Psychologically-induced Premature Ejaculation
|Group||Marked effect||Some effect||No effect||Total effectiveness|
|Treatment (68 cases total)||28||27||13||80.9%|
|Comparison (57 cases total)||23||13||21||63.2%|
Premature ejaculation (PE) is the persistent or recurrent experience of ejaculation with minimal sexual stimulation before or shortly after penetration. Therefore, ejaculation occurs before the man wants it to occur. Normally, men ejaculate approximately 2-3 minutes after vaginal penetration. In PE, ejaculation occurs in less than two minutes and may cause marked personal distress or interpersonal problems. Premature ejaculation may be lifelong, occurring throughout the patient’s active sexual life, or it may be acquired, meaning that there was a time when the patient did not have this sexual dysfunction. Further, PE may be generalized or situational. It is generalized if the disorder occurs with all partners and in all situations; it is situational if it occurs only with certain partners or in certain situations. Premature ejaculation is most common in younger, inexperienced males and tends to decline with age. Although there are physical causes which should be considered, the vast majority of cases of PE are due to psychological factors, such as guilt, fear, and performance anxiety, and PE is especially common when having sex with a new partner. If a single instance of PE becomes associated with fear that it will happen again, this may create a self-reinforcing negative feedback loop. The Western medical treatment of PE consists of behavioral therapy utilizing certain sexual techniques, such as the start and stop method and the squeeze method, psychotherapy, and, in certain cases, antidepressants to treat anxiety. On page 514 of issue #9, 2007 of the Zhe Jiang Zhong Yi Za Zhi (Zhejiang Journal of Chinese Medicine), Chen Cheng-de et al. published an article titled “Clinical Observations on the Treatment of “Heart-caused Premature Ejaculation with Xiao Yao Gu Jing Tang (Rambling Secure the Essence Decoction).” A summary of this article is presented below.
Altogether, there were 125 cases of PE enrolled in this two-wing comparison study. These 125 patients were randomly divided into a treatment group of 68 cases and a comparison group of 57 cases. All cases met the diagnostic criteria for PE based on the Chinese Index of Premature Ejaculation (CIPE). In the treatment group, ages ranged from 21-56 years, with an average age of 34.2 years. The course of disease ranged from six months to eight years, with an average disease duration of 1.5 years. Premature ejaculation was graded as slight in 12 cases, moderate in 32 cases, and severe in 24 cases. In the comparison group, ages ranged from 20-58 years, with an average age of 31.3 years, while disease duration ranged from five months to seven years, with an average duration of 1.1 years. In this group, 15 cases were judged slight, 31 cases were moderate, and 11 cases were severe. Thus, for the purposes of this study, these two cohorts were judged statistically comparable.
All members of the treatment group were orally administered self-composed Xiao Yao Gu Jing Tang (Rambling Secure the Essence Decoction) which consisted of:
Chai Hu (Radix Bupleuri)
Bai Shao (Radix Alba Paeoniae)
Bai Zhu (Rhizoma Atractylodis Macrocephalae)
Sha Yuan Zi (Semen Astragali Complanati)
Yi Zhi Ren (Fructus Alpiniae Oxyphyllae)
Sang Piao Xiao (Ootheca Mantidis), 10g each
Bo He (Herba Menthae Haplocalycis), 6g
Wu Wei Zi (Fructus Schisandrae), 10-15g
Ci Shi (Magnetitum)
Qian Shi (Semen Euryalis), 20-30g each
Lian Zi (Semen Nelumbinis), 10 pieces
If there was heart vexation with a bitter taste in the mouth, six grams of Huang Lian (Rhizoma Coptidis) were added.
If night-time sleep was difficult and restless, 10 grams of Bai He (Bulbus Lilii) and 15 grams of He Huan Pi (Cortex Albiziae) were added.
If low back pain was severe, 10 grams of Du Zhong (Cortex Eucommiae) and 15 grams of Xu Duan (Radix Dipsaci) were added.
If there was qi vacuity, 20 grams each of Huang Qi (Radix Astragali) and Dang Shen (Radix Codonopsis) were added.
If there was kidney yang vacuity, 10 grams each of Xian Ling Pi (Herba Epimedii) and Ba Ji Tian (Radix Morindae Officinalis) were added.
One packet of these medicinals was decocted in water, reduced to 250 milliliters, and administered in two divided doses per day, with four weeks of continuous administration equaling one course of treatment.
All members of the comparison group were orally administered 20 milligrams per day of an unidentifiable Western drug (Sai Le Te), presumably an antidepressant. Fours weeks continuous administration also equaled one course of treatment in this group.
An increase of more than 10 points on the CIPE scale was defined as a marked effect. An increase of 5-10 points was defined as some effect, and an increase of less than five points was defined as no effect. The following table shows the outcomes of the two groups based on these criteria.
Therefore, there was a marked statistical difference in therapeutic outcomes between these two groups, with the Chinese herbal therapy being, overall, more clinically effective.
According to the Chinese authors of this study, premature ejaculation in Chinese medicine is closely associated to the loss of regulation of the function of the heart, spleen, liver, and kidney viscera and, in general, is mostly caused by loss of the liver’s control over coursing and discharge, heart-spleen dual vacuity, heart-kidney non-interaction, yin vacuity and fire effulgence, and the kidneys’ loss of sealing and storing, securing and containing. However, in the case of psychologically induced PE, the main cause is tension resulting in liver qi depression and binding with loss of duty over coursing and discharge plus fear and fright causing kidney qi depletion and vacuity which then loses its command over sealing and storing. Therefore, within self-composed Xiao Yao Gu Jing Tang, the ingredients of Xiao Yao San, i.e., Chai Hu, Bai Shao, Bai Zhu, and Bo He, are meant to course the liver and resolve depression. Qian Shi, Sha Yuan Zi, Yi Zhi Ren, and Sang Piao Xiao are then chosen to boost the kidneys and secure the essence, while Wu Wei Zi and Ci Shi are added to quiet the spirit and stabilize the mind. When all these medicinals are combined together, their effect is to course the liver and supplement the kidneys, secure the essence and stop slippage. For best effect, treatment should be combined with relaxation and psychotherapy.
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