Sexual pain disorder

Vaginismus

Vaginismus is a sexual problem that causes much distress to the couple. When you go to consultation is baffled and does not understand what is happening. Adequate information and aid reassures, creating a good base for treatment. Vaginismus call to the extreme difficulty or inability to achieve vaginal penetration, due to the contraction of muscles that surround the entrance to the vagina. The spasm is an involuntary response that many women do not recognize, suffer its consequences, but they do not know why it happens. When a woman is sexually aroused experiencing a vaginal relaxation of muscles. In vaginismus, however, the muscle contracture is such that it prevents penetration.

It seems that there is an association of vaginal intercourse with a sense of danger, it is as if the defensive system was extremely active, so any attempt to produce this response reflects penetration. On many occasions, have no easy explanation for the woman who has it, because at the moment his desire and his ideas are to have a full and satisfactory coital. However, it is as if there was a warrant scheduled, an alarm system that enabled women can not control. The internalization of maternal and paternal mandates and follow strictly the social conventions in sexual matters may cause misalignments between what we want and what you can do. In addition, the rapid changes in sexual habits have led to that there is no correlation between what is done and what is allowed to be done, especially in adolescence and youth. This trend may create confusion and insecurity in sexual performance and result in a maladjusted as is vaginismus.

Some women are beginning to notice that something's going on in the penetration when menstruation in trying to get a tampon and realize that they do not succeed. That does not mean that all women who have difficulty in putting on a tampon toilet going to have problems in their sexual relationships, but if that difficulty is accompanied by irrational ideas on the penetration, anguish and fear, may be an indicator to consider. Vaginismus suffer it between 2% and 4% of women and comprises approximately 10% of sexual problems.

Women who have this disorder feel great anxiety at the thought of entering an object into the vagina, can not even try it with a finger or a tampon. In this way is developing a kind of fear of vaginal penetration and is presumed to be painful. Any attempt to penetrate the tense places, it seems to have a hypersensitivity to vaginal relaxation. This tension produces a response that has three typical signs: arqueamiento of the back (lordosis), closure of legs (contraction of the adductor muscles of the thighs) and involuntary spasms of muscles surrounding the vagina. In these circumstances, the penetration is very difficult. If the woman is lying on your back, as is customary in the first attempts to penetrate the entrance to the vagina is not in a position properly. Coupled with this, the tension in the thighs drives her to close her legs, it remains a movement of withdrawal, go crawling backwards, leaving the man paralyzed by a denial so physically forceful, but it leaves the mouth yes.

Attempts to scan gynecological also produce the same effect. The woman who was treated could not be recognized because his phobia prevents it. In some cases, the specialist who has failed to introduce the speculum may recommend an examination under anesthesia. As expected, is not found nothing abnormal in exploration because the contraction does not occur because women are unconscious. While the woman is asleep is introducing an expansion stems Hegar or any other instrument. When he wakes up is reassuring, explaining the intervention and saying that from now on there will be no problem. However, this procedure does not provide any results because the woman continues to show strength when it is conscious. We do not recommend this protocol, since it is not useful to rule out physical abnormalities and, moreover, vaginismus is quite reliable keys to the specialist can make a diagnosis on a positive basis without resorting to further tests to Interventions and much less aggressive than nothing We bring. Respect for the body must always be taken into account, especially in women who consult on this issue.

In sex therapy, especially in cases of vaginismus, it is very important educational work. These women have great ignorance of his body and the body of another, especially in the genitals. Furthermore, strict censorship of female sexuality has contributed to the lack of standardization in speech colloquial erógenas their areas. When the word penis was quite normal to us, of the vulva it was not so much. And they still are often used euphemisms or derogatory names to refer to this part of the body. Faced with that little or no sex education, the perception of one's genitals can be distorted. The vast majority of women who suffer from vaginismus are under the impression that her vagina is very small and its coming very close, so it is very difficult for the penis can enter. We also think that the vagina is closed by the hymen. The idea of this membrane is very confusing, even in women with a university education, despite the profusion of books explanatory. The hymen does not close the vagina of women and non-coats nothing. He is only the entrance of the vagina that ends in a membrane. Some people are very aware of the idea that something has to break, believe that the hymen is found in the vaginal canal. These beliefs about the hymen is found in postgraduate training courses in sexology, where students are graduates in medicine and psychology. This corroborates the limited information about female sexuality.

