How to Control Premature Ejaculation

 

What IS Premature Ejaculation

Premature ejaculation (PE) is a prevalent sexual condition among men. According to recent normative statistics, males with an intravaginal ejaculatory latency time (IELT) of less than one minute have "definite" PE, whereas men with IELTs between one and 1.5 minutes have "probable" PE. Although there is inadequate empirical data to determine the etiology of PE, there is some indication that males with PE have high levels of sexual anxiety and inherited impaired sensitivity of central 5-HT (5-hydroxytryptamine, serotonin) receptors. Pharmacological modulation of the ejaculatory threshold with off-label daily or on-demand selective serotonin re-uptake inhibitors is well tolerated and provides patients with a high likelihood of achieving improved ejaculatory control within a few days of starting treatment, as well as improvements in sexual desire and other sexual functions.  Dapoxetine, a Premature ejaculation  -selective serotonin transport inhibitor, represents a significant advancement in sexual medicine. These medications provide patients with the convenience of on-demand dosage, considerable improvements in IELT, ejaculatory control, and sexual satisfaction; all while causing minimal side effects.| Premature Ejaculation Treatment

PHYSIOLOGY OF EJACULATION

Ejaculation is a reflex involving sensory receptors and areas, afferent routes, brain sensory areas, cerebral motor centers, spinal motor centers, and efferent pathways. Normal ante grade ejaculation involves three essential mechanisms: emission, ejection, and orgasm. Emission is the outcome of a sympathetic spinal cord reaction triggered by genital and/or cerebral erotic impulses, and it involves the contraction of accessory sexual organs sequentially. The degree of voluntary emission control gradually lowers until ejaculatory inevitability is reached. Ejection is also accompanied by a sympathetic spinal cord response over which the patient has little or no deliberate control. Closure of the bladder neck, rhythmic contractions of the bulb cavernous, bulbospongiosus, and other pelvic floor muscles, and relaxation of the external urinary sphincter are all required for ejection. Orgasm is the product of pudenda cerebral processing.

The ejaculatory reflex is primarily controlled by a complex interplay between central serotonergic and dopaminergic neurons, with cholinergic, adrenergic, nitrergic, oxytocinergic, galanergic, and GABAergic neurons also playing a role. The brain events that occur during ejaculation, as well as the abnormalities evident in men with PE, have not been well described using positron emission tomography (PET) and functional magnetic resonance imaging (FMRI). Several forebrain regions, notably the medial peptic area (MPOA) and the nucleus paragigantocellularis (nPGi), integrate seminal emission and ejection into the complicated pattern of copulatory behavior. Ejaculation is topically inhibited via descending serotonergic pathways from the nPGI to the lumbosacral motor nuclei. [3 The MPOA enhances ejaculation by inhibiting the nPGI. In male rats, a population of lumbar spin thalamic neurons (LSt cells) has been found.

PE DRUG TRIAL DESIGN

The results of PE drug clinical trials are only reliable, interpretable and capable of being generalized to patients with the disorder studied when conducted in well defined and consistent populations, differentiation of lifelong and acquired PE as separate PE subgroups, exclusion or treatment as a separate subgroup subjects with erectile dysfunction (ED) or other co-morbid sexual disorders, using a double-blind placebo controlled study design, and consistent objective physiological measures or sensitive, validated outcome assessment instruments as study endpoints. In PE studies, the study population should be well characterized, representative of the overall patient population and defined using a multivariate definition of PE. As the population of men with PE is not homogenous, lifelong and acquired PE should be treated as demographically and etiologically distinct disorders and analyses as separate PE subgroups. Subjects should be involved in a stable, monogamous heterosexual relationship, prepared to attempt intercourse on a regular basis and provide written informed consent. The presence of co morbid ED should be evaluated using a validated instrument such as the International Index of Erectile Function (IIEF) and patients with any degree of ED should be either excluded from the study or treated as a separate subgroup. Patients with hypoactive sexual desire or other sexual disorders, urogenital infection, major psychiatric disorders, a history of drug and alcohol abuse or contraindications to the study drug should be excluded from the study. Measurement of the intravaginal ejaculatory latency time (IELT) by stopwatch is the best method to diagnose PE and the response to treatment and should be used as a primary efficacy endpoint. Laboratory studies of ejaculatory dysfunction may be simplified by the use of the Sexual Assessment Monitor (SAM), an electronic data collector which comprises a vibrator to induce ejaculation and a sensor to measure time-to-erection and IELT by the detection of ejaculatory pulses, but the role of such devices in large at-home Phase III clinical trials is limited. Recent normative IELT data supports earlier suggestions by several authors that intravaginal ejaculatory latency times (IELTs) of less than 1 minute or less than 2 minutes be regarded as cut-points for inclusion in a clinical trial. Subjective patient reported outcomes (PROs) of ejaculatory control, sexual satisfaction and bother/distress are important additional efficacy endpoints and can be evaluated using validated patient reported outcome instruments. Research into the development of validated, reliable and consistent patient reported outcome measures is ongoing.

TREATMENT  :-

Best Premature Ejaculation Treatment in Delhi is performed by Dr. Vinod Raina

If You Have a Premature Ejaculation, Visit Dr. Raina's SAFE HANDS                        (Call: 7687878787)

How To Reach Dr Vinod Raina

To reach Dr. Vinod Raina, you can contact him on WhatsApp on his number 9871605858. You can also contact him on our official website:

https://www.bestsexologistindelhi.com/

Call us - 7687878787, 9871605858

Watch our video -

KEYWORD - Premature Ejaculation treatment in Delhi, Premature Ejaculation Treatment, Premature Ejaculation solution, Best treatment for Premature Ejaculation, Early Discharge Treatment in Delhi