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{{penyangkalan medis}}
== Ejakulasi Dini ==
[[Ejakulasi dini]] atau ED atau dikenal juga dengan istilah EDi merupakan disfungsi seksual yang banyak dialami pria, di samping disfungsi ereksi. Tetapi pada awalnya banyak pria yang mengalami ejakulasi dini tidak menyadari bahwa itu termasuk gangguan fungsi seksual. Mereka hanya merasa dan mengeluh pada dirinya sendiri, mengapa ejakulasinya terlampau cepat terjadi. [[Ejakulasi dini]] ditentukan oleh mampu tidaknya pria mengendalikan ejakulasi agar terjadi sesuai dengan keinginannya.


{{Infobox disease|
== Penyebab Terjadinya Ejakulasi Dini ==
Name = Ejakulasi dini |
* Ejakulasi dini dapat disebabkan oleh adanya suatu gangguan yang bersifat [[psikofisiologik]]. Ada beberapa masalah yang melatar belakangi terjadinya ejakulasi dini, yaitu hubungan suami istri yang tidak harmonis, perasaan tidak senang terhadap pasangannya, dan rasa takut terhadap wanita.
Image = |
* [[Kecemasan]] juga berperan penting dalam proses ejakulasi dini karena masalah tersebut seringkali merupakan bagian dari situasi dan hampir semua penderita dapat mengendalikan [[ejakulasi]] selama [[masturbasi]]. [[Hubungan seksual terlarang]] dan takut diketahui orang lain mendorong timbulnya kecemasan. Adanya ketidakpuasan pasangan [[seksual]] juga akan menambah kecemasan yang ujungnya akan memperparah ejakulasi dini.
Caption = |
* Kebiasaan mencapai orgasme dan [[ejakulasi]] secara tergesa-gesa sebelumnya. Misalnya suka [[masturbasi]] atau [[onani]] dengan tergesa-gesa.
DiseasesDB = |
* Kurang berfungsinya [[serotonin]], suatu bahan [[neurotransmitter]] yang berfungsi menghambat [[ejakulasi]].
ICD10 = {{ICD10|F|52|4|f|50}} |
* Gangguan kontrol [[syaraf]] yang mengatur peristiwa [[ejakulasi]] (hipersensitivitas refleks ejakulasi). Pria dengan [[disfungsi ereksi]] pada umumnya mengalami ejakulasi dini. Sebaliknya, pria dengan ejakulasi dini pada akhirnya dapat mengalami disfungsi ereksi.
ICD9 = {{ICD9|302.75}} |
ICDO = |
OMIM = |
MedlinePlus = 001524 |
eMedicineSubj = med |
eMedicineTopic = 643 |
MeshID = |b
}}
'''Ejakulasi dini''' ([[bahasa Inggris]]: ''Premature ejaculation'', [[bahasa Latin]]: ''ejaculatio praecox'') adalah kejadian pria mengalami [[orgasme]] dan [[Ejakulasi|mengeluarkan air mani]] setelah melakukan [[persetubuhan|aktivitas seksual]] atau mengalami [[stimulasi penis]] dalam waktu singkat (minimal). Hal tersebut dapat disebut juga ''klimaks cepat,'' atau ''klimaks dini''.


Meskipun pria yang mengalami ejakulasi dini menganggap dirinya tidak memiliki tenaga setelah ejakulasi, ternyata menurut penelitian banyak dari pria yang berharap bisa bertahan lebih lama.<!-- Secara umum, pria Men's typical ejaculatory latency is approximately 4–8 minutes.--><ref name = Oxford2009 />
== Dampak Ejakulasi Dini ==
Apapun jenis berat-ringannya, yang pasti ejakulasi dini mengakibatkan hubungan seksual berlangsung tidak harmonis. Pada ejakulasi dini, ketidakharmonisan bahkan disebabkan karena ketidakpuasan pada kedua belah pihak. Pria yang mengalami ejakulasi dini merasa tidak puas karena hubungan seksual berlangsung sangat singkat di luar kehendaknya. Walaupun dapat mencapai orgasme, pria yang mengalami ejakulasi dini juga merasa sangat kecewa karena tidak mampu memberikan kepuasan seksual kepada pasangannya.


