premature ejaculation: it is nice to… ‘have the control’!
DESCRIPTION
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"TRANSCRIPT
PHARMACOTHERAPY7
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
1.2.3.
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 intercourseis 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.
SOURCE: McMahon et al. J Sex Med 2011;8:524-539
SOURCE: Hatzimouratidis K et al: Eur Urol. 2010;57:804-14
5DIAGNOSIS
Onset time of problem(PRIMARY or SECONDARY)
Occasional or permanent?
Impact on relationship and sexual life
Disorders/Diseases
Medications
Evaluation through special questionnaires
Duration of problem
Time until ejaculation
It is goodto… havecontrol!
PREMATUREEJACULATION
Ejaculation is the outcome of sexual arousal and, normally, occurs simultaneously with orgasm.
It is induced by nervestimulation, resulting in the expulsion of semen from the outer urethral ori�ce.
EJACULATION1
BRAIN SPINAL CORD
PERIPHERAL NERVES
}}
}BRAIN
PERIPHERAL NERVES
SPINALCORD
1
2
3
SOURCE: Dawson, S. Et al. Journal of Sexual Medicine.
(2013) Jannsen E et al. Journal of Sex Research (2000);1:8-23
NORMAL RESPONSE
PREMATURE EJACULATION
SOURCE: Donatucci CF: J Sex Med 2006;3:303-308T I M E
ST
IM
UL
AT
IO
N
CULMINATION
AROUSAL
WHAT HAPPENS IN PREMATURE EJACULATION?2
ORGASM!
FEATURES OF PREMATURE EJACULATION
}
9 out of10men ejaculate
within 1’
after vaginal penetration }1 out of 5presents PEirrespective of age
There are 2 different types of Premature Ejaculation: In PRIMARY PE- the most common type-the 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
1
SOURCE: Porst H, et al. Eur Urol. 2007,51:816-823
3
men
Premature Ejaculation is not just a «time problem»; it mainly has to do with the man’scontrol over ejaculation and sexual satisfaction.
SOURCE: Porst H, et al. Eur Urol. 2007,51:816-823 Waldinger M, et al. Int J Psychiat Clin Pract 1998, 2: 287-293
CONSEQUENCES
OF PREMATURE EJACULATION4
PREMATURE EJACULATION CAUSESEMBARRASSMENT 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 signi�cantly reduced.
AETIOLOGY
AETIOLOGY
6SOURCE: Hatzimouratidis K et al: Eur Urol. 2010;57:804-14
Being too «hasty»
Anxiety
Hypersensitivity
of the glans
Disorder of serotonin
receptors
in the brain
Erectile Dysfunction
Hyperthyroidism
Chronic prostatic in�amma-
tory diseases
Neurologic diseases
Drug side-effects
THERAPY
THERAPY
Treatment of Erectile
Dysfunction
Treatment of diseases related
to Premature Ejaculation
Combination of Pharma-
cotherapy & Sex
Therapy
PRIMARY
SECONDARYSECONDARY
Pharmacotherapy
Relationship Counselling
Behavioral/
Sex Therapy
Combination
of Pharmacotherapy
& Sex Therapy
PRIMARY
8
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
They follow an exercise program, accordingto their needs
Exercises are performed at home, while periodically the Expert evalutates their progress until reaching the desirable target.
Classical exercises include the «stop-start» technique with or without the use of vibrator devices.
PSYCHOSEXUAL THERAPY
THERAPEUTIC TARGETS9
Better sexual satisfaction
Improvement of emotional intimacy
Better control over ejaculation
SOURCE: Porst H, et.al. Eur Urol. 2007;3:816-23, Althof SE et al: J Sex Med 2013;10:26–35.
Higher self-con�dence
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