Surgical treatment, delay techniques, and traditional Chinese medicine for premature ejaculation

Is drinking alcohol a good way to control premature ejaculation?

Male ejaculation is caused by the excitation of the sympathetic nervous system. Alcohol and alcoholic beverages generally have a weakening and inhibitory effect on the nervous system, relieving or alleviating feelings of depression and tension. Since emotional changes affect nerve activity, they also influence ejaculation. Many people have found that drinking alcohol prolongs intercourse time and therefore believe that drinking alcohol can prolong ejaculation. However, this is not a good method.

First, only beverages containing a small amount of alcohol or low-alcohol drinks are effective, and controlling the "moderation" of drinking is crucial. Excessive drinking can severely affect penile erection and actually worsen sexual function. Second, relying on alcohol to treat premature ejaculation long-term can lead to alcohol dependence and, over time, a drinking habit, causing serious damage to marriage and family. Therefore, if you have premature ejaculation, you should consult a doctor instead of resorting to this method as a self-righteous solution.

Is surgery a viable treatment for premature ejaculation?

"Doctor, I have premature ejaculation, can I have surgery?" This is a common question patients ask in the outpatient clinic. So, is surgery a viable treatment for premature ejaculation?

If conservative treatments fail, some patients with premature ejaculation may consider surgery. Common surgical methods include selective dorsal penile nerve resection and penile prosthesis implantation. While surgery can be effective in treating premature ejaculation, it is an invasive procedure, and its safety and long-term effectiveness remain uncertain. Therefore, both doctors and patients must exercise caution before choosing surgical treatment.

Selective dorsal penile nerve resection involves making an incision in the penis to expose the dorsal penile nerve. The main trunk is preserved, while several branches are removed, thereby reducing penile sensitivity, increasing the ejaculation threshold, and prolonging ejaculation time. Reports indicate a recent effectiveness rate of over 80% for selective dorsal penile nerve resection. This surgery was reported abroad 20 years ago, but the problem is that many private hospitals in China now use it as a gimmick to attract patients, calling it the "nemesis of premature ejaculation" and claiming it can "solve premature ejaculation problems in 15 minutes." They perform the surgery on anyone with premature ejaculation symptoms, regardless of their specific circumstances. In reality, dorsal penile nerve resection is not as miraculous as it sounds. First, this surgery is only suitable for married patients with primary premature ejaculation who have already undergone long-term drug, psychological, and behavioral treatment with minimal effect. Only then is the resection of several nerves in the penis considered to reduce sensitivity. Surgery is not considered for patients whose ejaculation time can be improved with medication or for patients with secondary premature ejaculation. Furthermore, a professional measurement of the penis is required before surgery, followed by a comprehensive assessment based on objective data. More importantly, the specific method of this surgery is still controversial, and the surgery carries certain risks, including poor long-term postoperative results, psychological distress, numbness of the glans penis, and potential impact on erectile function; some patients may even experience erectile dysfunction after the surgery. Currently, the exact procedure is still under debate and is far from being widely adopted. Therefore, even if a patient meets the surgical criteria, doctors must carefully weigh the options before deciding to proceed.

Theoretically, penile prosthesis implantation does not prolong the ejaculation latency period in patients with premature ejaculation. It is mainly used for patients with erectile dysfunction accompanied by premature ejaculation. After surgery, 50% of patients reported improvement in premature ejaculation, while 50% reported no change. However, because patients can maintain an erection after ejaculation, penile prosthesis implantation can obviously help improve the sexual satisfaction of their partners. However, penile prostheses are expensive, and they have a limited lifespan and are prone to complications, which limits the application of this surgery.

Some believe that circumcision is one of the effective treatments for premature ejaculation. The mechanism may be that the surgery destroys some of the sexual receptors, reduces the amount of sexual stimulation signals input, and delays the ejaculation latency period. However, there is currently a lack of evidence regarding its efficacy and safety.

In conclusion, surgical treatment for premature ejaculation has not yet gained widespread acceptance in the medical community. It is recommended that you do not rush into surgery and wait a while.

