Premature Ejaculation seems to be a neurobiological problem that is related to low serotonin levels in those regions of the central nervous system that regulate ejaculation (brain and spinal cord). In this infographic we try to answer the questions "What happens in Premature Ejaculation (PE)", "What are the features of PE?", |How many types there are" and finally "Can a man with PE be helped"

1. PREMATURE
EJACULATION
It is good
to… have
control!
1
EJACULATION
}
1
BRAIN
Ejaculation is
the outcome of sexual
arousal and, normally,
occurs simultaneously
with orgasm.
It is induced by nerve
stimulation, resulting
in the expulsion
of semen from the
outer urethral orifice.
}
}
3
2
SPINAL
CORD
PERIPHERAL
NERVES
BRAIN
2
SPINAL
CORD
SOURCE: Dawson, S. Et al.
Journal of Sexual Medicine.
(2013) Jannsen E et al. Journal
of Sex Research (2000);1:8-23
PERIPHERAL
NERVES
WHAT HAPPENS IN
PREMATURE EJACULATION?
CULMINATION
S T I M U L A T I O N
ORGASM!
AROUSAL
PREMATURE
EJACULATION
NORMAL
RESPONSE
T I M E
3
SOURCE: Donatucci CF: J Sex Med 2006;3:303-308
FEATURES OF PREMATURE EJACULATION
}
There are 2 different types of
Premature Ejaculation:
In PRIMARY PE- the most
common typethe problem has been present
from the very beginning of the
man’s sexual life.
In some rare cases, PE may occur
suddenly at some point during
man’s life –SECONDARY PE
9
10
}
out of
men ejaculate
within 1’
after vaginal penetration
1
SOURCE: Porst H, et al. Eur Urol. 2007,51:816-823
4
1
out of
5
men
presents PE
irrespective
of age
CONSEQUENCES
OF PREMATURE
EJACULATION
Premature Ejaculation
is not just a «time
problem»;
it mainly has
to do with
the man’s
control over
ejaculation
and sexual
satisfaction.
PREMATURE EJACULATION CAUSES
EMBARRASSMENT AND ANXIETY.
With the lapse of time, PE causes
disappointment that leads to
avoidance of sexual and emotional
intimacy. In addition, problems often
arise in the couple’s relationship and their
quality of life is significantly reduced.
SOURCE: Porst H, et al. Eur Urol. 2007,51:816-823
Waldinger M, et al. Int J Psychiat Clin Pract 1998, 2: 287-293
5
Onset time of problem
(PRIMARY or SECONDARY)
DIAGNOSIS
Duration of problem
Occasional
or permanent?
Time until ejaculation
Impact on relationship
and sexual life
Disorders/Diseases
Medications
Evaluation through
special questionnaires
SOURCE:
Hatzimouratidis K et al: Eur Urol. 2010;57:804-14
AETIOLOGY
PRIMARY
Being too «hasty»
Anxiety
Hypersensitivity
of the glans
Disorder of serotonin
receptors
in the brain
AETIOLOGY
SECONDARY
6
SECONDARY
Treatment of Erectile
Dysfunction
Treatment of diseases related
to Premature Ejaculation
Combination of Pharmacotherapy & Sex
PRIMARY
Therapy
Pharmacotherapy
Relationship Counselling
Behavioral/
Sex Therapy
Combination
of Pharmacotherapy
& Sex Therapy
Erectile Dysfunction
Hyperthyroidism
Chronic prostatic inflammatory diseases
Neurologic diseases
Drug side-effects
THERAPY
SOURCE:
Hatzimouratidis K et al: Eur Urol. 2010;57:804-14
7
THERAPY
PHARMACOTHERAPY
Self-help therapies and online
/Internet purchase of preparations
are not effective and have
unknown side-effects.
Local application of anaesthetics
on the penis before intercourse
is not practical and brings poor results.
Oral Pharmacotherapy (Daxopetine)
increases levels of serotonin,
which is a substance in the brain
and spinal cord participating in the
control over ejaculation.
1.
2.
3.
It acts within 1 hour and
increases X 4 times time
until ejaculation
It is combined with psychosexual
therapy for optimal results
It increases the couple’s sexual
satisfaction
SOURCE: McMahon et al. J Sex Med 2011;8:524-539
8
PSYCHOSEXUAL
THERAPY
SOURCE:
Rowland D, Cooper S:
J Sex Med. 2011;8
(S4):342-52.
The man or couple practise
some exercises that help
to increase the man’s control
over ejaculation
9
Exercises are performed at home,
while periodically the Expert
evalutates their progress until
reaching the desirable target.
They follow an exercise
program, according
to their needs
Classical exercises include
the «stop-start» technique
with or without the use
of vibrator devices.
THERAPEUTIC
TARGETS
Better control
over ejaculation
Improvement
of emotional
intimacy
Higher
self-confidence
Better
sexual
satisfaction
SOURCE: Porst H, et.al. Eur Urol. 2007;3:816-23, Althof SE et al: J Sex Med 2013;10:26–35.
Visit
www.imop.gr
and get informed on SEXUAL
PROBLEMS and their solutions
www.facebook.com/imop.gr
youtube.com/imopgr
www.twitter.com/imop.gr
gplus.to/imop
linkedin.com/in/imop.gr