Treatment And Behavioral Techniques Of Ejaculatory Disorders
Therapies for PE include psychological, behavioral, and pharmacological approaches. In general, men with lifelong PE likely have lower ejaculatory thresholds compared to unaffected men, and thus may benefit most from medical therapies. In contrast, men with a history or acquired PE are more likely to be better treated with cognitive or behavioral therapy. Among the psychological approaches, psychotherapy has been reported as a primary therapy, but there is a lack of welldesigned clinical trials assessing the efficacy of this intervention.
Behavioral techniques include the “stop and start technique” and the “squeeze technique.” With the “stop and start technique,” patients are instructed to manually stimulate themselves in a controlled fashion and involve their partner in the manual stimulation once controlled arousal has been achieved. The couple then proceeds onto intercourse. The “squeeze technique” is very similar to the “stop and start technique,” except the penis is manually squeezed during the times when stimulation is stopped. The obvious advantage of behavioral techniques is that they are nonpharmacologic and thus avoid possible side effects associated with medical therapies. While some authors report success with behavioral approaches, these treatment modalities are overall poorly studied and lack long-term efficacy.