Men, 'Expert Consensus on Treatment of Premature Ejaculation with Traditional Chinese and Western Medicine' is here! A detailed interpretation of the article
Sexual dysfunction is an unspeakable secret for many men. Statistics show 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 Male Sexual Dysfunction in China" pointed out that sexual dysfunction is a chronic disease, and it is also a barometer of men's health . It has a common pathogenesis with sexual dysfunction , and it is a risk factor and early sign of many chronic diseases.
The good news is that in November 2021 , the "Expert Consensus on the Treatment of Premature Ejaculation Integrated Traditional Chinese and Western Medicine" was officially released. It integrates Chinese and Western medicine treatment strategies, allowing doctors to combine existing resources to better help patients achieve therapeutic effects.
Today, Xiao Jiu will explain it to everyone.
The Basics: Definition and Pathogenesis
At present, the pathogenesis of premature ejaculation ( PE ) is not yet clear, and the incidence rate is between 20% and 30% . According to different clinical manifestations, PE can be divided into primary, secondary, natural variability and subjectivity .
Although the etiology has not yet been clarified, the mainstream view is that PE is related to factors such as 5- HT neurotransmitter disorder, 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 Drugs and Adjuvant Therapy
What should I do if premature ejaculation occurs? Without hesitation, you should seek medical examination as soon as possible and formulate a reasonable treatment plan. Western medicine treatment of premature ejaculation is mainly oral medicine and adjuvant therapy.
1. Oral medication
① Dapoxetine
Dapoxetine is the first-line drug for the treatment of premature ejaculation. It belongs to the short-acting SSRI class of drugs , and it needs to be evaluated for premature ejaculation before use.
The pathogenesis of premature ejaculation is related to the concentration of 5 -hydroxytryptamine in the body. Clinical studies have shown that dapoxetine can be rapidly degraded and absorbed after entering the body, and the blood concentration reaches the peak in about 1.4 to 2 hours. In the first week of treatment , patients may experience nausea, diarrhea, fatigue, fatigue and other discomfort symptoms, but they will disappear on their own 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 married life . After taking it, pay attention to observe the physical condition. If the effect is not good or adverse reactions occur, the dosage can be adjusted under the guidance of a doctor.
② Long-acting SSRI drugs
Common long-acting SSRIs include paroxetine, sertraline, fluoxetine, and citalopram. The mechanism of action is similar to that of dapoxetine, and they are all related to the concentration of serotonin . Compared with short-acting SSRIs , the adverse reactions of long-acting SSRIs are more obvious. The common ones are nausea, vomiting, dry mouth, sweating, fatigue, lethargy, etc. After 2-3 weeks of continuous medication , the side effects can be relieved.
2. Local anesthetic
In addition to oral medication, there is also an auxiliary treatment: local anesthetics, common ones include compound lidocaine cream / gel, lidocaine / prilocaine spray, etc.
The main function of local anesthetics is to reduce sensitivity and reduce the impulse of central centers such as the spinal cord and brain. The method of application is to apply it to the target location and surrounding areas 20-30 minutes in advance. Local anesthetics have no obvious side effects, which mainly depends on the individual's physical condition, and some patients may experience excessive numbness.
TCM Treatment: "Cocktail" Therapy and Chinese Proprietary Medicine
The following introduces the treatment methods of traditional Chinese medicine, mainly "cocktail" therapy and Chinese patent medicine.
1. "Cocktail" therapy
That is to use the comprehensive therapy of "dapoxetine + sildenafil + Wuling powder medicine". The results of clinical research show that "cocktail" therapy can help improve the patient's latency time, control and bad mood.
2. Chinese patent medicine treatment
There are two main categories of Chinese patent medicines, one is mainly composed of Central Asian white and musk, ambergris, saffron, frankincense, etc. , can be used in combination with SSRI drugs.
In addition, if the patient is combined with dampness in the scrotum, drugs for clearing away heat and promoting dampness can be considered; for patients with backache and fatigue, drugs for warming and nourishing kidney yang can be considered; for patients with insomnia, drugs for nourishing the heart and calming the nerves can be considered.
What needs to be reminded is that it is not recommended to use Chinese patent medicine alone for treatment, 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 therapies can also 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 exchanges with their partners . Behavioral therapy is the use of motor skills to improve quality of life, including the " stop - and- go" 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 obviously associated with other diseases, such as prostatitis, hyperthyroidism and so on. Therefore, it is recommended that patients undergo relevant examinations as soon as possible and receive reasonable treatment under the guidance of a doctor.
References:
[1] Beijing Association of Traditional Chinese Medicine Andrology Expert Consensus Group , Li Haisong . Expert Consensus on Treatment of Premature Ejaculation with Integrated Traditional Chinese and Western Medicine [J]. Chinese Journal of Andrology , 2021, 35(6): 4.
[2] Li Zhansong . Clinical observation of functional premature ejaculation treated with antidepressants combined with behavioral therapy ( report of 85 cases ) [C]// The Fifth National Andrology Academic Conference of Chinese Medical Association . 0.
[3] Bao Binghao , Dai Hengheng . Premature ejaculation also has " cocktail therapy " [J]. Family Chinese Medicine , 2018(3): 2.
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