Pria yang mengalami ejakulasi dini dilaporkan memiliki keharmonisan yang terganggu, dan terkadang menolak melakukan hubungan seksual karena merasa malu dengan penyakit yang dialami.<ref name=Barnes>{{cite journal |author=Barnes T., I. Eardley |title= Premature Ejaculation: The Scope of the Problem |journal= Journal of Sex and Marital Therapy| volume=33|page=151|year=2007 |pmid=7365515 |issue=3}}</ref> Dibandingkan dengan pria, wanita tidak terlalu mempermasalahkan ejakulasi dini yang dialami pasangannya,<ref>{{cite journal |author= Byers, E.S. and G. Grenier |title= Premature or Rapid Ejaculation: Heterosexual Couples’ Perceptions of Men’s Ejaculatory Behavior |journal= Archives of Sexual Behavior |volume=32 |page=261 |year=2003 |pmid= 12807298 |issue=3}}</ref> tetapi dari beberapa penelitian menunjukkan kondisi tersebut yang menyebabkan ketidakharmonisan.<ref>{{cite journal |author= Limoncin, E. et al. |title= Premature Ejaculation Results in Female Sexual Distress: Standardization and Validation of a New Diagnostic Tool for Sexual Distress |journal= Journal of Urology |year=2013 |pmid=23142691 |doi=10.1016/j.juro.2012.11.007 |volume=189 |issue=5 |pages=1830–5}}</ref><ref>{{cite journal |author= Graziottin, A. and S. Althof |title= What Does Premature Ejaculation Mean to the Man, the Woman, and the Couple? |journal= Journal of Sexual Medicine |volume=8 |page=304 |year=2011 |pmid=21967392 |doi=10.1111/j.1743-6109.2011.02426.x}}</ref><ref>{{cite journal |author=Barnes T., I. Eardley |title= Premature Ejaculation: The Scope of the Problem |journal= Journal of Sex and Marital Therapy |volume=33 |page=151 |year=2007 |pmid= 7365515 |issue=3}}</ref>
== Cara Mengatasi Ejakulasi Dini ==

Ada beberapa cara yang dapat dilakukan untuk mengatasi ejakulasi dini. Pertama, dengan sex therapy. Kedua, menggunakan obat untuk mengontrol ejakulasi. Ketiga, dengan operasi syaraf. Cara pertama dan kedua banyak dilakukan dan memberikan hasil yang cukup baik. Tetapi cara ketiga walaupun pernah dilakukan di negara tertentu, sampai kini ternyata tidak populer dan tidak banyak digunakan.
== Penyebab ==
Penyebab dari ejakulasi dini tidak terlalu jelas. Banyak teori yang dikeluarkan, termasuk bahwa ejakulasi dini terjadi karena hasil dari melakukan masturbasi yang terlalu cepat ketika masa remaja untuk menghindari pengawasan orang tua, [[demam panggung]], [[Kompleks Oidipus|konflik oidipal]], agresivitas pasif, dan kurang melakukan aktivitas seksual — tetapi tidak ada satupun teori yang pasti dan bisa menjelaskan gejala tersebut.<ref name = Oxford2009>Strassberg, D. S., & Perelman, M. A. (2009). Sexual dysfunctions. In P. H. Blaney & T. Millon (Eds.), ''Oxford textbook of psychopathology'' (2nd ed.), (pp. 399–430). NY: Oxford University Press.</ref>

<!-- Several physiological mechanisms have been hypothesized to contribute to causing premature ejaculation including [[serotonin]] receptors, a genetic predisposition, elevated penile sensitivity, and nerve conduction atypicalities.<ref name = Althof2007>Althof, S. E. (2007). Treatment of rapid ejaculation: Psychotherapy, pharmacotherapy, and combined therapy (pp. 212–240). In S. R. Leiblum (Ed.), ''Principles and practice of sex therapy'' (4th ed.). NY: Guilford.</ref>

The nucleus paragigantocellularis of the brain has been identified as involved in ejaculatory control.<ref>{{cite journal |author=Coolen LM, Olivier B, Peters HJ, Veening JG|title=Demonstration of ejaculation-induced neural activity in the male rat brain using 5-HT1A agonist 8-OH-DPAT |journal=Physiol. Behav. |volume=62 |issue=4 |pages=881–91 |year=1997|pmid=9284512 |doi=10.1016/S0031-9384(97)00258-8}}</ref> Scientists have long suspected a [[genetics|genetic]] link to certain forms of premature ejaculation. In one study, 91 percent of men who have had premature ejaculation for their entire lives also had a first-relative with lifelong premature ejaculation. Other researchers have noted that men who have premature ejaculation have a faster neurological response in the pelvic muscles.{{citation needed|date=April 2013}}
-->
Ejakulasi dini dapat terjadi karena [[radang prostat]]<ref name=Althof2010>{{cite journal |author= Althof, S.E. et al. |title= International Society for Sexual Medicine’s Guidelines for the Diagnosis and Treatment of Premature Ejaculation |journal= Journal of Sexual Medicine|volume=7|page=2947|year=2010|pmid=21050394 |doi=10.1111/j.1743-6109.2010.01975.x |issue=9}}</ref> atau efek samping dari obat-obatan, juga karena pengaruh makanan berlemak dan manis sebelum melakukan hubungan intim..

