Mental well-being and prevention of sexually transmitted diseases in patients with premature ejaculation: Analyzing six psychological causes, four behavioral therapies, and prevention strategies for premature ejaculation [i]

Premature ejaculation (PE) refers to a man's lack of self-control during sexual intercourse, resulting in an inability to delay ejaculation. Ejaculation occurs before or very shortly after penetration, failing to ejaculate and induce female sexual pleasure [i]. Generally, the time from the start of intercourse to ejaculation for men ranges from 2 to 45 minutes, with 60% falling between 2 and 6 minutes [i]. Therefore, defining exactly how long ejaculation constitutes premature ejaculation is difficult [i]. Premature ejaculation is more of a subjective feeling, primarily reflected in the ability to control oneself [i]. There are different types of premature ejaculation: occasional premature ejaculation, which is more common when men first engage in sexual activity and is more prevalent among couples separated for extended periods; stress-induced premature ejaculation, which occurs acutely after a period of mental or physical stress and can also be considered an occasional form; age-related premature ejaculation, which is a natural occurrence; and habitual premature ejaculation [i]. Some people fail to adjust in time after occasional premature ejaculation, and premature ejaculation becomes a pattern of sexual intercourse, thus forming habitual premature ejaculation[i]. Such people often have normal penile erection and normal sexual desire[i]. Premature ejaculation brings a heavy psychological burden to many men, and it is this psychological burden that makes it difficult for men to get rid of the suffering of premature ejaculation[i]. Because only a very small number of premature ejaculations are caused by organic reasons, most premature ejaculations are caused by psychological reasons[i]. The psychological reasons that cause premature ejaculation include: (1) Hasty habit: Some masturbators, because of their incorrect understanding of masturbation, feel ashamed of it, so they are afraid of being discovered by others, and always seize the opportunity to ejaculate as quickly as possible in a hurry to get satisfaction[i]. Over time, this forms a habit of hasty ejaculation[i]. (2) Fear: Some people are afraid that their penis is too short and that it will affect sexual intercourse, thus generating fear[i]. Some newlyweds experience premature ejaculation during their first sexual encounter due to excessive drinking, wedding fatigue, excessive excitement, strong sexual urges, or nervousness during their first contact with the opposite sex [i]. This leads to fear [i]. (3) Emotional disorders: If a husband harbors resentment or anger towards his wife, he will feel unhappy during sexual intercourse and only want to finish quickly, thus easily leading to premature ejaculation [i]. This is closely related to psychology [i]. (4) Inferiority complex: Some men have a sense of admiration for their wives and believe that having sex with their wives is disrespectful to them, resulting in premature ejaculation involuntarily [i]. Freud said that men's sexual behavior is always quite threatened when facing women they respect [i]. (5) Excessive expectations: Some people always imagine what sexual intercourse will be like beforehand, and excessive expectations increase psychological pressure. When the time comes, premature ejaculation occurs before they have a chance to do anything [i]. (6) Operational anxiety: Regardless of the cause, men may occasionally experience premature ejaculation once or twice, and some people carry the burden of anxiety as a result [i]. Before each sexual intercourse, they worry that they will ejaculate prematurely, which is operational anxiety. As a result, the more you worry, the more trouble you will cause. One premature ejaculation becomes multiple premature ejaculations, and occasional premature ejaculation becomes habitual premature ejaculation [i]. The wife's complaints will cause the husband's operational anxiety to escalate sharply, making the premature ejaculation more serious. Thus, premature ejaculation triggers anxiety, and anxiety promotes premature ejaculation, and so on, forming a vicious cycle [i]. For the problem of premature ejaculation, men should adjust their mindset, and couples should be considerate of each other, eliminate tension, eliminate all anxiety factors, and recognize that sexual life is a common need for both husband and wife [i]. At the same time, patients should master some essential knowledge, methods and skills for sexual life to guide their sexual behavior: (1) The stop-start method [i]. When the man feels the urge to ejaculate, he can slow