Premature ejaculation is the process of ejaculating semen with sexual climax at the end of sexual intercourse, which means excessive ejaculation or incomplete growth (premature birth is called "premature birth"). The exact definition of premature ejaculation is undefined, but premature ejaculation is considered to be ejaculation before the man's will. This can happen continuously or intermittently.
A clear definition of premature ejaculation has not been reached so far. First, it must be understood that this is not a disease. The duration of ejaculation during sexual intercourse varies from person to person. In fact, this situation does not pose a major problem for the man in terms of obtaining pleasure (orgasm), but women cannot achieve sexual climax, so they cannot obtain sufficient pleasure from sexual intercourse, which makes both parties uncomfortable. Over time, this can lead to loss of confidence in men, avoidance of sexual relations, deterioration of relationships, and even erectile dysfunction. Therefore, this duration should be extended in these individuals, i.e., they should be treated.
As mentioned above, different opinions have been put forward on this matter:
1. The woman not reaching orgasm or the man ejaculating before half of the sexual intercourse is completed.
2. Ejaculation upon entry of the male organ into the vagina or shortly before.
3. Ejaculation within 7 minutes after entry of the male organ into the vagina.
4. Ejaculation within 2 minutes after entry of the male organ into the vagina.
5. Ejaculation within 1 minute after entry of the male organ into the vagina.
As can be noted from this, determining a specific duration is not the correct approach. Some authors believe that the important thing is not the extent of a man's ability to delay ejaculation, but the satisfaction of the man and his partner with the duration of sexual intercourse.
Around one-third of the population suffers from this problem, but the rate of hospital and doctor visits is very low. The reason for this is mostly shame and embarrassment. In societies where sexual life is considered shameful, often a man may not know or wonder if his partner has reached orgasm. Women also do not share with their partners that they have not reached orgasm. This is another reason for the low demand for medical consultations.
Two types of premature ejaculation have been identified. The first is lifelong, starting from the first sexual relationship and occurring with every partner (primary premature ejaculation). The second is one that has not occurred early in life, but starts later (acquired or secondary premature ejaculation). The second type usually occurs due to some diseases (such as prostatitis, urethritis, spinal tumors, injuries, etc.).
First and foremost, a detailed patient history must be taken, and it must be distinguished whether the patient actually has premature ejaculation or not. Because this term, which has not been clearly defined, may be interpreted differently by patients. There is a focus on hopes here. For example, a patient may request an extension of time even though he does not have premature ejaculation. Whether premature ejaculation is lifelong or acquired later can be determined through detailed history. If it is the second type, all diseases that could cause it should be reviewed. Blood, urine, and imaging tests may be performed if necessary.
The goal of treatment is to increase control over ejaculation in the individual and thus increase pleasure for both parties in the sexual relationship. Here are the traditional treatment options:
Behavioral and psychological therapy: First, men's anxiety about this issue must be eliminated. Since the sexual relationship is not an individual issue, this problem should be seen as a common problem between partners and a joint solution should be sought. Couples are included in sex therapy and continue this therapy for a certain period. In the first stage, they are suggested to practice masturbation without sexual intercourse and without relationship anxiety, and the woman stops when ejaculation occurs, then waits for a period and repeats it again. The same approach is applied for sexual intercourse in the second stage. It aims to enable the man to control the ejaculation period. However, it may be difficult for couples to continue this behavior because frequent cessation of sexual intercourse can cause problems in reaching sexual climax, especially for women.
Using condoms: Condoms reduce direct skin stimulation of the penis. Some men say they feel less stimulation when using a condom, so they can continue sexual activity for a longer period.
Using creams to reduce penile sensitivity: This type of treatment relies on applying creams containing numbing agents to the skin before sexual intercourse. The partner is directed to massage the penis before the scheduled ejaculation, and it is stopped for a period and then repeated again. This approach aims to delay the ejaculation period. However, this approach may reduce the pleasure of the man.
Drug therapy: The most commonly used drugs to prevent premature ejaculation are antidepressant drugs. These drugs are used for their antidepressant effects, and delaying ejaculation is also one of the side effects of these drugs, so they are used to benefit from this side effect. Antidepressant drugs should be taken daily (independent of sexual intercourse), and the dose should be reduced when discontinuing them. In recent years, new drugs have been introduced for single-use to prevent premature ejaculation. These drugs are taken with a glass of water an hour before sexual intercourse and should not be used daily.
One of the first methods people with premature ejaculation problems resort to in their daily lives is to stop when they feel they are about to ejaculate during intercourse, then withdraw and wait, then attempt to resume the relationship afterward. However, this method usually is not very successful and can be particularly bothersome to the relationship partner, especially if the interruption affects their concentration.
To make this method more effective, for many years, Kegel exercises and start-stop exercises have been known, but these exercises usually do not give tangible results unless they are consciously performed under expert supervision.
At this point, scientists have developed a device that allows people to practice these exercises at home as if they were under professional supervision. The only device currently available on the market is Myhixel.
