The Most Widespread Type of Sexual Dysfunction, according to the International Society for Sexual Medicine, is premature ejaculation, a disorder considered the most widespread form of sexual dysfunction in men, and it represents a huge neural and psychological burden to the man. It also causes depression for the woman, and it may lead to lack of desire and to avoiding intercourse for fear of not reaching satisfaction. In addition, a large percentage of newly married young men are suffering from premature ejaculation, and this problem can go on for many years.
This disorder is characterized by early ejaculation that occurs in all or most of the sexual intercourse before or after 1 minute of penetration, without ability to delay ejaculation in all or most of the sexual acts. And these symptoms are accompanied by negative social and psychological effects on the man, such as nuisance and depression, which may lead to avoiding the intimate relationship.
Based on studies and medical reports, premature ejaculation disorder is the most common form of sexual dysfunction, where presentation rates are estimated at about 39% in men aged between 18 and 64 years, and, unlike other sexual dysfunction types (e.g., erectile dysfunction), it is not related to the patient’s age.
Causes of the disorder
The most important causes of premature ejaculation are genetic, physiological, and psychological causes.
The physiological causes include the following:
1- Imbalance in the male hormone (testosterone).
2- Side effects of using some drugs like blood pressure lowering drugs and as one of the symptoms of withdrawing some drugs that treat psychological and mental health problems.
3- Increase in the discharges of the thyroid gland (50% of men infected with excessive thyroid gland discharges are presented with premature ejaculation).
4- Chronic prostate inflammation (77% of men having chronic prostate inflammations are suffering from premature ejaculation.
Meanwhile, the psychological causes include the following:
Depression, excessive anxiety that is related to sexual performance, and being sexually assaulted at a young age.
From a medical perspective, premature ejaculation is divided into two types:
First type: the man experiences it from the first sexual intercourse and it continues henceforth, and it is believed that among its most important causes are the hormonal and neural disorders as well as genetic imbalance.
Second type: The man presents the disorder in a late stage in his sexual life (i.e., after a normal previous relationship) and it is believed that its most important causes include psychological problems and prostate inflammations.
The disorder’s negative effects
The premature ejaculation disorder differs than other disorders in that its negative effects are not limited to the man only but it also extends to the wife, which puts the marital relationship at risk. The most important negative effects are as follows:
1- Decreasing self-esteem in the patient who loses confidence in his sexual ability, and the man may seek to end the relationship as a kind of running away from this condition or making problems to avoid feeling failure, and this disorders can prevent young men from seeking marriage.
2- Worry and anxiety which are reflected in the man’s dealings not just with his wife but with all those around him.
3- With regard to the wife, she feels worry and isolation towards inexplicable behaviors from the husband of moving away from her, and lack of self-confidence may extend to her as she feels that her husband no longer wants her or that he may be in a relationship with another woman.
Treatment methods ” Sexual Dysfunction “
There are three types of treatment
Psychological treatment: In this treatment, the focus is on resolving difficulties pertaining to the marital relationship by helping spouses speak about their problems especially those related to sexual satisfaction, and this kind of treatment also help the man to be less worried about his sexual performance.
Behavioral treatment: This kind of treatment depends on the man’s ability to control ejaculation through utilizing some techniques and exercises designed for this purpose, such as the technique of stopping and then restarting and the technique of pressing the penis, but this kind of treatment depends on the cooperation of the partner (the wife) which in some cases can be hard to take place in our conservative societies.
Nonspecific beneficial side effects drugs: in the beginning we must clarify that most used medications are not prescribed to treat premature ejaculation, but they are used to benefit from their side effects which is delaying ejaculation, and this is why they are not entirely safe.
These drugs include the following:
1- Creams and local anesthetics: here it is supposed that the cause of premature ejaculation is “excessive sensitivity of the penis” and this supposition has led to the use of local anesthetic to delay ejaculation since the 40s of the previous century, and, despite the effectiveness of using the local anesthetic, oftentimes some side effects are detected in case they are used to cure premature ejaculation, such as numbness in the penis, numbness in the partner’s genitals, and skin irritation which can lead to weakness in erection.
2- Antidepressants: they are used nowadays to treat premature ejaculation, as one of its positive side effects is delaying ejaculation. Since these drugs are primarily made to treat depression they have some characteristics such as slow absorption and prolonged medical effect and they are slow to leave the body, which leads to severe side effects in case they are used to cure premature ejaculation, such as dizziness, vomiting, headache, delusion, suicidal thinking, and other side effects that are withdrawal symptoms when attempting to stop them after using them continuously for a long time, such as dizziness, sensual disorders, sleeping disorders, worry, headache, irritation, vomit, shaking, confusion, sweat, emotional instability, visual complications, heart beats, and diarrhea and not only that but also its prolonged use can lead to negative effects on the sexual health such as weak erections and/or losing the sexual drive.
Modern drugs
The Saudi Food and Drug Authority (SFDA) has recently uncovered registering of a medication to be used in KSA to treat male premature ejaculation that is called Lejam, and it is now on the list of registered drugs in the Authority’s website. This is after the medicine has been evaluated in terms of safety and effectiveness and quality, and it is considered a specifically approved indicated drug, whose registration unmasks new therapeutic solutions in the Saudi market and for Saudi families to rebuild trust with a cure far away from the antidepressants, as well as sprays and anesthetic local creams, which have side effects and do not present an objective solution to the problem.
As we previously clarified, most of the medications used to treat premature ejaculation are nonregistered drugs for premature ejaculation.
Lejam contains the dapoxetine drug which has the following characteristics:
1- Some characteristics differ than the other drugs in terms of quickness of absorption, shortness of effect, and quickness in getting out of the body and this is why it has been approved by international health organizations as the first treatment for premature ejaculation.
2- Dapoxetine was found to be highly effective from the first dose and it elongates the intercourse duration 3 or 4 times, and due to its quick absorption, it can be taken when needed 1 or 1.5 hours before intercourse, and it can also be taken with or without food.
3- Dapoxetine can be taken side by side with impotence medications as there are conflicting results or increase in side effects.
As for the side effects for dapoxetine, they are limited, such as headache, dizziness, or vomit, and usually these symptoms have mild-to-moderate severity, and they can be overcome by taking the drug along with food or a full cup of water.
Dapoxetine is available as pills with 30 or 60 mg concentration, and it is recommended to start with the smaller dose of 30 mg which extends the period of the intercourse 3-fold, and in case wanting to increase the period length it is recommended to take 60 mg which increases the intercourse length 4-fold.
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