down or stop the amplitude and frequency of penile thrusting in the vagina and use distracting language or other behaviors to often diminish the urge to ejaculate before starting a new round of penile thrusting [i]. Repeat this process until both partners are satisfied and ejaculation occurs [i]. (2) Use a condom [i]. A condom will reduce the intensity of stimulation received by the sexual organs, thereby delaying ejaculation [i]. (3) Adjust the position of intercourse [i]. Generally, the position of intercourse is man on top and woman on the bottom, with the man in the active position. Large movements make it easier for the man to ejaculate because this weight-bearing position easily increases the sexual excitability of the spinal cord and ejaculation center nerve muscles [i]. If the position is changed to woman on top or side position, allowing the man to be in a relaxed passive position, it can not only fully mobilize the woman's emotions but also help delay the man's ejaculation because the woman's movements are often gentler and slower with smaller amplitude [i]. (4) Improve the penis's tolerance to stimulation [i]. Penile squeeze technique, also known as tolerance training or desensitization training, is a method used to prevent ejaculation when the penis is stimulated, thereby re-establishing a higher ejaculation threshold and gradually allowing the penis to tolerate stronger sexual stimulation [i]. This involves continuously stimulating the penis using various techniques. When the urge to ejaculate arises, the base of the coronal sulcus is squeezed with both hands for 3-5 seconds. After 20-30 seconds, the sexual impulse and urgency to ejaculate will weaken or disappear. Alternatively, pulling the testicles downwards with both hands can also reduce or eliminate sexual impulse and urgency to ejaculate [i]. Performing this once a day, or 2-3 times a week, for 20-30 minutes each time, for 3-6 months, can help overcome premature ejaculation [i]. Close cooperation between partners, along with behavioral therapy to train the man's ability to control ejaculation, can delay ejaculation, allowing for free and controlled ejaculation [i]. Medication is not necessary; it only provides support during the most challenging times for men [i]. Sex can bring men pleasure, but neglecting certain issues can lead to sexually transmitted diseases [i]. This statement doesn't mean men should give up normal sex, but rather reminds them to be mindful of their sexual health to avoid contracting diseases[i]. Sexually transmitted diseases (STDs) are infectious diseases primarily caused by unsafe sexual practices, with AIDS being the most serious. However, some STDs, such as gonorrhea and syphilis, can be completely cured with timely and proper treatment[i]. However, if patients are too embarrassed to seek proper antibiotic treatment at a hospital, instead self-medicate irregularly or seek treatment from unqualified practitioners, they may delay treatment and seriously damage their health due to the inability to achieve a complete cure[i]. Patients should rely on scientific treatment methods; street advertisements or unorthodox methods are unreliable[i]. Of course, the best way to treat disease is prevention. Therefore, the best way to avoid STDs is to morally restrain one's sexual behavior and avoid frequenting entertainment venues for unauthorized sexual activity[i]. In this sense, monogamous marriage is the safest[i]. Men who are fickle and prone to promiscuity are more susceptible to STDs[i]. Before engaging in sexual activity, one should be fully prepared and carefully observe the partner's physical condition[i]. Using condoms is a simple, convenient, and economical method of contraception, and also an important barrier to prevent sexually transmitted disease pathogens from invading the body [i]. Urinating immediately after intercourse can effectively flush away pathogens that have entered the urethra but have not yet had time to infect the mucous membranes, and urine also has a certain bactericidal effect [i]. Immediately rinsing the genital area with clean water can wash away the partner's secretions along with any remaining pathogens [i]. In daily life, a balanced diet, regular physical exercise, avoiding excessive alcohol consumption, and avoiding overwork all help maintain a healthy immune system [i]. The best way to prevent sexually transmitted diseases is to manage the intermediate links, that is, to cut off the transmission route: avoid unprotected sex, pay attention to hygiene in public places, do not use public towels, bathtubs, toilets, etc. casually, and be careful not to share items when entertaining guests at home. Men should also pay attention to the hygiene conditions of hotels and inns when traveling [i].