Premature ejaculation

• ICD–10: Premature ejaculation F52.4

The category "ejaculatio praecox" includes a wide range of short duration of sexual intercourse, which cannot be unreservedly understood as sexual dysfunction.

Precipitous ejaculation is an undoubted defect of sexual physiology . In this condition, semen is ejected sometimes before ejaculation (ejaculatio ante portas), sometimes when the penis is inserted into the vagina after several copulatory movements. In order for this dysfunction to be fully expressed, rapid ejaculation must occur during frequent intercourse (at least several times a week or daily), and during repeated sexual intercourse. Most of these men come for a sexological examination at a young age, up to 30 years. According to ICD-10, premature ejaculation is defined as “the inability to delay ejaculation sufficiently to allow sexual satisfaction to occur. Ejaculation occurs before or within 15 seconds after intercourse begins". What is important is what the ICD-10 states in the description, namely that "The problem is not the result of a long-term lack of sexual activity".

Mostly it is a primary matter. The condition fluctuates depending on how successful intercourse is. A lot depends on partner relationships. They are tolerant women who don't mind a short connection. They settle for non-coital intercourse as the main source of their sexual satisfaction. However, there are women with a high level of expectation that can stress men with premature ejaculation. The most typical is a situation in which a man has premature ejaculation mainly because he does not have intercourse regularly. The woman then does not agree to more frequent intercourse, because it is so short that "it is not worth it". And the vicious circle closes...

The basic therapeutic measure is the adjustment of the partner's sexual relations. There is no improvement in premature ejaculation without regular intercourse with a frequency that corresponds to the spontaneous needs of the patient.

In recent years, the squeeze technique has often been used as part of sex therapy for dysfunctional partners . It is a maneuver well known since ancient times. It consists in the fact that a strong squeeze of the glans (even painful) stops the development of the ejaculation reflex. The purpose of these exercises is to teach the man to tolerate a high level of sexual arousal without ejaculation. An indisputable advantage of couple training treatment is the emphasis on non-coital sexual activities. Sometimes practicing the sexual satisfaction of the woman with non-coital techniques helps to reduce the emotional tension of the couple. Local anesthetics can be used as supportive therapy for premature ejaculation. Some psychotropic drugs also prolong ejaculation latency (clomipramine, SSRI antidepressants).

Links

Premature ejaculation treatment (Czech)

Reference

Author: doc. MUDr. Jaroslav Zvěřina, CSc. (head of the Institute of Sexology of the 1st Faculty of Medicine and VFN)