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MFT 719 Fall, 2007 Sexual Issues in MFT: Premature Ejaculation

MFT 719 Fall, 2007 Sexual Issues in MFT: Premature Ejaculation. Kim Rogers. Diagnosis. DSM IV-R (302.75) Ejaculation before, upon, or shortly after penetration (before a person wishes) Persistent, Recurrent Minimal sexual stimulation Marked distress Not medical or substance abuse related

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MFT 719 Fall, 2007 Sexual Issues in MFT: Premature Ejaculation

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  1. MFT 719 Fall, 2007Sexual Issues in MFT:Premature Ejaculation Kim Rogers

  2. Diagnosis • DSM IV-R (302.75) • Ejaculation before, upon, or shortly after penetration (before a person wishes) • Persistent, Recurrent • Minimal sexual stimulation • Marked distress • Not medical or substance abuse related • Life-long or Acquired • Generalized or Situational

  3. Prevalence • Intravaginal ejaculatory latency time (IELT) • 30% of men (faster than they wish) • 16% see as a problem • 10% report to a physician • Co-morbid symptoms • stress, anxiety, depression • Relationship issues • frustration, guilt, embarrassment

  4. Diagnosis/Treatment Models • Medical • pharmaceutical • Psychological • behavioral • Psychosocial • relational • Intersystem • behavioral, psychoanalytic, systemic, medically aware

  5. Medical • Topical Anesthetics • lidocane, prilocane • Off-Label Antidepressants • SSRIs: Paxil, Zoloft, Prozac • Advantages: • fast, simple, inevitable • Disadvantages: • must continue indefinitely • side effects • unaddressed psychological and relational issues

  6. Psychological/Behavioral • Physical Awareness • PE, Couples Exercises • Squeeze technique • Start Stop technique • Quiet Vagina technique • Monitor and adjust stimulation

  7. Intersystem • Behavioral • PE Exercises • Systemic • Power struggles • Fear of commitment • Fear of intimacy • Unclear expectations • Awareness • Environmental effectors • Pharmaceutical issues

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