February 5th, 2016
Premature ejaculation is classified as one of the most common sexual disorders in males with a prevalence of 2 to 23% in the general population. Investigators believe that premature ejaculation affects a vast majority of men at some point of life and could be transient (self-resolving) or chronic/ problematic. There are two clinical varieties of premature ejaculation; primary or lifelong that is characterized by ejaculation within one minute or less of vaginal penetration and, secondary or acquired that is marked by an intra-vaginal latency duration of less than 3 minutes.
Pelvic floor is formed by a number of pelvic muscles that are attached anteriorly to the pubic symphysis and posteriorly to coccyx. It is supported by a number of ligaments, tendons and facial sheaths with a very rich neurovascular innervation. The primary function of pelvic floor is to provide support, strength and stability to the pelvic organs (especially bladder, lower gut and reproductive organs). Investigators suggests that this muscles play a vital role in the orgasm as well as sexual arousal (2). Hypo-tonicity due to an injury or traumatic incident can greatly affect this capacity, and may produce a wide range of discomforting symptoms such as pelvic organ prolapse, pelvic pain, and a number of other genito-urinary symptoms.
According to the results of a new trial that was first presented at the European Congress of Urology (Sweden), investigators provided statistical evidence that this training can help in managing the symptoms of primary premature ejaculation; without needing any other intervention (1).
Investigators from Sapienza University of Rome enrolled 40 men (age range 19 to 46 years) with a history of premature ejaculation in a study. As part of the interventional study, these men were trained to perform pelvic floor strengthening exercises for a period of 12-weeks. The time-to-orgasm/ ejaculation was measured before the study and was found to be 31.7 seconds. After the completion of the study 33 of 38 males (who were able to finish the study) reported significant improvement in the ejaculatory function with a mean ejaculatory time of 146.2 second (an approximate 4-fold increase); suggesting a success rate of 82.5% due to intervention. The results were effective even at 6-month follow-up period with continued training exercises.
According to a study reported in the Journal of Sexual Medicine (2), investigators concluded that poor tone of pelvic floor muscles is the leading cause of sexual dysfunction in both males and females that can be ideally managed with pelvic floor rehabilitation training. Pelvic floor exercises are traditionally advised by healthcare professionals to improve the urinary functions in both males and females. Several research studies indicate that pelvic floor training can help in regaining bladder and bowel control (or continence) after direct or indirect pelvic trauma (such as pelvic surgery, prostate removal procedures, prolonged labor in females etc.)
Although a number of treatment options are available for the management of PE; the pelvic floor training is considered fairly superior; here is why:
Healthcare providers advise through and comprehensive medical and diagnostic evaluation to identify the primary cause of premature ejaculation. But in idiopathic or primary cases, pelvic floor rehabilitation yield promising results and should be advised to strength pelvic muscles.
1. Pastore, A. L., Palleschi, G., Fuschi, A., Maggioni, C., Rago, R., Zucchi, A., … & Carbone, A. (2014). Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. Therapeutic advances in urology, 1756287214523329.
2. Rosenbaum, T. Y. (2007). REVIEWS: Pelvic Floor Involvement in Male and Female Sexual Dysfunction and the Role of Pelvic Floor Rehabilitation in Treatment: A Literature Review. The journal of sexual medicine, 4(1), 4-13.
3. Pastore, A. L., Palleschi, G., Leto, A., Pacini, L., Iori, F., Leonardo, C., & Carbone, A. (2012). A prospective randomized study to compare pelvic floor rehabilitation and dapoxetine for treatment of lifelong premature ejaculation. International journal of andrology, 35(4), 528-533.
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