Patient's question:
Male, 22 years old. I always feel the urge to urinate, having one every 20 minutes. But at night, I sleep through the night until dawn. I used to live with my girlfriend, and every time I experienced premature ejaculation. What could be the reason, can it be treated, and how long would it take approximately? Thank you.Doctor's answer:
Hello, the causes of premature ejaculation are mostly due to pathological excitement in the brain or enhanced central excitation in the spinal cord, with a few being organic.Treatment principles:
(1) Western medicine treatment:
A. Oral medication: To reduce excitability, low-dose anti-anxiety or sedative drugs can be administered. Choose one of the following:
Tr 0.1～0.3 grams, three times daily.
Phenobarbital 0.03 grams, three times daily.
Oryzanol 10 milligrams, three times daily.
Probenecid 30 milligrams, plus Librium 20 milligrams, once nightly.
Take 25 milligrams of thioridazine one hour before intercourse to inhibit ejaculation.
B. Topical medication: 0.5 to 1 hour before intercourse, wash the glans penis and apply a small amount of anesthetic cream, such as 1% dibucaine ointment, or 1% procaine or 2% cocaine. Note that only a small amount should be applied to the tip of the glans; excessive application may reduce the ejaculation reflex, even leading to anejaculation, and may also affect erectile function, causing weak erections.
(2) Traditional Chinese medicine treatment: The treatment for premature ejaculation is generally similar to that for impotence, as premature ejaculation is often a precursor to impotence, and the two share similar etiological and medical histories.
A. Excess of ministerial fire: Hypersexual desire, soreness in the lower back and knees, five-palm heat, dizziness, red eyes with tinnitus, flushed face, bitter taste in the mouth, dry throat, red tongue with yellow coating, wiry pulse. Use Zhi Bai Di Huang Tang (rehmannia, Chinese yam, cornus, peony root, poria, alisma, cinnabar, anemarrhena) plus oyster shell and dragon bone.
B. Insufficient kidney yang: Reduced sexual desire, soreness in the lower back and knees, facial...