Most of the specialists think that treatment of premature ejaculation should be principally pathogenic. In opinion of sexologists and sex-therapists premature ejaculation is observed pretty often, it bothers patients very heavily and in most cases can be treated easy with the help of psychotherapy (sex-therapy). Besides, they add that, this disorder is hardly treated with other methods.
The essence of successful treatment of premature ejaculation is to formulate for patient a precise identification of feelings which tell about shortly approaching orgasm. Formation of this sensory feedback is done in calm environment in presence and participation of wife. There are offered two effective ways of treatment of premature ejaculation – its “squeezing” method offered by W. Masters and V. Johnson, and “stop-start” method. The latter was developed by James Saymans. As a rule, man achieves a good result in controlling his ejaculation within 2 to 10 weeks, although long lasting effect is achieved within few months after of the therapeutic procedures. Though, negative reactions of both from the couple (weariness, disappointment, resistance, etc.) might be the obstacles standing before reaching progress in treatment. Use of such simple and physiologic methods as stopping of frictions right after putting the penis into vagina up to complete loss of pleasant genital feelings, slowing down of the frictions with complete muscle relaxation, give significant effect.
La Pera G. (1996) offers a method of ejaculation process control by training pelvis muscles.
Though in all cases it’s necessary to find and prevent according phobias and provide assurance in further treatment – patient has to dispose himself that treatment will take some time, effort, patience and insistence, but will definitely be successful.
One of the most important preconditions in treatment of premature ejaculation is presence of positively disposed sexual partner of the patient.
In spite of connection between different parts of nervous system, disorders of cortical, spinal or genital-reception character ask for different way and development of plan for treatment of premature ejaculation.
One of the approaches to correction of premature ejaculation is decreasing of sensitiveness of the penis’ reception structures. In nowadays to achieve this, there are usually used locally anesthetic preparations (ethylamine benzoate, anesthesin or lidocaine ointments) together with condom. These anesthetic preparations are put on the head of the penis, particularly more on the frenulum to avoid complete loss of sensitivity and anejaculation. Depending on the type of anesthetic used in preparation, there are different timings when to put it on before sexual intercourse. These creams are very popular in clinic practice since they have very good effect, small amount of side effects and low cost.
For therapeutic treatment of premature ejaculation there were and are traditionally used (but less often lately) magnesium sulfate, novocaine, ergot preparations and other medical preparations as well as chloroethane blockade. Magnesium sulfate decreases excitement of Central Nervous System (CNS). Novocaine slows down transmission of excitation in central synapses of spine’s reflex arches. Ergot preparations increase the tonus of unstriped muscles, blocs the sympathetic nervous impulses and help to slow down the excitement of ejaculation centre. Spasmolytin, thiphen, papaverine, diprophen are used in treatment of premature ejaculation since they stop the transfer of nervous impulses within ganglions of parasympathetic nerves. Minor tranquilizers (meprotan, meprobamate, elenium, trioxazole) are used to decrease anxiety and self-consciousness. Recommended sedatives are sodium bromide, potassium bromide, valerian tincture, motherwort tincture, etc.