Treatment methods for premature ejaculation, including Western medicine and traditional Chinese medicine diagnosis and treatment.
265.
Methods to treat premature ejaculation
In an effort to prolong the ejaculation latency period, most men with premature ejaculation try to shift their focus to other things during intercourse, such as diet, or use methods like condoms or alcohol.
However, these measures are not very effective and often lead to decreased libido, sexual pleasure disorders, and even erectile dysfunction, fundamentally hindering the ability to distinguish sexual sensations and aggravating the condition.
Therefore, the treatment of premature ejaculation should begin with analyzing its causes and selecting appropriate treatment methods.
(1) Sensate focus training: This is a treatment method based on gradually increasing the ability to distinguish penile sensations. It is suitable for the treatment of premature ejaculation caused by psychological reasons.
This method uses tactile stimulation such as hugging, touching, and massage to help people enjoy sexual pleasure, overcome their fear of sex, and establish and restore natural sexual responses.
During treatment, the following points should be noted: sexual pleasure is only permitted through touch, but intercourse is not allowed; and personal pleasure is derived by increasing the pleasure of one's partner.
It can be divided into two stages: non-genital sensuous focus training and genital sensuous focus training.
This method requires the woman's close cooperation over a long period of time. If she can persist, the effectiveness rate can reach 60% to 90%.
(2) Oral medication: Currently, the main medications used to treat premature ejaculation include antidepressants and α-adrenergic receptor blockers, with an efficacy rate of around 50%, but side effects are also more frequent, so they should be selected rationally.
(3) Penile cavernous body drug injection therapy: Injecting vasodilators into the penile cavernous body to treat premature ejaculation. Although premature ejaculation still exists, penile erection can be maintained for a certain period of time after ejaculation, which helps to improve the sexual satisfaction of the partner.
However, there is a risk of inducing a persistent erection.
(4) Penile prosthesis implantation: Among patients with erectile dysfunction and premature ejaculation, 50% of those who underwent penile prosthesis implantation experienced improvement in premature ejaculation, while the other 50% still had premature ejaculation. However, they could maintain penile erection after ejaculation, which helped improve their partner's sexual satisfaction.
(5) Penile dorsal nerve resection: It has been tried in some countries and its therapeutic effect has been recognized to a certain extent, but its safety and effectiveness need to be studied.
(6) Topical medication: Several preparations, such as sprays and ointments, are used to treat premature ejaculation.
266.
Western medicine treatment for premature ejaculation
While administering antidepressants to mental patients, someone accidentally discovered that they caused ejaculatory dysfunction, which attracted public attention.
Since then, research on the use of drugs to treat premature ejaculation has become increasingly active.
For a long time, people have used drugs that weaken the autonomic nervous system function that controls the ejaculation reflex to treat premature ejaculation, such as antidepressants, phenothiazines, sedatives, and monoamine oxidase inhibitors. These drugs can improve mood and reduce anxiety, and may prolong intercourse time, but their mechanism of action is still unclear. Some people think that they may have a sedative or comforting effect.
Some people have also used the alpha-adrenergic nerve blocker phenoxybenzamine 10-30 mg/day to treat premature ejaculation and monitor semen volume and sexual response, which has a certain therapeutic effect. This drug acts on the sympathetic nervous system that regulates and controls the ejaculation reflex during the ejaculation period.
Currently, commonly used medications include: tribromide mixture 10 ml/time, 3 times a day, or tablets 0.6 mg/time, 3 times a day, orally; oryzanol 20 mg/time, 1-2 times a day, orally; 2.5% magnesium sulfate solution, 5-10 ml/time, intramuscular injection, once a day or every other day; oral administration of methaqualone, diazepam, etc. before intercourse also has a certain effect.
The effectiveness rate of various drug treatments tends to be around 50%, but the accompanying side effects are also more frequent. It is essential to distinguish the benefits and risks during use and choose the appropriate treatment.
In addition, topical medications are often applied to the glans penis before intercourse, such as 1% lidocaine, 1% dyclonine ointment, or 3% ethyl aminobenzoate cold cream, to reduce the sensitivity of the glans penis to sexual stimulation.
However, these drugs are mainly local anesthetics and lack formal clinical trial results. They often lead to sexual pleasure disorders or erectile dysfunction. Once the drugs are discontinued, patients will lose control of ejaculation again.
SS-cream can increase the sensory threshold of the penis, reduce the excitability of sensory nerves, and increase penile blood flow, thus aiding in erection.
The clinical efficacy rate reached 84%, and the average ejaculation latency was extended to 11.4 minutes. Apart from a mild local burning sensation, no toxic side effects were found. No changes were observed in local tissues after long-term use, and the product is safe to use.