The hymen is a membrane that is at the entrance to the vagina. About membrane were so insignificant has created a multitude of literature, with many inaccuracies. First, it's not like a fabric that has to be broken, simply being at the entrance to the vagina. In some women, with the first penetrations entry is a bit bigger and sometimes it produces a small incision in the membrane and can leave a little blood, but the vagina is not sealed, by leaving her menstrual flow and other secretions . Nor is the hymen in the vagina, as a sort of wall. He is only the retreat of the post.

Treatment

In the treatment of vaginismus is very important that the couple understands that his case is not unique, but surmountable.

Dr. Simms was the first who described the syndrome in 1862, calling it vaginismus. Although at the time recommended surgical treatment, we now know that the cause of vaginismus is always a source of psychological and surgical interventions are a wrong treatment. Even so, it is still possible to find a specialist who, acting outside the scientific community, makes this type of intervention. The diagnosis of vaginismus can be done easily and their treatment is an example of integrative approach which covers the exploration of deep psychological reasons, the description of environmental and socio-educational work with the body and, of course, the relationship couple.

The couple of women with vaginismus

In vaginismus, as in other sexual problems, is a good prognostic factor that the couple go to consult together. The presence of the couple favored treatment in most cases. It is very important psychological support for the companion; analysis of the sexual myths; general information on sexuality and especially female sexuality. This information has to aboerdar so wide, with particular aspects and socio-emotional. Knowing the problem provides greater security and enhanced self-esteem, factors that favor a good prognosis. Thus, a companion secure, non-anxious and ready to test and accept the challenges and constraints, is an excellent partner in the treatment of vaginismus and support for your partner.

It should be noted that vaginismus is not a product of lack of information and can occur at any socioeconomic level: teachers, butchers, administrative, psychologists, journalists, lawyers and architects are the professions of some of the women treated with vaginismus. Though ostensibly looks like a very serious disorder, the scientific literature on the subject says it is a disorder that usually has a good prognosis.

Dyspareunia

Dyspareunia is the pain they can suffer, both men and women in the pelvic area during or shortly after the sexual relationship. The pain can be filed at the time of penetration, erection or ejaculation. If the pain persists, the person may lose interest in any sexual activity. It is important to note that to be successful intercourse must give the necessary physiological conditions. Both men and women have to be sufficiently stimulated and this means vaginal lubrication and erection of the penis. An indication that the man was carrying out a satisfactory relationship is the issue of the glands of the urethra by Cooper, a few drops of clear liquid that flows through the urinary meatus and acts as a natural lubricant. Women, meanwhile, note how the vagina is moistened. The pain can be felt during penetration or with the movements of the penis into the vagina, and it usually goes after a more or less long period of sex without problems.

Circumstantial causes of dyspareunia

Inadequate lubrication for erotic stimulation insufficient In these cases it is very important to enhance the stimulation with games and caresses. It is necessary for blood to flow in sexual organs to maintain a penile erection and lubricate the vagina.

Vaginal dryness

The vaginal mucosa loses its natural moisture. Often happens often with menopause. To facilitate the lubrication exist in pharmacies vaginal gels with soy isoflavones, with moisturizing properties and lubricants, which give a very good result.

Sex too soon after surgery or childbirth

In the case of childbirth is considered advisable to wait at least 6 weeks after the birth of the baby to restart sexual activity.

Genital irritation by soaps, detergents, showers or feminine hygiene products An effort to clean misunderstood can cause irritations frequent. It must be borne in mind that the vulva has its natural flow and its odor is distinctive and healthy.

Allergies to latex condoms or diaphragms

Causes of dyspareunia who need medical consultation Phimosis

Difficulty or impossibility for the retraction of the skin preputial, ie the skin that covers the tip or glans penis.

Frenulum

The frenulum is the small sheet of skin below the glans linking him with the foreskin. In an erect penis, if the frenulum is too short causes the foreskin will automatically slide forward and can cause pain, discomfort and injury.

Prostatitis

Inflammation of the prostate Endometriosis Endometriosis is a benign disease that affects women during their reproductive life. It occurs when endometrial cells, identical to their sisters who make up the endometrium (the tissue that is inside the uterus and is renewed every month after menstruation) outside the uterus, for example in the fallopian tubes, ovaries or anywhere in the abdominal cavity. Therefore outside of your site behave like their "sisters" on the inside of the uterus and evolve (proliferating and secreting) following the female hormone cycles. It is possible that the woman did not know you have endometriosis and only perceived to have pain during deep penetration. Hemorrhoids dilation of the veins of the venous plexus of the lining of the rectum or anus. Genital herpes, genital warts or other sexually transmitted diseases.

