Premature ejaculation?... Less therapy and more pills

Summer is a good time to improve the 'annual average' of sexual relations. You always have more time, less stress and there is usually more opportunity.

There are millions of people in our country who suffer from problems in controlling their ejaculation. Many men and their partners suffer 'in silence', and there are still few who are encouraged to seek medical help.

Exact figures are hard to pin down, but a sizeable proportion of men have premature ejaculation, as prevalence estimates have ranged from 3% to 20%, depending on the definition used. 

According to best sexologist in Delhi less than a minute time from penetration to ejaculation – results in a prevalence of 2% to 5%. But it is no less true that many men complain not only about the weather but, above all, about the lack of control; that is, not being able to decide when to ejaculate.

Classically, we had always considered that the so-called combined therapy, based on psychological (behavioral) treatment plus drugs, showed the best results.

Recently, the 'guru' of good medical practice, the ' Cochrane Library ' has published a review study in which it analyzes the value of psychological treatment with negative results regarding its efficacy.

According to the top sexologist in Delhi, behavioral therapy for premature ejaculation has little evidence to support its continued use. A few published studies showed "weak and inconsistent evidence" that psychological treatments improve any important endpoints related to premature ejaculation.

It is noteworthy that the results do not resemble the 97.8% success rate for psychological intervention published by Masters and Johnson, pioneer sex researchers in this field.

"We have to do more to show that it works," said Dr. P K Gupta, sexologist in Delhi, in a statement. The review included four studies with a total of 253 patients.

The causes of premature ejaculation remain poorly understood and possible explanations range from psychosomatic manifestations of anxiety to dysfunctional neurotransmitter signaling in the brain.

The neurotransmitter theory is the basis of pill treatment, using selective serotonin reuptake inhibitors (SSRIs), which modulate the 5-HT signal. 

Masters and Johnson defended the 'squeeze technique' (which requires the man's sexual partner to squeeze the base of the penis several times to delay ejaculation), possibly leading to increased latency. People who completed a two-week program with this technique solved the problem almost 100% (Human sexual inadequacy, Little Brown, 1970), according to data from these researchers.

In summary, the authors of this study concluded: "The vast majority of published results did not reach statistical significance, thus the clinical efficacy of the few included studies is questionable."

In any case, although we do not doubt the analytical accuracy of Evidence-Based Medicine reviews, good medical judgment, based on theoretical knowledge and experience, should always prevail. Undoubtedly, in this problem the old medical aphorism is more evident than ever, “there are no diseases but sick people” and both psychological and pills premature ejaculation treatment in Delhi have their place and must be applied in each specific case, suggests best sexologist in India.