Treatment of deeper psychological causes
As the fear of romantic success, fear of commitment, fear of intimacy, the ambivalence to the couple, requiring the strategies and expertise of a trained sex therapist.
Resources pharmacological
The search for the medicine that solves the problem is the aspiration of both the doctor and the man who comes to consultation. However, we must clarify that although there are drugs that slow squirting mirroring, no drug cures premature ejaculation. It is therefore a drug that handling on a temporary basis may be helpful for delaying ejaculation, but they have proved of little use unless it is integrated into a broader framework of sexological treatment. If we make an exclusive drug treatment for premature ejaculation, we run the risk of relapse, while having obtained an initial improvement in the situation, both for awareness and tolerance to the drug, such as, above all, by the persistence of untreated psychological factors.
In fact, an outstanding issue in the literature on drug treatment only for delaying orgasm is when and how to finish it. That should not discourage towards its use, although not to miss good resources is essential if drugs are used, integrate successfully into a sex therapy. However, some men, the least they can find a solution to the drug concerned when they find that they have a product that can take the day I want to be able to experience an increase in its latency squirting. In short, is the attentive interview which will detect if this is a man with these characteristics, which will be enough to recommend the drug for use situational.
Ejaculation delayed
This problem, much less common for premature ejaculation, is presented clinically as its antithesis. Although it is difficult for many of the boys as contemplated as a problem, as they are worried for their precocity, greater disorder that involves premature ejaculation. The man with delayed ejaculation is usually presented with an element of discomfort far greater than those suffering from premature ejaculation, and it is not unusual to get immersed in a query box incipient depressive. Delayed ejaculation is manifested with varying degrees of severity in each man. Some suffer feeling that they need to strive to get to ejaculate, remaining in doubt about whether it will succeed every time. For others it can never happen ejaculate with sexual intercourse, and even even before his partner, so that some do after masturbating. In more severe cases, the man comes to having no say never or almost never ejaculated. In the male homosexual can be manifested from retardation to ejaculate in the anal or oral intercourse, inability to ejaculate up with the couple, regardless of the type of sexual interaction maintained.
Diagnostic evaluation
As well as premature ejaculation at the beginning of the interview focusing our attention on determining the existence or not of true premature ejaculation, in the interview by ejaculation delayed diagnosis is usually easy and immediate. The distinction between organic or psychogenic etiology of squirting delay will be delayed further. If the delay is situational, ie, no show at all times when the subject ejaculate in their sexual relationships, something very common, has no problem when she masturbates, we can absolutely rule out the medical causes, as it relates to psychological reasons.
Organizational causes
Ejaculation delayed appears after a period of normality Squirting. In general is due to:
- Adverse effects of drugs that may become the treatment of the reverse problem (premature ejaculation). This is the case of psychotropic drugs; central depressants such as alcohol hypotensives alpha-blockers; antiandrogens.
- Neurological damage: spinal injuries (tumors, trauma, multiple sclerosis ...), interventions such as lumbar sympathectomy; neuropathies consistent with alcoholism, diabetes, uremia ...
Psychological Causes
The delay is usually squirting primary, that is, the more often the profile of a young man with obsessive personality traits, which always has been experiencing the delay or inability to ejaculate during intercourse or any form of sexual interaction. Among the psychological causes which lead to delayed ejaculation are behavioral mechanisms like self-observation obsessive or inordinate attention on the sexual partner; relational factors as the ambivalence toward the couple, and perhaps compared to women in general, or psychological causes more as a deep fear of intimacy, fear of compromise or conflict with the orientation of sexual desire, namely conflict of acceptance of homosexuality.
Treatment
Treatment depends on the severity of the table. When the orgasmic inhibition is not very severe and presents with any delays squirting, but the subject tends to ejaculate or does so after their own, usually enough to implement a systematic desensitization in vivo. Is to establish the man with a hierarchy of situations, from the least to the most dreaded ansiógena, usually intravaginal ejaculation. To do so, for example, he proposes to a man who gradually goes into having sex that will squirt the increasingly close to your partner: in the same house, in the same room, in physical contact with her, that is as she masturbates ... to verify that it is ready to experience intercourse without paralyzing anxiety levels.
Retrograde ejaculation
Not to expel foreign semen is not worrying as long as the patient knows who is due to retrograde ejaculation suffers It was well known to orgasm that does not produce an expulsion of semen to the outside due to reflux of ejaculated into the bladder. The removal of the prostate is the most common cause of this happening. The failure to expel foreign semen is not worrisome, provided that the patient is informed of what happens, so no wonder and fear, or doubt about whether the operation has left him impotent. Not ejaculate abroad is not an impotence, erection of the penis does not have to have been lost. In fact, the ejaculate is produced and, if observed under a microscope urine collection after feeling the orgasm, the sperm can be seen in it. Ultimately, the man orgasms and ejaculate, what happens is that there is abroad where the semen is ejected, but reflue his own bladder.
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