1) Management of premature ejaculation   

This is a particularly frequent ejaculation disorder.

It is defined as ejaculation that occurs too early to allow for full pleasure.

An organic cause is always sought : preputial anomaly, short frenulum, local irritation …

This disorder can be managed by the patient, with the help of his partner, who controls his ejaculation through several inhibitory reflexes, using a simple, systematic, sequential method that is usually effective.

Local treatment is only required in rare cases. Exceptionally, in the event of failure of rehabilitation and local treatment, oral treatment may be necessary (serotonin-reuptake inhibitors), although it remains controversial as premature ejaculation re-appears at the end of treatment, and the side effects are not negligeable. Indeed, the real goal of treatment is to learn to control one’s ejaculation.  Stress management techniques to control pyschogenic factors (over emotionality, instability, …) and to develop one’s full potential should also be proposed.
Learning this CONTROL is fundamental to preserve one’s full energy, vitality and reinforce the immune system.
Finally, it is worth noting that in the profile of premature ejaculation, the whole personality often confirms a propensity to be « quick » in numerous areas of daily life.
The people concerned by premature ejaculation should pinpoint tendencies to « hurry » (when eating, walking, finishing…etc) as it is a mental process that requires re-training.

2) Delayed ejaculation and anejaculation

While premature ejaculation is a well-known sexual disorder, delayed ejaculation has not been so extensively studied. However, this disorder may give rise to real, intense psychological suffering.

One of the main causes of delayed ejaculation, or the inability to ejaculate, is certain medicinal drugs (neuroleptics, …) or toxic substances like alcohol or certain soft drugs (hashish…). Retrograde ejaculation linked to surgery of the bladder neck or neurological disorders will have first been ruled out. This is the job of the andrologist.

From a psychogenic stance, insufficient arousal vis-à-vis the partner may suffice Let us underscore, however, that sexual appetite is an individual matter and is not linked to a given pathology (approximately one out of ten men, according to experts, is little or not interested in sex). Arousal may be impaired by negative emotions, like fear of intimacy, stress, or fear of being judged by the partner, not to mention sliding into a daily routine in the case of older couples.

The masturbation technique learned as a teenager can play a very important role as men often desribe a stimulation of their penis that does not match the feelings of penetration. Sex at an overly early age and watching too many pornographic films have also been incriminated.

Finally, difficulties ejaculating, or the absence of ejaculation, just like erectile dysfunction, are often the result of a lack of desire.

In any event, a physical evaluation by an andrologist and sexological treatment by a sex therapist will be envisaged.