Vaginal infections

Infeccionesdel urinary tract, such as cystitis. It also must go to the doctor if you have other symptoms related to the painful, such as bleeding, genital lesions, irregular menstrual periods and discharge from the penis or vagina.

Causes that require consultation sexological

If no cause is found to justify the pain sexological consultation is recommended. In this therapy, it may be necessary to address the relationship, feelings of guilt, internal conflicts or unresolved feelings about mistreatment in the past, as history of sexual abuse or rape. It is estimated highly desirable that the patient or the patient go with your partner.

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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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Solutions

Knowledge of the body

First, to achieve orgasm depends on the knowledge that women have of their bodies and the skill that has developed for sexually aroused. Orgasm can be induced by erotic genital stimulation and not genital. There are women who can orgasm by caressing the breasts. Others relate orgasms during sleep. The whole area of the clitoris and the anterior vaginal wall are areas of high excitability.

Adequate conditions

Sexual arousal is influenced by the physical condition: fatigue, illness, convalescence; mood: fatigue, distraction, anger, concerns and other factors are undoubtedly important as hormone levels, making contraceptives, age, or the use of drugs. Also the specific situation determines the ability to feel pleasure. The first experiments in cars or in stressful situations, such as those who have to live so many young people, are hardly suitable for beginners to satisfactorily in sexual pleasure. Both for them and for them. Self-esteem and self - It is important to the ability to feel comfortable with it. A large number of women feel dissatisfied with any part of your body and often those concerns influence how to meet them, in general, and as sexual beings, in particular. Learning to read and to have influence over one's body lets start enjoying the sex of the richness of sensory and emotional experience that can provide. This means becoming a very responsible for their own sexuality.

Attitudes to sexuality

The values related to sexuality and emotional transmitted in the family environment can influence one's attitude toward sex. It is common for women to grow in a society (as is the traditional western and much of the so-called third world countries) in which the model of sexuality is not respectful of women. In some cases, the mother and respectable women appear as asexual beings, if not clearly antisexuales.

Sexual history and loving

The feelings about current or past relationships, both emotionally and sexually, influence the orgasmic experience. Women with difficulty to feel orgasms have had sexual experiences or unpleasant little stimulant. Have been able to live unhappy love affairs, so that they fear being let go and dependent on the person with whom you share sexual pleasure, and that it leaves them and make them suffer. The feelings about the past or present relationships, both emotional or sexual, influence the orgasmic experience

Model improper sexual relationship

Another frequent cause of Anorgasmia are the patterns of inappropriate sexual relationship. The model of relationship where there is little caresses and no preamble makes it difficult for women is sufficiently excited to have an orgasm. On the other hand, that kind of encounter ends when men ejaculate, which is usually very soon, especially if there has been no preamble. So it is very difficult, almost impossible, for women having an orgasm in that scene. In this situation the woman is often at the beginning of the relationship, confused, frustrated, uncomfortable and tense. And over time, if you have not been able to change the picture, the accumulation of frustration coupled with the resignation takes her wish that he finished as soon as possible and not bother the most. Over time, this Anorgasmia becomes so hopeless in lack of desire.

Fears

They are so varied that everyone can add his own, and are very effective in inhibiting the pleasure and block the response. The fear of pregnancy, fear of being caught, fear of pain, mistrust to the couple, particularly at the early-relationship, afraid to look bad, shame ...

Learning to have orgasms

Learning to have orgasms or take them more easily is just one part of a process of evolution that sexual extends throughout life. Knowing one's own body and its reactions to help calm down, but knowing what's wrong or the cause that leads to the difficulty in reaching orgasm is not enough to bring about change. This change is an active process that involves, among other things, made a very responsible for their own sexuality. The sexual growth and cultivation of a form of sexual expression more pleasant, with or without a partner, they have to start with the knowledge of the same. The treatment of orgasm is designed to intervene in cases that have difficulty orgasmic. Much of the Anorgasmia have to do with the body's ignorance and lack of ability of women to provide stimulation, so that masturbation is very effective for direct treatment. The majority of women do not orgasm usually do not have other sexual problems and lack of orgasm is the result of little or no sex education for the pleasure. Therefore, the self helps women who have difficulties or are unable to achieve orgasm.

Premature ejaculation

Along with erectile dysfunction, premature ejaculation (PE) is the male complaint of a sexual nature more frequent in consultation sexological. Data collected by Carrobles and Sanz (1991) show that the prevalence varies according to authors, between 15% and 40% of the male population. However, it has been noticed that in recent years, the incidence decreases. In what we call premature ejaculation. There is talk of premature ejaculation when a response before squirting a minimal sexual stimulation before, during or shortly after penetration, and before the person you want, but at that point must be borne in mind that some men, partly because of limited information appropriate sex, they have unrealistic expectations about the response squirting male. The reference models that offer pornography is as unrealistic as some novels of romantic love.

