PREMATURE EJACULATION

• Also referred to as rapid ejaculation
• Frequent sexual function disorder of men of all ages (prevalence of up to 30%) 
• May occur with erectile dysfunction

• Largely unknown
• Psychogenic factors- Depression, Anxiety, Relationship problems, Irregular sexual intercourse
• Organic factors - Penile hypersensitivity, Hyperexcitability of the reflex arc

• Persistent or recurrent ejaculation that occurs within 1 minute of penetration and before the patient wishes to ejaculate
• Occur during ≥ 75% of all sexual encounters and is present for at least 6 months
• Causes clinically significant distress in the individual
• Not due to another mental disorder, severe relationship distress, substance abuse, or an organic disorder

• According to DSM V criteria, a clinical diagnosis is made
• Testosterone levels, Prolactin – if associated with Impotency

• Depends on the psychological strain on the affected individual
• Psychotherapy/ Behavioural therapy 
• Medical therapy
  • Local: Topical anaesthetics (e.g., lidocaine- prilocaine spray)
  • Systemic: SSRIs (e.g., paroxetine ) are first-line treatment

Ayurvedic Treatment

Internal Medicines 

• Kalyanaka kashaya
• Chiruvilwadi kashaya
• Avipathi choorna
• Manasamitra vataka
• Chandraprabha vati
• Aswagandharishta
• Jatiphala choorna
• Sidhamakaradwaja
• Manasamitra vataka 
• Poorna chandrodaya rasa
• Vanga bhasma

Procedures

• Virechana – Gandharva eranda
• Matra vasti – Ksheerabala
• Nasya – Ksheerabala taila
• Ext application – Bala Aswaghandadi taila