Premature Ejaculation: It is nice to… ‘have the control’!

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Premature Ejaculation seems to be a neurobiological problem that is related to low serotonin levels in those regions of the central nervous system that regulate ejaculation (brain and spinal cord).
In this infographic we try to answer the questions "What happens in Premature Ejaculation (PE)", "What are the features of PE?", |How many types there are" and finally "Can a man with PE be helped"

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Premature Ejaculation: It is nice to… ‘have the control’!

  1. 1. PREMATURE EJACULATION It is good to… have control! 1 EJACULATION } 1 BRAIN Ejaculation is the outcome of sexual arousal and, normally, occurs simultaneously with orgasm. It is induced by nerve stimulation, resulting in the expulsion of semen from the outer urethral orifice. } } 3 2 SPINAL CORD PERIPHERAL NERVES BRAIN 2 SPINAL CORD SOURCE: Dawson, S. Et al. Journal of Sexual Medicine. (2013) Jannsen E et al. Journal of Sex Research (2000);1:8-23 PERIPHERAL NERVES WHAT HAPPENS IN PREMATURE EJACULATION? CULMINATION S T I M U L A T I O N ORGASM! AROUSAL PREMATURE EJACULATION NORMAL RESPONSE T I M E 3 SOURCE: Donatucci CF: J Sex Med 2006;3:303-308 FEATURES OF PREMATURE EJACULATION } There are 2 different types of Premature Ejaculation: In PRIMARY PE- the most common typethe problem has been present from the very beginning of the man’s sexual life. In some rare cases, PE may occur suddenly at some point during man’s life –SECONDARY PE 9 10 } out of men ejaculate within 1’ after vaginal penetration 1 SOURCE: Porst H, et al. Eur Urol. 2007,51:816-823 4 1 out of 5 men presents PE irrespective of age CONSEQUENCES OF PREMATURE EJACULATION Premature Ejaculation is not just a «time problem»; it mainly has to do with the man’s control over ejaculation and sexual satisfaction. PREMATURE EJACULATION CAUSES EMBARRASSMENT AND ANXIETY. With the lapse of time, PE causes disappointment that leads to avoidance of sexual and emotional intimacy. In addition, problems often arise in the couple’s relationship and their quality of life is significantly reduced. SOURCE: Porst H, et al. Eur Urol. 2007,51:816-823 Waldinger M, et al. Int J Psychiat Clin Pract 1998, 2: 287-293 5 Onset time of problem (PRIMARY or SECONDARY) DIAGNOSIS Duration of problem Occasional or permanent? Time until ejaculation Impact on relationship and sexual life Disorders/Diseases Medications Evaluation through special questionnaires SOURCE: Hatzimouratidis K et al: Eur Urol. 2010;57:804-14 AETIOLOGY PRIMARY Being too «hasty» Anxiety Hypersensitivity of the glans Disorder of serotonin receptors in the brain AETIOLOGY SECONDARY 6 SECONDARY Treatment of Erectile Dysfunction Treatment of diseases related to Premature Ejaculation Combination of Pharmacotherapy & Sex PRIMARY Therapy Pharmacotherapy Relationship Counselling Behavioral/ Sex Therapy Combination of Pharmacotherapy & Sex Therapy Erectile Dysfunction Hyperthyroidism Chronic prostatic inflammatory diseases Neurologic diseases Drug side-effects THERAPY SOURCE: Hatzimouratidis K et al: Eur Urol. 2010;57:804-14 7 THERAPY PHARMACOTHERAPY Self-help therapies and online /Internet purchase of preparations are not effective and have unknown side-effects. Local application of anaesthetics on the penis before intercourse is not practical and brings poor results. Oral Pharmacotherapy (Daxopetine) increases levels of serotonin, which is a substance in the brain and spinal cord participating in the control over ejaculation. 1. 2. 3. It acts within 1 hour and increases X 4 times time until ejaculation It is combined with psychosexual therapy for optimal results It increases the couple’s sexual satisfaction SOURCE: McMahon et al. J Sex Med 2011;8:524-539 8 PSYCHOSEXUAL THERAPY SOURCE: Rowland D, Cooper S: J Sex Med. 2011;8 (S4):342-52. The man or couple practise some exercises that help to increase the man’s control over ejaculation 9 Exercises are performed at home, while periodically the Expert evalutates their progress until reaching the desirable target. They follow an exercise program, according to their needs Classical exercises include the «stop-start» technique with or without the use of vibrator devices. THERAPEUTIC TARGETS Better control over ejaculation Improvement of emotional intimacy Higher self-confidence Better sexual satisfaction SOURCE: Porst H, et.al. Eur Urol. 2007;3:816-23, Althof SE et al: J Sex Med 2013;10:26–35. Visit www.imop.gr and get informed on SEXUAL PROBLEMS and their solutions www.facebook.com/imop.gr youtube.com/imopgr www.twitter.com/imop.gr gplus.to/imop linkedin.com/in/imop.gr

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