What methods can prolong ejaculation time?

Some friends have asked, "I don't have premature ejaculation, but I want to prolong ejaculation time. Is there any way to adjust this?" First, both partners need to recognize that sex is a mutual need, strengthen communication and emotional exchange, eliminate misunderstandings and barriers, and be considerate of each other. Men should maintain a positive attitude, avoid excessive excitement, and eliminate tension and all anxiety. Based on this, the following methods can help adjust your ejaculation time to some extent.

(1) Improve sexual skills: sufficient foreplay to allow the woman to enter the excitement period first; adjust the position, preferably the woman on top or the side position; after the man's penis is inserted into the vagina, reduce the amplitude and speed of thrusting to prolong the ejaculation time; when the feeling of ejaculation occurs, distract attention from sexual stimulation and shift the feeling of the penis to thinking about other issues, which will help delay ejaculation.

(2) Multiple ejaculation method: For young men, increasing the number of ejaculations can prolong sexual intercourse. This involves ejaculating through masturbation before engaging in sexual intercourse, which significantly delays the second ejaculation and prevents premature ejaculation during intercourse. Increasing the frequency of sexual activity each night can also achieve a similar effect. However, this method is not suitable for men with low sexual function or middle-aged and elderly men experiencing sexual decline. If you feel fatigued, you can try having intercourse in the morning after waking up or after a nap, when you are more energetic and can achieve the effect of prolonging ejaculation time.

(3) Local cooling method: Before intercourse, soak the testicles in cold water or wrap the entire penis and scrotum with a damp, cold towel. This can lower the temperature of the testicles, slow down blood flow, and eliminate tension. The man can then have intercourse more easily, which can prolong ejaculation time.

(4) Use a condom: The condom covers the glans penis, so that the stimulation it receives is not too strong, thereby delaying ejaculation. If one condom is not effective, another one can be added.

Finally, friends should remember that there is no fixed standard for the duration of sexual intercourse, nor is it the case that the longer the better. Do not deliberately pursue the length of time with a competitive mentality. As long as both parties feel satisfied, your success is yours.

How does Traditional Chinese Medicine (TCM) understand premature ejaculation?

Traditional Chinese medicine defines premature ejaculation as "ejaculation before intercourse or immediately after intercourse," and believes that the occurrence of premature ejaculation is related to a variety of factors, and is closely related to the heart, liver, kidneys and Yangming meridian.

Traditional Chinese medicine believes that premature ejaculation can be caused by: excessive sexual activity or congenital deficiency leading to kidney deficiency and an inability to store essence, resulting in uncontrolled ejaculation; overwork or excessive mental exertion damaging the heart and spleen, leading to insufficient production and circulation of qi and blood, causing qi and blood deficiency; excessive alcohol consumption or a diet high in fatty and sweet foods generating damp-heat, or external invasion of damp-heat causing damp-heat to descend into the liver meridian, disturbing the seminal chamber and causing the kidney to lose its ability to store essence; depression and anger causing liver fire to flare up, easily disturbing the storage of essence and leading to premature ejaculation; depression damaging the liver, causing abnormal liver function and inability to control essence storage, resulting in premature ejaculation; and fear damaging the kidneys, weakening the seminal gate and causing premature ejaculation. In short, premature ejaculation is mostly caused by liver qi stagnation, liver and gallbladder damp-heat, deficiency of both heart and spleen, disharmony between the heart and kidneys, and yin deficiency with excessive fire.

Because premature ejaculation has diverse causes and complex pathogenesis, there are many different syndrome differentiations. For example, some people classify it into types such as kidney qi deficiency, yin deficiency and yang hyperactivity, heart and spleen deficiency, heart and kidney disharmony, liver qi stagnation, and liver and gallbladder damp-heat.

In terms of treatment, in addition to oral Chinese medicine based on syndrome differentiation, there are also acupuncture, thread embedding, moxibustion, massage, and topical application of Chinese herbal medicine.