<!-- ==Mechanism==
[[Berkas:Mechanism of Ejaculation.jpg|thumb|Mechanism of Ejaculation]]
The physical process of [[ejaculation]] requires two actions: emission and expulsion.
The emission is the first phase. It involves deposition fluid from the [[ampulla of ductus deferens|ampullary]] [[vas deferens]], [[seminal vesicle]]s, and [[prostate gland]] into the [[Posterior (anatomy)|posterior]] [[urethra]].<ref>{{cite journal |author=Böhlen D, Hugonnet CL, Mills RD, Weise ES, Schmid HP |title=Five meters of H(2)O: the pressure at the urinary bladder neck during human ejaculation |journal=Prostate |volume=44 |issue=4 |pages=339–41 |year=2000 |pmid=10951500|doi=10.1002/1097-0045(20000901)44:4<339::AID-PROS12>3.0.CO;2-Z}}</ref> The second phase is the expulsion phase. It involves closure of bladder neck, followed by the rhythmic contractions of the [[urethra]] by pelvic-perineal and [[bulbospongiosus muscle]], and intermittent relaxation of [[external sphincter muscle of male urethra|external urethral sphincters]].<ref>{{cite journal |author=Master VA, Turek PJ |title=Ejaculatory physiology and dysfunction |journal=Urol. Clin. North Am. |volume=28 |issue=2 |pages=363–75, x |year=2001 |pmid=11402588|doi=10.1016/S0094-0143(05)70145-2}}</ref>

Sympathetic motor neurons control the emission phase of ejaculation reflex, and expulsion phase is executed by somatic and autonomic motor neurons. These motor neurons are located in the thoracolumbar and lumbosacral [[spinal cord]] and are activated in a coordinated manner when sufficient sensory input to reach the ejaculatory threshold has entered the [[central nervous system]].<ref>{{cite journal |author=deGroat WC, Booth AM |title=Physiology of male sexual function |journal=Ann. Intern. Med. |volume=92 |issue=2 Pt 2 |pages=329–31 |year=1980 |pmid=7356224 |doi=}}</ref><ref>{{cite journal |author=Truitt WA, Coolen LM |title=Identification of a potential ejaculation generator in the spinal cord |journal=Science |volume=297 |issue=5586 |pages=1566–9 |year=2002 |pmid=12202834 |doi=10.1126/science.1073885}}</ref>

=== Intromission time ===
The 1948 [[Kinsey Report]] suggested that three quarters of men ejaculate within two minutes of penetration in over half of their sexual encounters.<ref>{{citation|author=Kinsey, Alfred |title=Sexual Behavior in the Human Male |year=1948 |publisher=W. B. Saunders Co |location=[[Philadelphia]]}}</ref>

Current evidence supports an average [[intravaginal ejaculation latency time]] (IELT) of six and a half minutes in 18–30 year olds.<ref>{{cite web |url=http://www.medicine.ox.ac.uk/bandolier/band137/b137-4.html |title=Ejaculation delay: what's normal? [July 2005; 137-4] |accessdate=2007-10-21 |work=}}</ref><ref>{{cite journal |author=Waldinger MD, Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M |title=A multinational population survey of intravaginal ejaculation latency time |journal=The journal of sexual medicine |volume=2 |issue=4 |pages=492–7 |year=2005 |pmid=16422843 |doi=10.1111/j.1743-6109.2005.00070.x}}</ref> If the disorder is defined as an IELT percentile below 2.5, then premature ejaculation could be suggested by an IELT of less than about two minutes.<ref>{{cite journal |author=Waldinger MD, Zwinderman AH, Olivier B, Schweitzer DH |title=Proposal for a definition of lifelong premature ejaculation based on epidemiological stopwatch data |journal=The journal of sexual medicine |volume=2 |issue=4 |pages=498–507 |year=2005 |pmid=16422844 |doi=10.1111/j.1743-6109.2005.00069.x}}</ref> Nevertheless, it is possible that men with abnormally low IELTs could be "happy" with their performance and do not report a lack of control. Likewise, those with higher IELTs may consider themselves premature ejaculators, suffer from detrimental side effects normally associated with premature ejaculation, and even benefit from treatment.

== Diagnosis ==
When deciding the appropriate treatment, it is important for physician to distinguish PE as a "complaint" versus PE as a "syndrome".<ref name="ReferenceA">{{cite web|last=Waldinger|first=MD|title=Changing paradigms from a historical DSM-III and DSM-IV view toward an evidence based definition of premature ejaculation. Part II: Proposals for DSM-V and ICD-11|work=Proposals for DSM-V and ICD-11|publisher=J Sex Med}}</ref> About 20 years ago, PE was classified into "lifelong PE" and "acquired PE".<ref>{{cite journal|last=Godpodinoff|first=ML|title=Premature ejaculation: clinical subgroups and etiology|journal=J Sex Marital Ther. |volume=15|page=130|year=1989|pmid=2769774|doi=10.1080/00926238908403817}}</ref> Recently, a new classification of PE was proposed based on controlled clinical and epidemiological stopwatch studies,<ref name="ReferenceA" /> and it included 2 other PE syndromes: "natural variable PE" and "premature-like ejaculatory dysfunction". Only individuals with lifelong PE with IELT shorter than 1–1.5 minutes should require medication as a first option, along with or without therapy. For those who fall into one of the other categories, treatment should consist of patient reassurance, behavior therapy, and/or psychoeducation<!-- better term for 'psychoeducation' needed to explain that irregular early ejaculation is a normal variation.<ref>{{cite web|last=Waldinger|first=Marcel D.|title=New Insights in Premature Ejaculation|url=http://www.psychiatrictimes.com/dsm-5/content/article/10168/54676|work=Psychiatric Times Vol. 24 No. 9|publisher=Psychiatric Times|accessdate=1 August 2007}}</ref><ref>{{cite journal|last=Serefoglu|first=EC|coauthors=Yaman O, Cayan S, et al.|title=Prevalence of the complaint of ejaculating prematurely and the four premature ejaculation syndromes|journal=J Sex Med|year=2011|issue=8|pages=540–8|pmid=21054799}}</ref>