In response squirting must take into account factors influencing the duration of phase excitation, such as age, is not the same as the response of a young, much-faster-novelty to a new partner is usually add the own nervousness of the situation, with increasing excitement at the novelty of the stimulus, or the lack of practice time if you do not have had sex, the threshold of excitation can be so sensitive that it can trigger a response inversely proportional to win that has the man to "get well" and enjoy the moment. It is therefore very important to consider that a rapid response, including ultra-fast in those circumstances, it is simply a response commensurate with the circumstances and not a sexual problem. However, many men feel insecure in their physiological response, particularly by the false belief that when men ejaculate ends the act of love. The linking of sex with an exclusive reproduction is responsible for this misunderstanding. If a man has ejaculated seems to continue the meeting makes no sense. This false belief has done much harm to the relationship, focusing on loving encounter on an exclusive and introducing coitus in its final ejaculation in men.

Data from Kinsey

In our culture, at least not until many years ago, the idea of pleasure was something unique to the male and female sexuality was denied. In that context, worry about early ejaculation was insopechable. In fact, in 1948 Kinsey found that three quarters of married men who believed in the ejaculate that used the first two minutes after vaginal penetration.

Definition of Masters and Johnson

In 1966, Masters and Johnson define premature ejaculation as the "inability to delay squirting mirroring during the penetration long enough to satisfy your partner in 50% of the experience of intercourse." This assertion reflects a subtle change in the point of view: "the pleasure of women is a thing of men."

Occurs widely in society and the recognition of female sexuality. While retaining the role of men as responsible for the orgasm of women, paradoxically star of the performance makes him defenseless victim. It is the era in which they say phrases like "no women frígidas but inexperienced men." It opens the door to legions of men feel guilty, dysfunctional, in sum sick because your partner does not reach orgasm during intercourse and, even more terrible call, do not do this simultaneously with them.

Other definitions

Followed proposed definitions of premature ejaculation based on quantitative criteria of minimum. It was estimated the minimum duration of intercourse, which was to range between 30 seconds and 2 minutes, or the number of intra preeyaculatorios pelvic movements, which should be between 3 to 5 minimum to rule out early. All these attempts to objectify a definition of premature ejaculation have been sterile and sometimes even have contributed to generate dissatisfaction and frustration in much of the population.

Contributions of Kaplan

In 1974 Kaplan received a key to premature ejaculation was the lack of awareness of the erotic sensations once the subject is intensely excited. Then defined as those early ejaculation in which "the man is unable to exert voluntary control over your reflection ejaculated, with the result that after being sexually excited very quickly reaches orgasm." This definition implies that "the pleasure of men is a thing of the man."

Though comprises an achievement to point out that in the sexual pleasure itself is personal responsibility of each individual involved. This definition has been interpreted so confused by many health professionals as a description of quantitative ceilings. Thus, it is still possible to find professionals who say that the duration of intercourse should be all that man wants, and not being so, this is an early ejaculated. Again this is the paradoxical figure of the healer as a generator of anxiety and discomfort. Psychological factors are most frequent in the suffering of premature ejaculation, on learning of abnormal sexuality, for anxiety or fear Kaplan, the same work in 1974, contributing to the evolution of the concept of early unintentionally in a direct way when he says, referring to female sexuality, that the fact of not having vaginal orgasms might represent "a normal variant of female sexuality ".

Both women and men can relax, and hence, to be closer to the non-pleasure of feeling the pressure of an often frustrating requirement of female orgasm coital. Ultimately, it remains useful to the definition of Kaplan, "orgasm or ejaculation before the person you want," but adding, as a clarifier nuance, something that Kaplan had to clarify itself in a text devoted to premature ejaculation (Kaplan, 1990). Thus, as of early diagnostic codes used the phrase "Man with the absence of a reasonable control of their reflection squirting." With "reasonable" to emphasize that this is a problem pluricausal, so that should be taken into account in each case, the factors that may be an impact on the earliness of the response. With all these considerations, premature ejaculation is a sexual problem that usually has a very favorable prognosis, especially in young men. It's very rare that the organic component is relevant. The vast majority of cases are primary and respond to psychological causes. A good portion of the cases of premature ejaculation can be resolved or improved significantly with proper intervention sexological.

