Also a man who has maintained grade A with the wife might be graded F by the secretary if examined under the tense office melleu.
Thus we can achieve objectivity in diagnosis for premature ejaculation by using the DSM-5 Criteria.
-Experience of ejaculation in less than 1 minute of vaginal penetration and before the individual wishes it in 75%-100% of sexual encounters.
-The symptoms above have continued for not less than 6 months.
-The symptoms above cause significant distress to the individual.
-The dysfunction cannot be better elucidated by non-sexual mental disorder, a medical condition, the effects of a drug or medication.
Classifications of premature ejaculation
This can be classified based on severity:
Mild: 30 seconds- 1 minute of vaginal penetration.
Moderate: 15 seconds-30 seconds of vaginal penetration.
Severe: occurring before sex or within 15 seconds of vaginal penetration.
Duration
This can be:
Lifelong: present since first sexual exposure
Acquired: developing after a period of normal sexual functioning.
Context of occurrence
Generalized: Not limited to kinds of stimulations, conditions or partners.
Situational: Limited to specific type of titillations, situation and partners.
Cause
It is believed to be psychological. Acquired form is however associated with erectile dysfunction, performance anxiety, psychotropic, drug use, depression or associated medical conditions.
Management
It usually involves both partners and can be pharmacologic or non-pharmacologic.
Non-pharmacologic
-Sex therapy, for example, stop and start, squeeze and pause techniques.
-Second attempt at coitus.
Pharmacologic
-Topical desensitizing agent such as lidocaine and prilocaine
-Phosphodiesterase type 5 (PDE5) inhibitor therapy i.e sidenatil and tadalatil.
-Selective serotonine reuptake inhibitor (SSRI) i.e paroxetin, serotonine, dapoxetin, fluoxetin and citalopram.
-Other agents such as tramadol and pindolol.
Essential update
Computed tomography percutaneous unilateral cryoablation of the dorsal penile nerve appears to be a safe and effective treatment of premature ejaculation. It has been found to increase intra vaginal ejaculation time from 54.7 seconds-256 seconds. This method is still under research.