Practical Tips for Sexual Counseling and Psychotherapy in Premature Ejaculation

Abstract

Introduction A number of milestones in the treatment of premature ejaculation (PE) have occurred over the past five decades, including the development of various behavioral and cognitive techniques as well as pharmacotherapies that modify neurophysiological processes involved in ejaculation. Nevertheless, the notion that sexual responses such as PE are influenced by physiological, psychobehavioral, cultural, and relationship factors is as valid now as it was 50 years ago, and therefore, interventions should consider all such domains in the development of effective treatment strategies. Aim Provide an overview of which patients with PE are suitable to receive psychosexual treatment and the psychological approaches for managing this disorder. Methods Review of the literature. Main Outcome Measure Psychosexual treatments that integrate behavioral, psychological, and relationship functioning. Results PE is typically a couple's problem and, therefore, psychotherapy is best when the partner is involved. Before embarking on psychotherapy, the clinician should obtain a medical history pertaining to sexual-, psychological-, and relationship-related factors, so that the treatment strategy can be tailored to the needs of the individual. General strategies underpinning integrative, “process-oriented” elements of psychotherapy most relevant to PE are: developing the therapist–patient relationship; expressing empathy, genuineness, and positive regard; motivational interviewing, i.e., developing motivation to change; developing discrepancy; working through resistance; identifying PE-related affect, cognitions, and behaviors (including interaction with partners); and supporting self-efficacy. The four main domains that encompass psychotherapy techniques specific to the treatment of PE are: behavioral; cognitive; affective; and relational. Sustained positive outcomes in PE may be obtained using a combination treatment strategy that addresses all elements of PE, including psychological and biological factors. Conclusions Psychosexual treatments may help the patient with PE and his partner to address their sexual problems and improve their overall relationship. The effects of psychosexual therapy may be augmented by combining this intervention with pharmacotherapy.

Premature ejaculation: Pharmacotherapy vs group psychotherapy alone or in combination

“…plinarity (32,33): our data showed that group C, treated with the combination of pharmacotherapy and psychotherapy, was the one that improved the most in terms of results, as shown in Table 2. According to the results of our study, Group Psychotherapy appears to be effective in improving IELT, sexual satisfaction and anxiety both alone or in combination with Dapoxetine in treatment of PE.…”

Effects of Partners' Age, Marriage Duration and Monthly Coitus Number on Mean Intravaginal Ejaculation Latency Time on Premature Ejaculation Patients

“…PE'nin ortaya çıkması, alevlenmesi, devamı, bu dönemler-deki değişken aşırı tepkiler PE boyutunu çok daha yukarılara taşıyarak içinden çıkılmaz bir hâl almasına neden olmakta ve PE'ye yaklaşımı çok daha önemli kılmaktadır. 22 Primer PE'de PE süresinin 25±14 yıl, akkiz PE'de 5,6±4 yıl (p<0,01) olduğu gösterilmiştir. 8 Buna ek olarak daha ayrıntılı incelediğimizde, ça-lışmamızda da primer PE'de hasta yaşı arttıkça, yani PE'li geçen süre arttıkça aylık ilişki sayısında anlamlı bir azalma gözlenmiştir (p<0,01).…”

Premature ejaculation: old story, new insights

“…On the other hand, sexologic and behavioral techniques are considered the most efficacious care for restoration of desire within a couple and for the management of marital conflicts, PE, and the combination of medical and psychological treatments in PE (127). In this regard, a recent study demonstrated that sexual behavioral treatment combined with 30 mg of dapoxetine for 24 weeks had a higher efficacy than dapoxetine alone.…”