Several possible sub-classifications have been discussed, but none is in universal usage. ''Primary premature ejaculation'' refers to lifelong experience of the problem (since puberty), and ''secondary premature ejaculation'' reference to the problem beginning later in life. It has also been subdivided into ''global premature ejaculation'', when it occurs with all partners and contexts, and ''situational premature ejaculation,'' when it occurs in some situations or with specific partners.<ref>Godpodinoff M.L. ''Premature Ejaculation: Clinical Subgroups and Etiology'' Journal of Sex and Marital Therapy 1989; 15(2):130-134</ref>
-->

== Pengobatan ==
Beberapa macam metode pengobatan sudah diuji coba untuk mengobati ejakulasi dini. Kombinasi dari pengobatan medis dan nonmedis merupakan metode yang efektif untuk mengobati ejakulasi dini antara lain:

1. '''Pelatihan otot seksual''' adalah salah satu metode paling mudah untuk memecahkan ejakulasi dini. Fungsi ejakulasi sperma dilakukan dengan bantuan otot PC, yang terletak di dasar panggul. Dan sebenarnya, pada beberapa pria otot ini tidak dilatih dengan baik untuk melaksanakan fungsi ejakulasi dengan benar.

2. '''Menjaga erotisme seksual pada kecepatan normal''' sangat penting untuk mencapai ereksi lengkap. Kebanyakan pria khawatir tentang perasaan dan yang itu akan mengakibatkan kehilangan kontrol dan berakhir dengan klimaks terlalu cepat. Untuk mengatasi ini, Anda perlu meningkatkan foreplay dan seks oral sementara terlibat dalam hubungan seksual. Latihan pernapasan juga akan membantu Anda untuk santai dan mengendalikan ejakulasi selama hubungan seks.

3. '''Gunakan Ramuan Herbal:''' penunda ejakulasi atau pil Anti ejakulasi dini tersedia saat ini. Selalu memilih pil bahan herbal yang diperkaya untuk mengobati jenis-jenis gangguan tersebut. Jika pil mengandung bahan-bahan herbal, maka kita dapat mengatakan 100% aman untuk digunakan karena tidak memberikan efek samping.

=== Diri sendiri ===
Banyak pria mencoba untuk mengobati dirinya dari ejakulasi dini dengan mengalihkan pikiran, seperti mencoba untuk menjauhi segala sesuatu yang dapat menstimulasi aktivitas seksualnya. Cara yang lain adalah melakukan hubungan seksual dengan perlahan, menolak melakukan masturbasi, ejakulasi sebelum melakukan aktivitas seksual, dan menggunakan lebih dari satu [[kondom]]. Menggunakan lebih dari satu kondom sangat tidak dianjurkan, karena akan terjadi gesekan antara kondom dengan penis dan akan menyebabkan iritasi hingga kerusakan. Banyak pria yang berpendapat bahwa cara tersebut berhasil.<ref name = Oxford2009 />

Konsultasi dengan dokter yang sudah ahli dalam bidang seksual dapat membantu sekitar 75 sampai 80 persen dalam proses penyembuhan.<ref>{{cite journal |author= McCabe, M.P.|title= Evaluation of a Cognitive Behavior Therapy Program for People with Sexual Dysfunction |journal= Journal of Sex and Marital Therapy |volume=27 |page=259|year=2001|pmid=11354931 |issue=3 |doi=10.1080/009262301750257119}}</ref>

<!--===Psychoanalysis===
[[Freudian]] theory postulated that rapid ejaculation was a symptom of underlying [[neurosis]]. It stated that the man suffers unconscious hostility toward women, so he ejaculates rapidly, which satisfies him but frustrates his lover, who is unlikely to experience [[orgasm]] that quickly.<ref name=Kaplan /> Freudians claimed that premature ejaculation could be cured using psychoanalysis. But even years of psychoanalysis accomplished little, if anything, in curing premature ejaculation.<ref name=Kaplan>{{citation|author= Kaplan, Helen S. |title= PE: How to Overcome Premature Ejaculation |page=28 |year=1989 |publisher=Brunner Mazel/New York Times}}</ref>

There is no evidence that men with premature ejaculation harbor unusual hostility toward women, however.<ref>{{citation|author= Kaplan, Helen S. |title= The New Sex Therapy |page=295 |year=1974 |publisher=Brunner Mazel/New York Times}}</ref>

=== Sex therapy ===
Several techniques have been developed and applied by sex therapists, including [[Kegel exercise]]s (to strengthen the muscles of the pelvic floor) and Masters and Johnson's "stop-start technique" (to desensitize the man's responses) and "squeeze technique" (to reduce excessive arousal).<ref name = LeVay />