This device, after being tested on more than 3000 men, has been shown to triple the duration of ejaculation without the need for additional treatment such as drugs or creams.
• Ejaculate within 3 minutes after penetration.
• Suffer from premature ejaculation since their first sexual experience.
This device is sold online, and detailed information about it is available on its official website. The device artificially simulates the vagina and is essentially a device for masturbation.
When purchasing the device, a mobile app is also purchased with it, and this app teaches you step by step how to use the device and the exercises you should perform.
1. It has no side effects, and the materials used in its manufacture do not cause any harm to the body.
2. Easy to use and easy to clean.
3. Its results are permanent because it is primarily based on an exercise program, while many other treatments are temporary.
1. The protocol consists of 8 types of exercises that become increasingly difficult as you progress, requiring commitment and willpower. Using this device can be compared to going to the gym to lose weight, and the failure rate in using this device can reach 90% due to the discontinuity of the exercise program.
2. Exercises with this device should be done 2-3 times a week, making it difficult for men who have regular sexual relationships or are married. It is very likely that spending sexual energy on this device will reduce the relationship with the partner, in addition to the need for the partner's consent to this type of exercise. Therefore, in our clinic, we strongly recommend this device for singles and people who do not have regular sexual relationships.
Penile injection is one of the alternative treatments for premature ejaculation. The goal of this procedure is to reduce excessive penile sensitivity and increase ejaculation duration.
1- Hyaluronic acid
2- A substance prepared from the patient's blood (biological filler)
This is a daily procedure that can be performed in an outpatient clinic or doctor's office. In other words, it is a non-surgical procedure. Before the procedure, the area to be injected is anesthetized either with a topical anesthetic cream or with a thin needle. The injection is administered in the glans area where sensitivity is highest and nerve density is high. The procedure takes about 15 minutes and is painless.
The patient can return to their normal life on the same day. There is no need to stay in the hospital or receive care. The period of abstaining from sexual intercourse should be about 3 days. It is advised not to take very hot showers or enter saunas in the first three days. Also, drinking plenty of water in the first three days is recommended.
Many scientific studies have been conducted in this regard. The success rate ranges from 50% to 90%. Studies have also shown that it increases the average duration of ejaculation by about 3 times.
The stability period with hyaluronic acid injection ranges from 6 months to 1 year. After this period, the injection dissolves and disappears. Although some patients say that the effect persists after dissolution, the vast majority of cases do not.
As for injections made of biological filler, the stability period is longer (1-2 years), but there is a higher risk of shape distortion compared to the former.
One of the alternative treatments for erectile dysfunction is penile nerve regulation. The goal of this procedure is to reduce excessive penile sensitivity and increase ejaculation duration. This is achieved by creating permanent or long-term damage to the nerves or nerve network using heat obtained from a high-frequency electric current. Radiofrequency energy is used for this purpose and has been used in the medical field for many years. This technique is applied to alleviate chronic pain usually by applying it to nerve fibers in the back and spine to provide relief without surgery. We use this energy whose effects and side effects are well known for the treatment of premature ejaculation by applying it to the nerves responsible for excessive sensitivity of the penis. Many scientific studies have been conducted in this regard and no side effects have been observed. Studies that have been conducted have shown that it increases the average duration of ejaculation by about 3 times.
Radiofrequency waves (RF) are used to create tissue damage in the applied tissues by providing controlled electrical energy regulated by modified temperature or application duration. A physically insulated but electrically non-insulated needle is placed, which operates to create damage in the targeted nerve tissues. The needle is connected to an RF device and a current is generated from the device to the tissue. Heating occurs within the tissue itself, not through the sensor tip. When the sensor reaches the maximum temperature in the tissue, thermal equilibrium is achieved between the sensor and the tissue. At this point, heat along the tissue reaches its maximum. Due to the spread of current from the sensor tip to the tissue, the area where the heat is highest and therefore denser is the one closest to the sensor tip. The extent of damage depends on temperature and application duration.
This is a daily procedure that can be performed in clinics and examination facilities. In other words, it is a non-surgical procedure. General anesthesia is not given to the patient during the procedure. Local anesthesia may be administered in some specific cases. The procedure is usually performed without the use of anesthesia. The procedure is applied to the nerves running to the head area of the penis, which end in the abdomen. The procedure is performed in this area, where two points on each side of the penis are felt. The procedure is performed at each point separately. The procedure takes about 15 minutes. Due to the lack of local anesthesia, the procedure causes some pain. However, local anesthesia is used for patients who cannot tolerate pain.
The patient can return to their daily life on the same day. There is no need to stay in the hospital or receive care. There are no restrictions on sexual intercourse. There is no pain after the procedure. There is no loss of erection or sensation in the regulated area.
Many scientific studies have been conducted in this regard. The success rate ranges from 70-80%. Studies conducted have shown that this procedure increases the average duration of ejaculation by about 3 times.
The treatment period ranges from 1 to 5 years.
