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Forum Name: Male Sexual Disorders

Question: Over active sexdrive


 lonedenkai - Tue Jan 03, 2006 7:55 pm

I have the problem of being very easly stimulated. Erections happen very quickly, something as little as a hand on my leg could set it off. As well as i ejaculate prematurely. My lasting time is about 1 min - 5 most. I would like to know what my options are to help me last longer. Are there any not drug sulutions?- thank you for your time
 Dr. Tamer Fouad - Sat Jan 14, 2006 11:22 am

User avatar Hello,

Premature ejaculation is best defined as persistent or recurrent ejaculation with minimal stimulation before, on or shortly after penetration, and before the sexual partner wishes it.

Premature ejaculation is thought to be the most common form of male sexual dysfunction, with an estimated prevalence of up to 40 percent.[1]

It is believed to be a psychological problem and does not represent any known organic disease involving the male reproductive tract or any known lesions in the brain or nervous system. Anxiety may play an important role especially in secondary premature ejaculation.

Treatment of ejaculatory dysfunction are mainly non-pharmacological and centers on relationship counseling, behavioral therapy. If treatment with the previous methods are unsatisfactory pharmacologic interventions are then indicated.

Relationship counseling is of paramount importance because premature ejaculation can create discord and increase the tension surrounding sexual intercourse. Because many therapies involve the patient's sexual partner, it is important to educate both members of the relationship about premature ejaculation and to facilitate communication between the partners. An important objective is to relieve any form of performance anxiety on the male.

Behavioral therapy has been considered the gold standard of treatment, with reported success rates ranging from 60 to 95 percent.[2]Techniques include the Seman's pause maneuver, the Masters and Johnson pause-squeeze technique and the Kaplan stop-start method.

The methods can be self-applied, although with suboptimal outcomes; hence, involvement of the sexual partner is essential. Short-term gains can be substantial, but long-term outcomes are less favorable and depend on continued partner involvement.[1]

Because of the limitations of behavioral therapy, pharmacologic interventions are often used to treat premature ejaculation. Anorgasmia and delayed ejaculatory response are well-known side effects of tricyclic antidepressants and selective serotonin reuptake inhibitors.[1,2]

Consultation with a sex therapist, psychologist, or psychiatrist may prove helpful in order to explore psychological issues and to implement behavioral techniques (eg, squeeze-pause).

References:
==========
1. Balon R. Antidepressants in the treatment of premature ejaculation. J Sex Marital Ther 1996;22:85-96.
2. Kim SC, Seo KK. Efficacy and safety of fluoxetine, sertraline and clomipramine in patients with premature ejaculation: a double-blind, placebo controlled study. J Urol 1998;159:425-7.

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