Men, 'Expert Consensus on Premature Ejaculation Integrating Traditional Chinese and Western Medicine' is here! A detailed interpretation of the article
Sexual dysfunction is a hidden problem for many men. Data shows that about 31% of men have sexual dysfunction.
What you may not know is that male dysfunction not only affects quality of life, but is also seen as a sign of declining overall health .
The 2016 edition of "Guidelines for the Diagnosis and Treatment of Sexual Dysfunction in Chinese Men" pointed out that sexual dysfunction is a chronic disease and a barometer of men's health . It has a common pathogenesis with sexual dysfunction , and it is a risk factor and an early sign of many chronic diseases.
The good news is that in November 2021 , the "Expert Consensus on the Treatment of Premature Ejaculation with Traditional Chinese and Western Medicine" was officially released, which integrates Chinese and Western medicine treatment strategies, allowing doctors to combine existing resources to better help patients achieve therapeutic effects.
Today, Xiao Jiu will come to explain it to you.
Basics: Definition and pathogenesis
At present, the pathogenesis of premature ejaculation ( PE ) is still unclear, and the incidence rate is between 20% and 30% . According to the different clinical manifestations, PE can be divided into primary, secondary, natural variability and subjective .
Although the etiology has not been clarified, the mainstream view is that PE is related to factors such as disturbance of serotonin neurotransmitter, high sensitivity, and increased central excitability . The clinical diagnosis of PE is mainly based on the patient's medical history and sexual life history. Specifically, the occurrence of PE is related to insufficient knowledge and experience of sexual life, poor physical fitness, excessive fatigue, psychological factors, and reproductive system diseases.
Western Medicine Treatment: Oral Medicine and Adjuvant Therapy
What should I do if premature ejaculation occurs? Don't hesitate, seek medical attention as soon as possible and formulate a reasonable treatment plan. Western medicine treatment of premature ejaculation is mainly oral drugs and adjuvant therapy.
1. Oral medication
①Dapoxetine
Dapoxetine is the first-line drug for the treatment of premature ejaculation .
The pathogenesis of premature ejaculation is related to the concentration of serotonin in the body. Clinical studies have shown that dapoxetine can be rapidly degraded and absorbed after entering the body, and the blood drug concentration reaches a peak in about 1.4 to 2 hours. In the first week of treatment , patients may experience nausea, diarrhea, fatigue, fatigue and other uncomfortable symptoms, but they will disappear after 2-3 weeks of continuous treatment.
At present, the dosage specifications of dapoxetine are 30mg and 60mg . It is recommended to take it 2-3 hours before the start of the married life . After taking it, pay attention to the physical state. If the effect is not good or there are adverse reactions, the dosage can be adjusted under the guidance of a doctor.
②Long-acting SSRI drugs
Common long-acting SSRI drugs include paroxetine, sertraline, fluoxetine, and citalopram, etc. The mechanism of action is similar to that of dapoxetine, which is related to the concentration of serotonin . Compared with short-acting SSRIs , long-acting SSRIs have more obvious adverse reactions, such as nausea, vomiting, dry mouth, sweating, fatigue, drowsiness, etc. The side effects can be relieved after 2-3 weeks of continuous medication.
2. Local anesthetics
In addition to oral drugs, there is also an adjuvant treatment: local anesthetics, commonly compound lidocaine cream / gel, lidocaine / prilocaine spray, etc.
The main effect of local anesthetics is to reduce sensitivity and reduce impulses in centers such as the spinal cord and brain, and is applied 20-30 minutes in advance to the target site and surrounding area. Local anesthetics have no obvious side effects, and it mainly depends on the individual's physical condition. Some patients may experience excessive numbness.
Chinese medicine treatment: "cocktail" therapy and proprietary Chinese medicine
The following describes the treatment methods of traditional Chinese medicine, mainly "cocktail" therapy and proprietary Chinese medicine.
1. "cocktail" therapy
That is, the comprehensive therapy of "dapoxetine + sildenafil + Wuling bacteria powder" is used. Clinical studies have shown that the "cocktail" therapy can help improve patients' latency time, control and negative mood.
2. Chinese patent medicine treatment
There are two main categories of Chinese patent medicines, one is mainly composed of Zhongya Baiji, musk, ambergris, saffron, frankincense, etc. , can be used in combination with SSRI drugs.
In addition, if the patient is complicated with scrotal dampness, heat-clearing and damp-damping drugs can be considered; with backache and fatigue, warm-tonifying kidney-yang drugs can be considered; with insomnia, nourishing and soothing drugs can be considered.
It should be reminded that it is not recommended to use Chinese patent medicine alone, and it is recommended to use it as an adjuvant therapy on the basis of Western medicine.
Other: Psychological, behavioral therapy
In addition to oral medications and local anesthetics, a combination of psychological and behavioral therapy can be used.
The purpose of psychotherapy is to enable patients to correctly understand and learn to deal with married life , enhance self-confidence, reduce anxiety, tension, depression and other emotions, and strengthen communication and communication with partners . Behavioral therapy is the use of movement techniques to improve quality of life, including the "go - stop" method and the "squeeze" method.
All in all, the treatment of premature ejaculation is not as simple as imagined, it is also divided into secondary and primary. Secondary is clearly associated with other diseases, such as prostatitis, hyperthyroidism, etc. Therefore, it is recommended that patients undergo relevant examinations as soon as possible and receive reasonable treatment under the guidance of doctors.
References:
[1] Expert Consensus Group of Andrology Diseases of Beijing Association of Traditional Chinese Medicine, Li Haisong . Expert consensus on the treatment of premature ejaculation by integrating traditional Chinese and Western medicine [J]. Chinese Journal of Andrology , 2021, 35(6):4.
[2] Li Zhansong . Clinical observation of antidepressants combined with behavioral therapy in the treatment of functional premature ejaculation ( with a report of 85 cases ) [C]// The Fifth National Andrology Academic Conference of the Chinese Medical Association . 0.
[3] Bao Binghao , Dai Hengheng . Premature ejaculation also has " cocktail therapy " [J]. Family Traditional Chinese Medicine , 2018(3):2.
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