To treat premature ejaculation, Masters and Johnson developed the "squeeze technique". Men were instructed to pay close attention to their arousal pattern and learn to recognize how they felt shortly before their "point of no return", the moment ejaculation felt imminent and inevitable. Sensing it, they were to signal their partner, who squeezed the head of the penis between thumb and index finger, suppressing the ejaculatory reflex and allowing the man to last longer.<ref>{{citation|author=Castleman, M. |title=Great Sex|year=2004|pages=137–138 |publisher=[[Rodale, Inc.]] }}</ref><ref>{{citation|author= Masters, W. and V. Johnson |title= Human Sexual Inadequacy |year=1970|publisher=[[Little Brown & Company]] }}</ref><ref>{{citation|author= Belliveau, F. and L. Richter |title= Understanding Human Sexual Inadequacy |year=1970|publisher=[[Hodder and Stoughton]] }}</ref>

The squeeze technique worked, but many couples found it cumbersome. From the 1970s to the 1990s, sex therapists refined the Masters and Johnson approach, largely abandoning the squeeze technique and focused on a simpler and more effective technique called the "stop-start" technique. During intercourse, as the man senses he is approaching climax, both partners stop moving and remain still until the man's feelings of ejaculatory inevitability subside, at which point, they are free to resume active intercourse.<ref>{{citation|author=Castleman, M. |title=Great Sex|year=2004|pages=136–137 |publisher=[[Rodale, Inc.]] }}</ref><ref>{{citation|author= Kaplan, Helen S. |title= PE: How to Overcome Premature Ejaculation |pages=48–58 |year=1989 |publisher=Brunner Mazel/New York Times}}</ref><ref>{{citation|author= Metz, M. and B. McCarthy |title= Coping With Premature Ejaculation |pages=123–128|year=2003 |publisher= New Harbinger Publications }}</ref><ref>{{citation|author= Silverberg, S. |title= Lasting Longer: The Treatment Program for Premature Ejaculation |pages=44–57|year=1978, 2010 |publisher= Physicians Medical Press }}</ref><ref>{{citation|author= Birch. R.W.|title= A Short Book About Lasting Longer|pages=27–38|year=2007 |publisher= PEC Publishing }}</ref> To help the man increase awareness of his sexual experience, he is encouraged to create an excitement scale of 1-100. Successful completion of this scale will include paying attention to his heart rate, when (and if) he squeezes his inner thighs, and sensations in all parts of his body. By creating this scale, he will be more able to pace himself as he uses the "stop-start" technique.
In addition to the stop-start technique, other sexual adjustments help men develop and maintain ejaculatory control, among them: masturbation exercises, deep breathing, and whole-body massage. Sex therapists estimate that the refined last-longer program teaches effective ejaculatory control to 90 percent of men.<ref>{{citation|author=Castleman, M. |title=Great Sex|year=2004|pages=122–141 |publisher=[[Rodale, Inc.]] }}</ref><ref>{{citation|author= Kaplan, Helen S. |title= PE: How to Overcome Premature Ejaculation |pages=43–61 |year=1989 |publisher=Brunner Mazel/New York Times}}</ref><ref>{{citation|author= Metz, M. and B. McCarthy |title= Coping With Premature Ejaculation |pages=105–133|year=2003 |publisher= New Harbinger Publications }}</ref><ref>{{citation|author= Silverberg, S. |title= Lasting Longer: The Treatment Program for Premature Ejaculation |pages=42–57|year=1978, 2010 |publisher= Physicians Medical Press }}</ref><ref>{{citation|author= Birch. R.W.|title= A Short Book About Lasting Longer|pages=16–44|year=2007 |publisher= PEC Publishing }}</ref> The authors of one study concluded that sex therapy "has a remarkable therapeutic effect on premature ejaculation."<ref name=Chen>{{cite journal |author= Chen, G.H. et al.|title= A Clinical Study on Psycho-Behavioral Therapy for Premature Ejaculation |journal= Zonghua Nan Ke Xua (Chinese journal) |volume=15 |page=929 |year=2009|pmid= 20112744 |issue=10}}</ref>

=== Medications ===
Drugs that increase serotonin signalling in the brain slow ejaculation and have been used successfully to treat PE. These include [[selective serotonin reuptake inhibitor]]s (SSRIs), such as [[paroxetine]], as well as [[clomipramine]]. Ejaculatory delay typically begins within a week of beginning medication. The treatments increase the ejaculatory delay to 6–20 times greater than before medication. Men often report satisfaction with treatment by medication, many discontinue it within a year.<ref name=Althof2007 /> SSRIs can cause various types of sexual dysfunction such as [[anorgasmia]], erectile dysfunction, and diminished libido. It can last for months, years, or sometimes permanently after the discontinuation of SSRIs.

