What is premature ejaculation?

Patient's question:

Patient male, 24 years old, previously in good health

Doctor's answer:

Okay, here is the English translation of the provided text, following your instructions:
I. What is Premature Ejaculation?
Premature Ejaculation (PE) is a type of male sexual dysfunction. The causes of premature ejaculation can primarily be divided into two main parts: psychological and physiological (habitual premature ejaculation and pathological premature ejaculation). Premature ejaculation refers to a sexual intercourse disorder characterized by the male reaching orgasm and ejaculation shortly after the penis is inserted into the vagina, before the female reaches orgasm, and with the total intercourse time being less than 2 minutes. Generally, 30% of men experience this condition. Although it may seem minor, it can lead to low sexual quality and may also cause other sexual dysfunctions such as erectile dysfunction. The consequences can be serious, and it should be taken seriously with early treatment. It is generally understood that premature ejaculation refers to a male reaching orgasm and ejaculation before the penis is inserted into the vagina, or right at insertion, or even before any thrusting begins. Following ejaculation, the penis naturally becomes flaccid and enters a refractory period. Clinically, ejaculation occurring before the penis enters the vagina is diagnosed as premature ejaculation. Similarly, if a man enters the vagina for intercourse but achieves ejaculation after very few thrusts, this is also defined as premature ejaculation.
II. Causes of Premature Ejaculation
There are two main types of premature ejaculation:
1. Habitual Premature Ejaculation: This refers to men who have been experiencing premature ejaculation consistently since adulthood. These individuals have normal sexual physiological function and strong penile erections. Symptoms include a high sex drive, strong penile erection, and an urgent desire for intercourse, most commonly seen in young and middle-aged men; (they ejaculate quickly because they want to reach climax faster, and this is governed by the nervous system). If this is due to long-term excessive masturbation, it can lead to the second type.
2. Pathological Premature Ejaculation: This includes conditions like excessive prostatic hyperemia and hypertrophy (often resulting from excessive masturbation in young and middle-aged men), which is sometimes referred to as "masturbation-induced premature ejaculation." In older adults, it involves prostatic hyperplasia and hypertrophy, sometimes termed "age-related premature ejaculation." In summary, both types are fundamentally linked to prostatic hypertrophy. Due to this hypertrophy, the prostate gland secretes an excessive amount of prostatic fluid into the urethra, which can trigger ejaculation. (The neurological mechanisms of ejaculation are complex and are not elaborated upon here). Therefore, individuals with premature ejaculation may experience a significant flow of prostatic fluid into their urethra, sometimes even expelling it outside the body. Some may mistakenly call this lubricating fluid and feel pleased, but this is a sign of ignorance. The lubricating fluid for intercourse should be provided by the female partner, not the male.
III. Treatment for Premature Ejaculation
Based on the causes of premature ejaculation, the following treatment methods are proposed:
1. Treatment for Habitual Premature Ejaculation: During intercourse, it is important to control the rhythm, relax, and not be overly eager. Take time to enjoy the process.
2. Treatment for Pathological Premature Ejaculation: We know that the cause of pathological premature ejaculation is fundamentally related to excessive prostatic fluid secretion, which is linked to prostatic hypertrophy. Therefore, to treat premature ejaculation effectively, it is necessary to restore the prostate gland to a normal state. Since the causes differ between "masturbation-induced" and "age-related" premature ejaculation, the medication composition used in treatment will also differ. For "masturbation-induced" premature ejaculation, the focus is on promoting blood circulation, resolving stasis, astringent and consolidating essence, supplemented by warming and tonifying kidney yang. For "age-related" premature ejaculation, the focus is on tonifying the kidney and strengthening yang, as well as consolidating yang and essence.