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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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Presentation Transcript
diagnosis
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
prevalence
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
diagnosis treatment models
Diagnosis/Treatment Models
  • Medical
    • pharmaceutical
  • Psychological
    • behavioral
  • Psychosocial
    • relational
  • Intersystem
    • behavioral, psychoanalytic, systemic, medically aware
medical
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
psychological behavioral
Psychological/Behavioral
  • Physical Awareness
  • PE, Couples Exercises
    • Squeeze technique
    • Start Stop technique
    • Quiet Vagina technique
    • Monitor and adjust stimulation
intersystem
Intersystem
  • Behavioral
    • PE Exercises
  • Systemic
    • Power struggles
    • Fear of commitment
    • Fear of intimacy
    • Unclear expectations
  • Awareness
    • Environmental effectors
    • Pharmaceutical issues