[[Dapoxetine]] is a short-acting SSRI which appears to work when taken as needed for PE.<ref>{{cite journal|last=Hutchinson|first=K|coauthors=Cruickshank, K; Wylie, K|title=A benefit-risk assessment of dapoxetine in the treatment of premature ejaculation.|journal=Drug safety : an international journal of medical toxicology and drug experience|date=May 1, 2012|volume=35|issue=5|pages=359–72|pmid=22452563|doi=10.2165/11598150-000000000-00000}}</ref> It is generally well tolerated.<ref>{{cite journal|last=McMahon|first=CG|coauthors=Althof, SE, Kaufman, JM, Buvat, J, Levine, SB, Aquilina, JW, Tesfaye, F, Rothman, M, Rivas, DA, Porst, H|title=Efficacy and safety of dapoxetine for the treatment of premature ejaculation: integrated analysis of results from five phase 3 trials.|journal=The journal of sexual medicine|date=February 2011|volume=8|issue=2|pages=524–39|doi=10.1111/j.1743-6109.2010.02097.x|pmid=21059176}}</ref> [[Tramadol]], an atypical oral analgesic, appears to be effective.<ref>{{cite journal|last=Wong|first=BL|coauthors=Malde, S|title=The use of tramadol "on-demand" for premature ejaculation: a systematic review.|journal=Urology|date=Jan 2013|volume=81|issue=1|pages=98–103|pmid=23102445|doi=10.1016/j.urology.2012.08.037}}</ref>

Desensitizing topical medications that are applied to the tip and shaft of the penis can also be used. These are applied "as needed," 10–15 minutes before sexual activity and have fewer potential systemic side effects as compared to pills.<ref>An overview of pharmacotherapy in premature ejaculation. Porst H. J Sex Med. 2011 Oct. 8 4:335-41. {{DOI|10.1111/j.1743-6109.2011.02451.x}}</ref> Use of topicals is sometimes disliked due to the reduction of sensation in the penis as well as for the partner (due to the medication rubbing onto the partner).<ref>MacCarty E.J. & Dinsmore W.W. ''Premature Ejaculation: Treatment Update'' International Journal of STD AIDS 2010; 21:77-81</ref> Penis insensitivity and transference to the partner are practically eliminated when using topical anesthetic sprays based on absorption technology<ref>Preparation and characterization of two-phase melt systems of lidocaine. Kang L. Jun HW, Mani N. Int J Pharm 2001 Jul 3; 222(1)35-44</ref> which enable the active ingredient to penetrate through the surface skin of the penis (stratum corneum) to the sensory nerves which reside in the dermis. The only FDA approved spray available in the U.S. is [[Promescent]].<ref>U.S. [[Food and Drug Administration]] External Analgesic Drug Products for Over-The-Counter Human Use http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=348&showFR=1</ref>

== Epidemiology ==
Premature ejaculation is a prevalent [[sexual dysfunction]] in men;<ref name="premature ejaculation">{{cite web|url=http://www.mayoclinic.com/health/premature-ejaculation/DS00578|title=Premature ejaculation|publisher=[[Mayo Clinic]].com|accessdate=2007-03-02}}</ref> however, because of the variability in time required to ejaculate and in partners’ desired duration of sex, exact prevalence rates of PE are difficult to determine. In the “Sex in America” surveys (1999 and 2008), [[University of Chicago]] researchers found that between [[adolescence]] and age 59, approximately 30% of men reported having experienced PE at least once during the previous 12 months, whereas about 10 percent reported [[erectile dysfunction]] (ED).<ref name=Laumann>{{cite journal |author= Laumann, E.O., et al.|title= Sexual Dysfunction in the United States: Prevalence and Predictors |journal= Journal of the American Medical Association |volume=281 |page=537 |year=1999 |pmid= 10022110|doi=10.1001/jama.281.6.537}}</ref> Although ED is men's most prevalent sex problem after age 60, and may be more prevalent than PE overall according to some estimates,<ref name="erectile dysfunction">{{cite journal | pmid = 20497307 | doi=10.1111/j.1743-6109.2010.01849.x |volume=7 | issue=7 | title=Erectile dysfunction in the community: trends over time in incidence, prevalence, GP consultation and medication use—the Krimpen study: trends in ED|date=July 2010 | author=Schouten BW, Bohnen AM, Groeneveld FP, Dohle GR, Thomas S, Bosch JL |journal=J Sex Med | pages=2547–53}}</ref> premature ejaculation remains a significant issue that, according to the survey, affects 28 percent of men age 65–74, and 22 percent of men age 75–85.<ref name=Laumann /> Other studies report PE prevalence ranging from 3 percent to 41 percent of men over 18, but the great majority estimate a prevalence of 20 to 30 percent—making PE a very common sex problem.<ref name=Barnes /><ref name=Althof2010>{{cite journal |author= Althof, S.E. et al. |title= International Society for Sexual Medicine’s Guidelines for the Diagnosis and Treatment of Premature Ejaculation |journal= Journal of Sexual Medicine|volume=7|page=2947|year=2010|pmid=21050394 |doi=10.1111/j.1743-6109.2010.01975.x |issue=9}}</ref><ref name="premature ejaculation" /><ref>{{cite journal |author= Mathers, M.J. et al. |title= Premature Ejaculation in Urological Routine Practice |journal= Aktuelle Urology (German)|volume=44 |page=33 |year=2013|pmid= 23381878 |doi=10.1055/s-0032-1331727 |issue=1}}</ref><ref>{{cite journal |author= Serefoglu E.C. and T.R. Saitz |title= New Insights on Premature Ejaculation: A Review of Definition, Classification Prevalence, and Treatment |journal= Asian Journal of Andrology |volume=14|page=822 |year=2012|pmid=23064688 |doi=10.1038/aja.2012.108 |issue=6}}</ref><ref>{{cite journal |author= Tang, W.S. and E.M. Khoo |title= Prevalence and Correlates of Premature Ejaculation in a Primary Care Setting: A Preliminary Cross-Sectional Study |journal= Journal of Sexual Medicine |volume=8 |page=2071 |year=2011|pmid= 21492404 |doi=10.1111/j.1743-6109.2011.02280.x |issue=7}}</ref><ref>{{cite journal |author= Porst, H. et al. |title= The Premature Ejaculation Prevalence and Attitudes (PEPA) Survey: Prevalence, Co-morbidities, and Professional Help-Seeking |journal= European Urology |volume=51|page=816|year=2007|pmid=16934919|doi=10.1016/j.eururo.2006.07.004 |issue=3}}</ref><ref>{{cite journal |author= Rowland, D. et al. |title= Self-Reported Premature Ejaculation and Aspects of Sexual Functioning and Satisfaction |journal= Journal of Sexual Medicine |volume=1|page=225|year=204|pmid= 16429622|issue=2 |doi=10.1111/j.1743-6109.2004.04033.x}}</ref>

