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Author: Admin | 2025-04-28
Outcome, the female partner should be included as fully as possible in the treatment and counseling sessions. Outpatient care can be scheduled as appropriate for the clinical circumstances. Nonpharmacologic therapy may include the following: Efforts to relief of underlying performance pressure on the male Sex therapy (eg, instruction in the stop-start or squeeze-pause technique popularized by Masters and Johnson [2] ) Second attempt at coitus – If another erection can achieve be achieved shortly after an episode of premature ejaculation, ejaculatory control may be much better the second time Pharmacologic therapy may include the following: Topical desensitizing agents (eg, lidocaine and prilocaine) for the male Selective serotonin reuptake inhibitor (SSRI) therapy (eg, sertraline, paroxetine, fluoxetine, citalopram, or dapoxetine); alternatively, use of an agent with SSRI-like effect Phosphodiesterase type 5 (PDE5) inhibitor therapy (eg, sildenafil, tadalafil, or possibly vardenafil) Other agents (eg, pindolol or tramadol) No recommended surgical therapy exists. See Treatment and Medication for more detail. Background Premature (early) ejaculation—also referred to as rapid ejaculation—is the most common type of sexual dysfunction in men younger than 40 years. An occasional instance of premature ejaculation might not be cause for concern, but, if the problem occurs with more than 50% of attempted sexual relations, a dysfunctional pattern usually exists for which treatment may be appropriate. Most professionals who treat premature ejaculation define this condition as the occurrence of ejaculation earlier than both sexual partners wish. This broad definition thus avoids specifying a precise “normal” duration for sexual relations and reaching a climax. The duration of intimate relations is highly variable and depends on many factors specific to the individuals involved. For example, a male may reach climax after 8 minutes of sexual intercourse, but if his partner regularly climaxes in 5 minutes and both are satisfied with the timing, this is not premature ejaculation. Alternatively, a male might delay his ejaculation for up to 20 minutes of sexual intercourse, but if his partner, even with foreplay, requires 35 minutes of stimulation before reaching climax, he may still consider his ejaculation and subsequent loss of erection premature because his partner will not have been satisfied (at least, not through intercourse). Because many females are unable to reach climax at all with vaginal intercourse, no matter how prolonged, the second situation described may actually represent delayed orgasm in the female partner rather than premature ejaculation in the male; the problem can be either
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