Hello everyone, I am a clinician who has been practicing for many years. Speaking of the topic of "premature ejaculation", I think no male friend in reality is willing to admit this, even if some patients with serious premature ejaculation go to the andrology clinic for treatment, it is twisted and pinched, and it takes several turns to go around the problem of "short time" in the life of the couple. Although premature ejaculation is not more critical and dangerous than acute abdomen, myocardial infarction, cerebral infarction, cerebral hemorrhage and other diseases, it is not as good as taking medicines such as hypertension and diabetes. Premature ejaculation is more to bring men an inferiority, negative mentality, because in the genes of men have an innate desire to conquer, when premature ejaculation comes, it seems very embarrassing, and even feel that they are useless! I understand everyone's psychology, mentality, and thoughts, so I am here today to solve problems for male friends with such problems, so please follow me to continue to read down.
● When many male friends gather together to talk about the topic of time, they often like to add more water to "time", after all, who does not have a little self-esteem. But in fact, in reality, there are many friends with premature ejaculation, and there are many who are reluctant to go to the hospital for treatment because of their face. Premature ejaculation is the most common sexual dysfunction in our men, according to the American Health and Longevity Organization, about 71% of adult men have sexual disabilities, of which about 39% also have erectile dysfunction, and 61% of them are not satisfied with their sexual activity for a long time, many people just don't say it. Referring to the 2013 Asia Pacific Sexual Behavior and Sexual Satisfaction Survey, the results of the survey show that about one-third of men in adult men experience different degrees of premature ejaculation.
● According to China's census statistics estimates, there are now about 460 million adult males in China, and the analysis shows that there are now about 1.5 adult male premature ejaculatory patients in China. Therefore, in this regard, everyone does not need to be inferior and blamed, and many male compatriots are "pitied with you". So how to define premature ejaculation clinically? There are three small points, (1) from the first sexual intercourse, ejaculation often or always occurs before or within about 1 minute of vaginal insertion (primary premature ejaculation); or the ejaculation latency is significantly shortened, usually less than 3 minutes (secondary premature ejaculation). (2) Always or almost always can not control/delay ejaculation. (3) It will be accompanied by negative physical and mental effects, such as distress, worry, depression, and avoidance of sexual life. The above definition of premature ejaculation is also a big vernacular to tell everyone, very easy to understand, you can see if you meet the standard?
●This has to be explained by the pathogenesis of premature ejaculation, which does not have an exact cause like hypertension and diabetes. The study found that the process of ejaculation is mainly regulated by our brain and spinal cord, of which "serotonin" is one of the neurotransmitters that play an important role in the regulation of ejaculation, I believe that friends with premature ejaculation should have a deep understanding, they do not want to be so short, but a stimulus is unbearable! Looking further down, the serotonin is a substance that is widely distributed in the ejaculatory meridian center and peripheral ejaculation-related organs to regulate ejaculatory activity.
●When our concentration of 5-ht in the synaptic space increases, it leads to a delay in ejaculation, so therapeutic drugs can start with this mechanism. At this time, "selective serotonin reuptake inhibitors" were also born in response to the needs of the times. In the past, most of the symptomatic therapies for prolonging the ejaculation time were anesthetics, through local injections or topical use to achieve the effect of prolonging ejaculation, but the tolerance of people after using anesthetics was certainly not good. Like other drug injection therapies such as cavernous body, the penis can maintain an erection for a period of time after ejaculation, which may help to improve the sexual satisfaction of the spouse, but premature ejaculation still exists. There are even transurethral administrations, penile implants, and dorsal penile nerve amputations that can be used for premature ejaculation, but most people find it difficult to accept.
●While selective serotonin reuptake inhibitors can inhibit serotonin transporters (5-htt) to reuptake 5-ht in the synaptic space, increasing the serotonin concentration in the synaptic space, thereby delaying ejaculation, this classic, epoch-making representative drug is "dapoxetine hydrochloride". It is the world's first short-acting SSRI drug with indications for premature ejaculation treatment, and a number of clinical trials at home and abroad have confirmed that dapoxetine can effectively treat premature ejaculation, and its contribution to human beings is no less than sildenafil (a drug for the treatment of male erectile dysfunction), so dapoxetine hydrochloride can be described as a gospel for friends with premature ejaculation.
●After taking dapoxetine hydrochloride tablets, such drugs are rapidly absorbed by the body, and the maximum plasma concentration is expected to be achieved 1-2 hours after administration. Absolute bioavailability is 42%. After oral administration of dapoxetine 30 mg and 60 mg on an empty stomach, the maximum plasma concentration will arrive after 1.01 h and 1.27 h. Note that, for example, after oral administration, the terminal half-life of the drug is about 19h, and the blood concentration will reach a very low level at 24h. Therefore, oral dapoxetine is a drug that accumulates less in the body and is excreted quickly. According to the clinical data of phaseS, II and III,the most common are gastrointestinal and neurologic systemic symptoms such as nausea, diarrhea, dizziness, headache, insomnia and fatigue, which are usually mild to moderate, self-limiting, and do not cause serious safety problems.
●This drug is currently available in 30mg and 60mg dosage forms on the market, and the drug instructions are recommended that the first dose recommended for all patients with premature ejaculation is 30 mg, which needs to be taken about 1 to 3 hours before sexual activity. If the effect is not satisfactory after taking 30 mg and the side effects are still within the acceptable range, the dose can be increased to the maximum recommended dose of 60 mg. The recommended maximum dose frequency is every 24 hours. It doesn't matter if you eat before or after a meal. To swallow the tablets intact, it is recommended to take them with at least one glass of water. Suitable for adult men aged 18 to 64 years old, note that less than 18 years old can not eat, if you are a person with severe kidney damage (such as chronic kidney disease stage 3 or more), moderate to severe liver damage, heart with obvious pathological conditions, while taking thioridazine / ketoconazole / itraconazole / saquinavir / nefazodone and other drugs are prohibited.
Premature ejaculation is nothing to be ashamed of, but you should cheer up, face yourself squarely, and actively adjust your mentality. To the regular hospital andrology department to seek the help of doctors, premature ejaculation although it did not bring any physical pain, but it is actually a disease, to be cured! In their daily lives, they should also pay attention to maintaining good living and eating habits, exercising frequently, and doing more Kegel exercises (that is, lifting exercises). On this basis, combined with drug treatment, it will be able to revitalize male male style! Come on! Believe in yourself!
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bibliography: 1.GUO Jun, ZHANG Chunying, ZHANG Guoxi, et al. Pe screening and doctor-patient communication-PE diagnosis and treatment Chinese expert consensus. Chinese Journal of Andrology 2016; 30(6): 57-60 2.Yang L, Luo Lei, Chen X F, et al. Clinical observation of dapoxetine hydrochloride in the treatment of premature ejaculation. Chinese Journal of Andrology 2015; 21(10): 892-895 3.Shi Z L, Wang X L, Tu M J, et al. Clinical observations on the treatment of male premature ejaculation and improvement of female partner sexual satisfaction by dapoxetine hydrochloride. Chinese Journal of Andrology 2016; 30(11): 41-44 4.Si Tianmei, Liu Y, Su Yun'ai, et al. Pharmacokinetic study of dapoxetine hydrochloride among male volunteers in China. Chinese Journal of New Drugs 2009; 18(22): 2138-2142.