The method of use is to apply 0.2 grams to the surface of the glans penis 30 minutes before intercourse, and wash it off before intercourse. The effect lasts for 1 to 2 hours.
267.
Traditional Chinese Medicine Treatment of Premature Ejaculation
(1) Kidney Qi deficiency: symptoms include premature ejaculation, decreased libido, soreness and weakness of the waist and knees, fatigue, spontaneous sweating, frequent and clear urination, loose stools, or five-center heat, night sweats, sallow complexion, pale tongue with thin white coating, and deep and weak pulse.
Treatment principle: Warm and tonify kidney yang.
Prescription: Modified Shenqi Wan (Kidney Qi Pill).
The medicinal ingredients include Rehmannia glutinosa (processed), Dioscorea opposita, Cornus officinalis, Eucommia ulmoides, Poria cocos, Cuscuta chinensis, Cinnamomum cassia, Aconitum carmichaelii (processed), Epimedium brevicornu, Curculigo orchioides, and Yangqi stone.
(2) Damp-heat in the liver meridian: Symptoms include premature ejaculation, easy erection, bitter taste in the mouth, poor appetite, irritability, short and difficult bowel movements, yellow and reddish urine, itching in the genital area, red tongue with yellow and greasy coating, and wiry and rapid or slippery and rapid pulse.
Treatment principle: Clear heat and promote diuresis.
Prescription: Modified Longdan Xiegan Decoction.
The medicinal ingredients include Rehmannia glutinosa, Gentiana scabra, Scutellaria baicalensis, Gardenia jasminoides, Alisma plantago-aquatica, Akebia trifoliata, Plantago asiatica, Angelica sinensis, Bupleurum chinense, and Glycyrrhiza uralensis.
(3) Deficiency of both heart and spleen: Symptoms include premature ejaculation, accompanied by decreased libido, limp limbs, shortness of breath and weakness, pale complexion, poor appetite and loose stools, dreaminess and forgetfulness, poor sleep, spontaneous sweating, pale tongue, thin coating, and weak pulse.
Treatment principle: Tonify the heart and spleen, and consolidate and astringe the essence.
Prescription: Modified Gui Pi Tang.
The medicinal ingredients include Astragalus membranaceus, Codonopsis pilosula, Poria cocos, Atractylodes macrocephala, Ziziphus jujuba var. spinosa, Angelica sinensis, Longan aril, Polygala tenuifolia, Euryale ferox, Aucklandia lappa, Cinnamomum cassia, fossilized bone, and Glycyrrhiza uralensis.
(4) Yin deficiency with fire excess: symptoms include premature ejaculation, accompanied by hypersexuality, soreness and weakness of the waist and knees, flushed face, dizziness and tinnitus, dry mouth and throat, palpitations and night sweats, five-center heat, scanty dark urine, red tongue with little coating, and thready and rapid pulse.
Treatment principle: Nourish Yin and clear heat.
Prescription: Modified Da Bu Yuan Jian.
Medicinal ingredients include ginseng, cornus officinalis, eucommia ulmoides, angelica sinensis, wolfberry, rosehip, rehmannia glutinosa, scrophularia ningpoensis, anemarrhena asphodeloides, phellodendron chinense, peony bark, and glutinous rice root.
268.
Common Chinese patent medicines for treating premature ejaculation
Jin Suo Gu Jing Wan: Used for premature ejaculation due to weak sperm control.
Take 1 pill each time, twice a day.
Gui Pi Wan: Used for premature ejaculation caused by deficiency of both heart and spleen.
Take 1 pill each time, twice a day.
269.
Commonly used traditional Chinese medicine prescriptions for treating premature ejaculation
(1) Gallnut decoction for washing: 20 grams of gallnut, simmered over low heat for half an hour, then add an appropriate amount of warm water, and use the hot decoction to fumigate and wash the genitals for several minutes. After the medicine is warm, soak the glans penis. Do this once every night for 15 to 20 days as one course of treatment.
(2) Premature ejaculation decoction: 500g of Rosa laevigata, 50g each of Codonopsis pilosula, Dipsacus asper, Epimedium brevicornu, and Cnidium monnieri, and 2500ml of white wine.
Place the medicine in a bottle, soak it in white wine, seal the bottle, and use it after half a month.
Take 25 ml twice a day, morning and evening, for 10 consecutive days as one course of treatment, and continue until the illness is cured.
(3) Five-fold Bone Pill: 250g of gallnut, 30g of dragon bone, and 60g of Poria.
Grind the above-mentioned herbs into a fine powder, mix with water to form a paste, and make into pills the size of a paulownia seed.
Take 6 grams twice daily.