premature%20ejaculation
PREMATURE EJACULATION
Premature ejaculation is a male sexual dysfunction characterized by short, easily stimulated ejaculation that occurs always or nearly always before or within one minute of vaginal penetration.
It is involuntarily controlled and causes negative personal consequences like distress, frustration and avoidance of sexual intimacy.
Exact etiology and risk factors are unknown.

Introduction

  • A male sexual dysfunction characterized by:
    • Short, easily stimulated ejaculation that occurs always or nearly always before or w/in 1 minute of vaginal penetration or a clinically significant & bothersome reduction in latency time, often to about 3 minutes or less
    • Either present from the first sexual experience or following a new bothersome change in ejaculatory latency
    • Involuntarily controlled
    • Causes negative personal consequences eg distress, bother, frustration, avoidance of sexual intimacy & interpersonal difficulty
  • Most common male sexual dysfunction w/ prevalence not affected by age
    • More common in younger men

Etiology

  • Unknown exact etiology w/ few data to support the following suggested biological & psychological hypotheses including:
    • Anxiety
    • Penile hypersensitivity
    • 5-HT receptor dysfunction

Risk Factors

  • Risk factors include:
    • Genetic influences (lifelong PE)
    • Prostatic inflammation & chronic bacterial prostatitis (acquired PE)
    • Hormonal aberrations or thyroid hormone disorders
    • Poor overall health status & obesity
    • Psychological factors that may precipitate PE are historical factors (eg sexual abuse, attitude towards sex in the home), individual psychological factors (eg body image, depression, performance anxiety) or relationship factors (eg intimacy, anger)
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Erectile dysfunction (ED) is a common condition defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance.1 It is one of the most common complaints in men’s sexual medicine, affecting both physical and psychosocial health and having a significant impact on the patient and partner’s quality of life.1 Moreover, ED is commonly associated with other comorbid conditions, including hypertension, dyslipidaemia and diabetes mellitus.1

Evaluation of ED should include a detailed medical and sexual history of the patient. 1 A discussion of the patient and partner’s preference and treatment goals is essential to better tailor treatment and improve patient satisfaction and adherence to treatment.2 Lifestyle modification and management of risk factors should precede pharmacotherapy, while first-line treatment with oral phosphodiesterase type 5 inhibitors (PDE5i) is well established for the management of patients with ED.1