There is a common misconception that younger men are more likely to suffer premature ejaculation and that its frequency decreases with age. Prevalence studies have indicated, however, that rates of PE are constant across age groups.<ref name = Althof2007 />

== History ==
Other [[mammals]] ejaculate quickly during intercourse, prompting [[biologists]] to declare that rapid ejaculation had [[evolved]] into men's genetic makeup to increase their chances of passing their [[genes]].<ref name="Birch">{{cite web|first=Robert|last=Birch |title=Did you orgasm?|publisher=Sexualhealth.com|date=16 November 2007|accessdate=21 April 2010|url=http://www.sexualhealth.com/article/read/women-sexual-health/orgasm/486/|archivedate=16 July 2011|archiveurl=http://web.archive.org/web/20110716044630/http://www.sexualhealth.com/article/read/women-sexual-health/orgasm/486/}}</ref>

Ejaculatory control issues have been documented for more than 1,500 years.{{citation needed|date=August 2013}} The [[Kamasutra]], the 4th century Indian sex handbook, declares: "Women love the man whose sexual energy lasts a long time, but they resent a man whose energy ends quickly because he stops before they reach a climax."<ref>{{citation|author= Vatsyayana, M. (translators) Doniger, W. and Kakar, S.|title= Kamasutra |year=2009 |publisher=[[Oxford University Press]] }}</ref>{{primary source-inline|date=August 2013}}

Sex researcher [[Alfred Kinsey]] did not consider rapid ejaculation a problem, but viewed it as a sign of "masculine vigor".<ref>{{citation|author= Kaplan, Helen S. |title= The New Sex Therapy |page=292 |year=1974 |publisher=Brunner Mazel/New York Times}}</ref>
-->

== Referensi ==
{{reflist}}

== Pranala luar ==
* {{Commons category-inline|premature ejaculation|Ejakulasi dini}}

[[Kategori:Andrologi]]
[[Kategori:Gangguan alat kelamin laki-laki]]
[[Kategori:Penis manusia]]
[[Kategori:Disfungsi seksual]]
[[Kategori:Ejakulasi]]
[[Kategori:Peristiwa dini]]

Revisi terkini sejak 10 Februari 2023 02.22

Ejakulasi dini
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Ejakulasi dini (bahasa Inggris: Premature ejaculation, bahasa Latin: ejaculatio praecox) adalah kejadian pria mengalami orgasme dan mengeluarkan air mani setelah melakukan aktivitas seksual atau mengalami stimulasi penis dalam waktu singkat (minimal). Hal tersebut dapat disebut juga klimaks cepat, atau klimaks dini.

Meskipun pria yang mengalami ejakulasi dini menganggap dirinya tidak memiliki tenaga setelah ejakulasi, ternyata menurut penelitian banyak dari pria yang berharap bisa bertahan lebih lama.[1]

Pria yang mengalami ejakulasi dini dilaporkan memiliki keharmonisan yang terganggu, dan terkadang menolak melakukan hubungan seksual karena merasa malu dengan penyakit yang dialami.[2] Dibandingkan dengan pria, wanita tidak terlalu mempermasalahkan ejakulasi dini yang dialami pasangannya,[3] tetapi dari beberapa penelitian menunjukkan kondisi tersebut yang menyebabkan ketidakharmonisan.[4][5][6]

Penyebab

Penyebab dari ejakulasi dini tidak terlalu jelas. Banyak teori yang dikeluarkan, termasuk bahwa ejakulasi dini terjadi karena hasil dari melakukan masturbasi yang terlalu cepat ketika masa remaja untuk menghindari pengawasan orang tua, demam panggung, konflik oidipal, agresivitas pasif, dan kurang melakukan aktivitas seksual — tetapi tidak ada satupun teori yang pasti dan bisa menjelaskan gejala tersebut.[1]

Ejakulasi dini dapat terjadi karena radang prostat[7] atau efek samping dari obat-obatan, juga karena pengaruh makanan berlemak dan manis sebelum melakukan hubungan intim..


