Ejaculation Problem

Lovelyn S. Bico

Premature Ejaculation j(PE) is an inability to control the ejaculatory reflex. premature climax. Also known as rapid ejaculation. rapid climax. in more than fifty percent of their sexual encounters. . Other sex researchers have defined premature ejaculation as occurring if the man ejaculates within two minutes of penetration. j PE defines as the condition in which a man ejaculates before his sex partner achieves orgasm. or early ejaculation.

unrealistic expectations about performance. or an overall lack of confidence. stress over financial matters. or unresolved conflicts that interfere with the ability to achieve emotional intimacy . and premature ejaculation can be caused by a lack of communication between partners. Interpersonal dynamics strongly contribute to sexual function. hurt feelings.Possible psychological and environmental factors j Psychological factors : Premature ejaculation can be caused by temporary depression. a history of sexual repression.

jPhysical factors Science of mechanism of ejaculation The physical process of ejaculation requires two sequential actions: emission and expulsion. .

Mechanism of Ejaculation .

j In one study. ninety-one percent of men who have had premature ejaculation for their entire lives also had a first-relative with lifelong premature ejaculation. Other researchers have noted that men who have premature ejaculation have a faster neurological response in the pelvic muscles .

Other ejaculation disorder types j Delayed ejaculation .Semen flows from the prostate gland into the bladder rather than exiting out of the penis. j Inhibited orgasm in males .Ejaculation takes a long time j Retrograde ejaculation .

various medications are being tested to help slow down the speed of the arousal response.Treatment j Treatments are focused on gradually training and improving mental habituation to sex and physical development of stimulation control. In clinical cases. j Treatment modalities depend upon the nature and severity of the ejaculation problem such as behavioral therapies. Performing routines such as Kegel exercises. j Another method is that of control instead of prevention. .

Zoloft. The drug has the added benefit of also improving erection quality in some patients. Examples include Prozac. and Lexapro. . such as SSRI (Selective Serotonin Reuptake Inhibitors). j Tramadol has been shown to be effective in delaying ejaculation. Celexa. can delay ejaculation. j Clomipramine often helps with serious cases that are related to the central nervous system. SSRIs are commonly used as anti-depressants. Clinical trials indicate that Paroxetine gives the largest increase in intravaginal ejaculation latency time.Medications j Serotonergic medications.

Priapism .

within four hours. despite the absence of both physical and psychological stimulation.j Priapism is a potentially harmful and painful medical condition in which the erect penis or clitoris does not return to its flaccid state. .

and other conditions such as leukemia. especially sickle-cell disease. . and neurologic disorders such as spinal cord lesions and spinal cord trauma. and Fabry's disease. thalassemia.Causes j The causative mechanisms are poorly understood but involve complex neurological and vascular factors. Priapism may be associated with haematological disorders.

antipsychotics (e. anticoagulants. Other groups reported are antihypertensives. chlorpromazine. . clozapine). antidepressants (most notably trazodone). The most common medications that cause priapism are intracavernous injections for treatment of erectile dysfunction (papaverine.j Priapism can also be caused by reactions to medications. cantharides and recreational drugs (alcohol and cocaine). alprostadil)..g.

Assessment j Erection is harder than normal. j Discoloration of the Penis j Penile pain j Urinary retention j Bladder retention Nursing Management j Analgesic. icepack j Sedation. hydration and surgery j Discuss concerns and prognosis with his sexual partner .

which could necessitate penis removal. . clotting of the blood retained in the penis (thrombosis).Complications j Potential complications include ischemia. the ischemia may result in gangrene. In serious cases. and damage to the blood vessels of the penis which may result in an impaired erectile function or impotence.

as phenylephrine can cause severe hypertension. This should only be performed by a trained urologist. . Otherwise. the therapy at this stage is to aspirate blood from the corpus cavernosum under local anaesthetic. bradycardia. tachycardia. and arrhythmia.Treatment j Medical advice should be sought immediately for cases of erection beyond four hours. Orally administered pseudoephedrine may be effective. with the patient under constant hemodynamic monitoring. If this is still insufficient. then intracavernosal injections of phenylephrine are administered.

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