Premise
Although it represents a much more widespread discomfort than one might believe, premature ejaculation can be overcome: it is a problem that, in the eyes of many men, may appear to be apparently unsolvable, but the remedy is there, therefore it must not frighten too much.
In this article the diagnostic strategies useful for identifying this felt sexual discomfort will be studied in depth.
Diagnosis
In the diagnosis of premature ejaculation, the specialist must take into consideration several factors: in this regard, often the multidisciplinary approach is necessary, necessary to study the psychological, organic, physical and sexual factors that interpose one each other, causing an obvious lack of ejaculatory control. It is important to remember that "premature ejaculation" means the anticipated spermatic emission: therefore, the affected male concludes the sexual act just before or immediately after penetration, denying the female partner the possibility of reaching pleasure.
The time between the moment of actual penetration and the emission of sperm is an important diagnostic method, known as Intravaginal Ejaculatory Latency Time : this alternative method can also be taken into consideration for self-diagnosis. In this regard, some statistical surveys have been carried out, from which it emerged that the average duration of a complete sexual relationship (whose starting point must coincide with the moment of vaginal penetration) is between 5.5 and 6.5 minutes . Shocking data, considering that 90% of males with premature ejaculation consume the ratio in less than a minute.
The diagnosis must be aimed at the type of premature ejaculation: in the previous articles we have distinguished the various forms of ejaculatory precocity. We focus on the primary type of premature ejaculation: the disorder can have a presumed genetic origin, therefore it will be the duty of the specialist to instruct the affected man to have a greater mastery of his body, delaying the infamous "ejaculatory point" as much as possible of no return ”, beyond which the emission of sperm is inevitable.
The secondary premature ejaculation, on the other hand, is more complex, since it requires a careful psychological analysis of the affected subject: in this second case, the multidisciplinary approach is essential, since the patient will be asked to perform the culture test of the seminal fluid, the examination urological and andrological and, lastly, the post-prostatic urethral swab. These clinical trials are useful for recognizing the nature of the disorder: from the analysis of the aforementioned tests one can understand, for example, when the patient suffers from premature ejaculation due to genital inflammation.
But premature ejaculation could conceal erectile deficits, both in terms of acquisition and maintenance of erection: the meticulous diagnosis helps to clarify the causes that determined it.
After studying the patient from the physical point of view, the psychological approach is useful: often, the ejaculatory precocity is born precisely in the psyche, regardless of the presence or absence of physical disorders. Among all, performance anxiety plays a decisive role in the sexual act; not to forget even the anedonia, the absence of pleasure, and the anorgasmia, the impossibility of reaching orgasm. We remember him once again: not for all men ejaculation coincides with orgasm. Stress and depression, as well as the excessive use of drugs - in particular pharmaceutical specialties against Parkinson's disease - are factors that contribute to ejaculatory precocity.
Differential diagnosis
The specialist should not stop at the "superficial and apparent" diagnosis of the subject complaining of premature ejaculation: it is in fact indispensable to accompany him with a psychological investigation, which helps the doctor find the most suitable therapy for the patient.
Depending on the diagnosis, patients suffering from ejaculatory precocity can be divided into two categories: hypo- aggressive fusional men and aggressive drives .
- The first category includes all those who complain of a peculiar character fragility and an evident progressive decline in desire; the term "fusion" is linked to the presumed almost morbid bond with the mother - a typical characteristic of these patients - while the term "hypo-aggressive" refers to the psychological profile of these men, unknowingly frightened by their presumed physical aggression towards the woman.
- The interpretative key to those "aggressive drives" affected by premature ejaculation is different: they represent the exact opposite of the previous category, being energetic and sexually eager to satisfy their woman. In similar circumstances, premature ejaculation is due to a phase of sexual stasis, in which man loses the ability to self-control himself and, when the possibility of having a relationship returns, premature ejaculation also occurs.
By comparing the two types of patients, the hypo-aggressive fusion undoubtedly presents the category with the greatest difficulty in regaining complete mastery of one's body: however, this does not mean that these patients can completely recover from premature ejaculation, later, of course, to a targeted diagnostic and therapeutic approach.
