Patient's question:
I've had premature ejaculation since the very first time I had sexual intercourse. Is it something I was born with?Doctor's answer:
Most patients attempt to prolong the latency period of ejaculation during sexual intercourse by shifting their focus to other aspects such as diet, recreation, etc., or by using methods like condoms or alcohol, but these methods are often ineffective. Instead, they frequently lead to decreased libido, sexual pleasure disorders, and even conditions like erectile dysfunction, thereby worsening the condition. Therefore, the treatment of premature ejaculation should be based on the underlying causes and appropriate treatment methods should be selected.1. Psychological therapy, which requires coordination between both partners. It is important to inform both partners that premature ejaculation is a common issue. Both partners should understand the necessity and possibility of reconstructing the reflex for ejaculation, eliminate abnormal psychological states such as anxiety, unease, and guilt in the patient, and build confidence in curing the disease. With mutual cooperation in treatment, the condition can still be cured.
2. Behavioral guidance, the basic treatment method of sensory focus training. The goal is to teach patients to experience and enjoy sexual pleasure through tactile stimulation techniques such as hugging, caressing, and massage, helping them overcome psychological barriers. Additionally, pulling the scrotum and testicles downward before reaching climax, or applying thumb and index finger pressure to the glans to reduce sexual arousal, can decrease erection hardness by 10%–25%. After prolonged training, sexual intercourse can be performed in the woman-on-top position, still using the thrusting-stopping-repeating method to gradually increase the threshold for ejaculation, achieving more satisfactory artificial control before ejaculation.
3. Oral medication, which is currently primarily 5-hydroxytryptamine (5-HT) reuptake inhibitors. In China, dapoxetine hydrochloride (marketed as Priligy) is available. The recommended dose is 30 mg, taken 3 hours before sexual activity. It mainly prolongs the latency period of ejaculation but has certain side effects and contraindications and must be taken under the guidance of a doctor. Its price is relatively high. Other similar medications, such as paroxetine, should also be used under medical supervision.