Pengobatan

Beberapa macam metode pengobatan sudah diuji coba untuk mengobati ejakulasi dini. Kombinasi dari pengobatan medis dan nonmedis merupakan metode yang efektif untuk mengobati ejakulasi dini antara lain:

1. Pelatihan otot seksual adalah salah satu metode paling mudah untuk memecahkan ejakulasi dini. Fungsi ejakulasi sperma dilakukan dengan bantuan otot PC, yang terletak di dasar panggul. Dan sebenarnya, pada beberapa pria otot ini tidak dilatih dengan baik untuk melaksanakan fungsi ejakulasi dengan benar.

2. Menjaga erotisme seksual pada kecepatan normal sangat penting untuk mencapai ereksi lengkap. Kebanyakan pria khawatir tentang perasaan dan yang itu akan mengakibatkan kehilangan kontrol dan berakhir dengan klimaks terlalu cepat. Untuk mengatasi ini, Anda perlu meningkatkan foreplay dan seks oral sementara terlibat dalam hubungan seksual. Latihan pernapasan juga akan membantu Anda untuk santai dan mengendalikan ejakulasi selama hubungan seks.

3. Gunakan Ramuan Herbal: penunda ejakulasi atau pil Anti ejakulasi dini tersedia saat ini. Selalu memilih pil bahan herbal yang diperkaya untuk mengobati jenis-jenis gangguan tersebut. Jika pil mengandung bahan-bahan herbal, maka kita dapat mengatakan 100% aman untuk digunakan karena tidak memberikan efek samping.

Diri sendiri

Banyak pria mencoba untuk mengobati dirinya dari ejakulasi dini dengan mengalihkan pikiran, seperti mencoba untuk menjauhi segala sesuatu yang dapat menstimulasi aktivitas seksualnya. Cara yang lain adalah melakukan hubungan seksual dengan perlahan, menolak melakukan masturbasi, ejakulasi sebelum melakukan aktivitas seksual, dan menggunakan lebih dari satu kondom. Menggunakan lebih dari satu kondom sangat tidak dianjurkan, karena akan terjadi gesekan antara kondom dengan penis dan akan menyebabkan iritasi hingga kerusakan. Banyak pria yang berpendapat bahwa cara tersebut berhasil.[1]

Konsultasi dengan dokter yang sudah ahli dalam bidang seksual dapat membantu sekitar 75 sampai 80 persen dalam proses penyembuhan.[8]


Referensi

  1. ^ a b c Strassberg, D. S., & Perelman, M. A. (2009). Sexual dysfunctions. In P. H. Blaney & T. Millon (Eds.), Oxford textbook of psychopathology (2nd ed.), (pp. 399–430). NY: Oxford University Press.
  2. ^ Barnes T., I. Eardley (2007). "Premature Ejaculation: The Scope of the Problem". Journal of Sex and Marital Therapy. 33 (3): 151. PMID 7365515. 
  3. ^ Byers, E.S. and G. Grenier (2003). "Premature or Rapid Ejaculation: Heterosexual Couples' Perceptions of Men's Ejaculatory Behavior". Archives of Sexual Behavior. 32 (3): 261. PMID 12807298. 
  4. ^ Limoncin, E.; et al. (2013). "Premature Ejaculation Results in Female Sexual Distress: Standardization and Validation of a New Diagnostic Tool for Sexual Distress". Journal of Urology. 189 (5): 1830–5. doi:10.1016/j.juro.2012.11.007. PMID 23142691. 
  5. ^ Graziottin, A. and S. Althof (2011). "What Does Premature Ejaculation Mean to the Man, the Woman, and the Couple?". Journal of Sexual Medicine. 8: 304. doi:10.1111/j.1743-6109.2011.02426.x. PMID 21967392. 
  6. ^ Barnes T., I. Eardley (2007). "Premature Ejaculation: The Scope of the Problem". Journal of Sex and Marital Therapy. 33 (3): 151. PMID 7365515. 
  7. ^ Althof, S.E.; et al. (2010). "International Society for Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation". Journal of Sexual Medicine. 7 (9): 2947. doi:10.1111/j.1743-6109.2010.01975.x. PMID 21050394. 
  8. ^ McCabe, M.P. (2001). "Evaluation of a Cognitive Behavior Therapy Program for People with Sexual Dysfunction". Journal of Sex and Marital Therapy. 27 (3): 259. doi:10.1080/009262301750257119. PMID 11354931. 

Pranala luar

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