculation, related to the primary type, then practiced gel implants also advisable to use a selective crossing of the rear of the nerve of the penis, in other words - neyrotomiya.
In the first method the gel substance, the basis of which is hyaluronic acid, is placed in the skin of the head of the penis. Thus, the surface of the skin is in the isolation of receptor sensitivity, and duration of sexual intercourse increases. The patient can choose any kind of gel. They have a different term, and their dispersal is required at different times. In other words, the body slowly absorbs the men of this, the process takes from three to twelve months, and there are no side effects.
Positive quality is that even after the gel is completely dissolved, almost all patients continue to have sexual intercourse duration increased, and this may persist for life. But many people have to resort to re-treatment, and once again enter the gel. The gel implant is similar to using anesthetics, but at the same time much more convenient. The price is also much greater, since the hyaluronic acid has a high cost. With this method there is no need to use the male condom, there is no discomfort, which is due prior to application of the drug on the surface of the glans. But we must remember that those men who suffer from an accelerated eruption of semen before contact with the penis sheath, gel implant type has no meaning.
Many patients want a permanent effect, increasing the time they had sex, so they choose the operation, which is called selective penile neyrotomiya. The surgeon makes the intersection, and then sewn back of the nerves of the penis responsible for the degree of sensitivity.
Feedback from patients, the glans penis during the first postoperative month in a state of anesthesia, but after a while begins restoration of sensitivity, and sexual contact is becoming longer. This operation is quite expensive, since its implementation requires special equipment used in microsurgery, as well as conducting its specialist andrologist having high qualifications.
In this case, you also need to know that the selective penile neyrotomiya not suitable for the treatment of patients with ejaculation before penetration of the penis into the vagina. If there is a secondary form of accelerated ejaculation, which is due to Erectile Dysfunction, it is recommended to use inhibitors of phosphodiesterase-5. The market of our country is four drugs with similar properties. This Viagra Zidena, Cialis, Levitra. All of them provide a stable clinical effect, and have been successfully used by patients who have an erection disorder at seventy - eighty percent.
Men with a secondary form of early ejaculation, which is the cause of hyperthyroidism should be treated by an endocrinologist. Typically, the patient is prescribed tiamazol, radioactive iodine, propylthiouracil. In some cases, can not do without surgery. As a rule, after the problem with hyperthyroidism in the weeks ejaculation becomes normal.
If the cause of premature ejaculation is a chronic prostatitis, the first thing you need to do to treat the infection, which struck the prostate gland. But first you need to carry out treatments that destroy the pus plugs, plug the ducts of the prostate, and has since then engaged in antibiotic therapy.
If the rapid ejaculation blame short frenulum of the penis, then you can rectify the situation only by surgery. Plastic surgery prolongs the bridle, but it happens that this is impossible, then the surgeon is limited to the circumcision of the foreskin, and along with it removes the bridle. Circumcision makes the sensitivity of head of the penis below, therefore, sexual intercourse is prolonged.
Summary and Conclusions
One of the most common genital disorders in men is premature ejaculation. On this basis, there are often quarrels between partners, and couples often break up. But modern medicine can solve this problem the most appropriate way for a man. The range of methods is quite wide, from conservative treatments, and ending surgery.
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