Psychological factors

Psychological factors are, without doubt, the most frequent.

As noted, it is not unusual in young people, but with time many are learning to make a reasonable control over their ejaculation. Some of the most common psychological factors are:

Learning anomalous

Are frequent stories of masturbation early followed by guilt; antisexuales messages in childhood or inflated expectations. Occasionally you have had early sexual experiences problems with prostitutes or in situations where the rapidity in intercourse has been the pattern.

Anxiety

By having an anxious personality. In some cases, premature ejaculation is given by a significant degree of anxiety himself as a person anxious.

Associated with sexual behavior

When anxiety is associated with sexual behavior may appear premature ejaculation. It is very common in young people the insecurity early in the sexual role, especially the lower self-esteem. Feed anxiety, feelings of shame or guilt after the repeated experience of precocity. It's a common mistake to think that can be resolved anxiolytica with premature ejaculation or local anesthetics (associated with condom, gel, cream, etc.).

Some men use distracting thoughts or even self to distract attention. These practices are absolutely contraindicated and start from the wrong approach, because the sexual activity requires activation of the general. To the extent that man is going to relax or diminish their sensory perception, is far from an effective provision to sexual pleasure. Sex requires activation in our central nervous system of circuits linked to pleasure and not linked to the stress or anxiety, whose start-up interferes in the first. This happens in some cases where the fear has just derailed early experience into something worse, erectile dysfunction.

Fear

Fear mobilizes anxiety.

ny form of fear that is associated at the time of the sexual experience can act early advocate. Can be profound fears, the commitment to privacy, or just the fear of re-experience early, which often leads him to become its own viewer, auto discussed since early in the game sex, so that, unintentionally, Derailments in anxiety for the performance instead of pleasure. Sometimes, fear plays a significant role inhibitor that can lead to avoidance of sexual encounters with the suffering they may pose.

Factors organic

The causes are turned off by organizational problems among all men affected by premature ejaculation. These are neurological or urological problems. They are usually given when premature ejaculation is secondary, that is, arises after a period of normalcy, understood as a reasonable control of squirting. In these cases may be due to the presence of infectious and inflammatory processes in the prostate and / or urethra. Also neuropathies affecting the orgasmic reflex, peripheral, in spinal cord or universities can be causes of boxes "incontinence squirting" secondary, which is found in multiple sclerosis or other degenerative neurological disorders.

Treatment

We will expose the resources used in general in the sex therapy for premature ejaculation problems. Improve the communication of the couple Have a proper place for sexual relations, in time for privacy and control concept of the event, allowing improving the pace of ejaculation The couple is affected when this is premature ejaculation. It is important to address the malaise of the couple, so often did not interview the man only dysfunctional. The mere mention both in consultation to discuss their concerns often exert a powerful effect that leads to improvement of its communication. Other aspects that the interview with both partners allows exploring and could be decisive for the intervention is the vulnerability of man's attitude towards the couple and, in short, the situation of the same: from more or less an accomplice to degrees Major hostility and conflict, in which the concern about a precocious allows them not to confront the real issues between them. All this while most elementary aspects in appearance, such as the provision of a suitable place for sex, provision of time for intimate as lovers, the fear of pregnancy or the decision on contraceptive method to use.

Behavioral prescriptions

A technical resource frequent intervention with sexual dysfunction, also with premature ejaculation, the call is focalising sensory. These exercises are usually correct errors in dropping the couple dysfunctional, as the game erotic restricted and the avoidance of sexual relations. In essence is to launch a program to caress in the privacy, aimed at the couple discovered that key to solving the problem.

This program usually include information such as: In the early stages, usually forbidden intercourse, to remove the source of anxiety in the sexual partner. In its place are proposing, by way of games, forms of close physical progressing in terms of the genitalia to behave. Always depending on the case, techniques such as stop-start. Like the man has been able to do alone, when it is stimulated by her partner, you must tell when you notice that it has approached the point of no return, and this will stop the stimulation. This is repeated several times until it frees ejaculation.

Clamping

A variant more severe and rarely needed is to stop the stimulation and also clamping the glans, thereby dramatically interrupted the progress of excitement. In a state of erection, clamping a maneuver is not painful when done in an appropriate manner. The technique of stop-start often referred to offer equivalent results.

Paradoxical prescriptions

On one occasion, faced with a precocious recalcitrant males, and always be their partner agrees, which is prescribed along a given time, one week, for example, be as early as possible. This kind of prescription can be raised in an appropriate way to unlock and dramatically advancing the clinical situation.

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