Summary
We have reached the last chapters to deal with premature ejaculation: in the previous investigations we have analyzed what is meant by premature ejaculation, the incidence of the disorder, the triggering causes, the diagnostic strategies and, finally, we have traced a psychological profile of the affected patients, in order to frame them within a therapeutic context aimed at healing the problem. And it is precisely from this last point that we will resume the discussion, trying to highlight the therapies and - in the next article - the most useful natural remedies for correcting premature ejaculation. In order to avoid burdening the question, in these latter articles premature ejaculation will not be properly considered a "problem", rather a "misunderstanding" which, as we shall see, will prove to be absolutely reversible.
therapies
After the specialist check, the patient will undergo a therapeutic procedure useful to overcome the unpleasant misunderstanding under examination; as is well known, premature ejaculation frames a mix of vulnerable causal elements of mental, psychosexual, physical or relational origin. Each of these problems will have to be addressed individually, since, if this were not the case, the subject's precocious precociousness would be even more urgent: in this regard, therapeutic strategies against premature ejaculation can be summarized in:
- Sexological rehabilitation therapy
- Pharmacological therapy
- Psychodynamic therapy
- Natural remedies
Among the various therapeutic options useful in delaying premature ejaculation, circumcision should also be mentioned: in fact, it seems that hypersensitivity to the glans is an important cause of premature ejaculation. Strictly speaking, the doctor will be able to advise the patient on a circumcision associated with glandular neurotomy, which is useful for significantly reducing sensitivity to the glans, consequently postponing ejaculation.
Psychological therapy
Many elements held responsible for premature ejaculation have psycho-sexual origins: consequently, the best therapeutic approach to overcome this unpleasant misunderstanding is represented precisely by sexological rehabilitation. From the writings of Dr. A. Graziottin, important conclusions emerged: first of all, sexological rehabilitation therapy is useful for monitoring not only anxiety, but above all body perceptions, those physical sensations useful for controlling ejaculation, therefore to postpone the so-called - and already discussed - "point of no return" as much as possible.
In order to (re) acquire an excellent mastery of one's own body, this therapy consists of manual practices (masturbation) associated with a respiratory education, aimed at dissolving tension and muscles. Self-massage, yoga and muscle training practices also help to control ejaculatory timing. But not only: through rehabilitative - sexological therapy, the premature ejaculator will be able, progressively, to "feel" its own body, to begin to love it and to listen to its own drives, managing them. It must be the mind that guides the body, never vice versa.
Pharmacological therapy
The use of drugs to correct the timing of ejaculation during a relationship is a much discussed topic, but at the same time a subject of great interest for the medical profession. There are controversial theories: some specialists are against the administration of pharmacological specialties aimed at delaying ejaculation, others are absolutely in favor.
We try to understand the reasons. According to some authors, to correct premature ejaculation, drugs should be avoided not because they are not very effective, but because of the side effects, which far outweigh the desired effects.
In the other ideological side, there are doctors who are absolutely favorable to the administration of pharmacological specialties for these patients: regardless of the consequences, drugs actually slow down ejaculatory times.
It seems that the ejaculatory precocity is due to functional deficits of the neurotransmitters, among which the serotonin stands out: in the light of these considerations, it is clear that a drug capable of interacting with serotonin appears able to prolong the duration of the relationship, therefore postponing the male orgasm. Two useful substances have been isolated in this regard: fluoxetine and paroxetine. This elective therapy should last for a fairly long period, even six months, during which the doctor will modify the dosage, gradually decreasing it over the course of the months.
Of course, the advantages of drug therapy are surprising and immediate: they allow better self-control, an enhancement of self-esteem and an optimization of interpersonal relationships with the partner. On the other hand, the abuse of these drugs could cause significant anxiety.
As an alternative to fluoxetine and paroxetine, there are vasoactive substances, reserved, however, only to those patients suffering from severe premature ejaculation, in whom the therapy of choice did not give satisfactory results. Furthermore, vasoactive substances (eg Viagra) could be a valid aid, particularly when the ejaculatory precocity reflects erectile deficits.
Among the other possible solutions useful to obviate premature ejaculation, local anesthetics also emerge: however, these pharmaceutical formulations are useful only in the case of hypersensitivity at the level of the glans. The use of condoms is recommended for men who use such local anesthetics, to avoid anesthetizing the genital area of the partner. [taken from www.alessandragraziottin.it/]
Psychodynamic therapy
Among all, psychodynamic therapy is perhaps the most complex, since it aims to decode the psyche of the patient, to discover that "mental illness" that is reflected outwardly on the physical, that psychological distress that prevents man from fully living his sexuality. Through this inner analysis and this search for self, the patient learns to recognize his errors and to manage them: the awareness of the basic problem helps to strengthen man, both psychologically and physically, thus acquiring complete mastery of one's body. Many men who undertake the psychodynamic therapeutic path manage to make their mistakes a strength, a stimulus from which to start from scratch, in search of a new, cleaner sexuality, dismembered by anxieties, fears and sometimes totally unfounded tensions. Of course, the partner plays a fundamental role also in this case: it is essential that the woman is sensitized and that she understands male fragility. It is more than clear that women are absolutely forbidden to deride their partner and to use heavy verbal expressions or offenses, which would worsen even more the "unpleasant" misunderstanding of premature ejaculation.
