Patient's question:
I recently don't know why my lower body is very uncomfortable, and I'm also not experiencing morning erections anymore. How can I deal with difficulties during intimacy?Doctor's answer:
Erectile dysfunction has multiple causes, and appropriate strategies should be adopted based on different etiologies. First and foremost, sexual knowledge should be popularized. A comprehensive understanding of the sexual history of different couples is necessary, combined with the specific conditions of the patient to provide guiding suggestions and overcome psychological anxiety. The time for pre-coital comfort is essential. The male should appropriately distract himself, avoiding excessive tension, while both partners should coordinate and employ various behavioral therapies to prolong the time to ejaculation. Simultaneously, medication should be used to ensure both partners have sufficient time to reach sexual arousal and pleasure during intercourse.(1) Stop-Start Technique
Erectile dysfunction is fundamentally due to an excessively low threshold for the ejaculation reflex. The treatment aims to increase the ejaculation threshold and enhance the male's tolerance to sexual stimulation. The female provides limited castration, allowing the male's penis to reach an erect state. Then, the male lies down while the female sits beside him or between his legs to facilitate easy stimulation of the penis. Once the male feels the premonition of sexual climax, the stimulation is immediately stopped. After the premonition of ejaculation completely disappears, the massage is resumed. Repeating this process three or more times can raise the ejaculation threshold. Through long-term training, the penis can adapt to the movements within the vagina, thereby increasing the ejaculation threshold.
(2) Penile Head Squeeze Therapy
For some severe cases of premature ejaculation, despite improvements in penile erection after various treatments, the patient may still carry psychological burdens and lack confidence. The penile head squeeze method is used, where the female places her thumb at the frenulum of the penis and her index and middle fingers above and below the corona. The penile head is squeezed and compressed for 3–4 seconds, then suddenly released, with pressure applied from front to back, without pressing to the sides.
(3) External Application of Drugs to the Penile Head
The penile head (i.e., glans) is the most sensitive area of the sexual organ for receiving sexual stimulation. Half an hour before intercourse, a 1% lidocaine, 1% dyclonine ointment, or 3% ethyl acetate of benzoic acid is applied to the penile head, or a condom is used to reduce peripheral nerve sensitivity and increase the ejaculation threshold during intercourse.
(4) Sedatives
Librium (diazepam) 20 mg is taken orally half an hour before intercourse, along with 10 mg of vitamin B6, taken three times daily.