1Sreeram P. U, 2Jithesh M
DOI : http://dx.doi.org/10.47191/ijahm/v12i3.01
1Final year MD Scholar, Manovigyan Avum Manasroga, Department of Kayachikitsa, Vaidyaratnam P.S Varier Ayurveda College, Kottakkal, Malappuram Dt., Kerala
2Professor and Head of the Department, Department of Kayachikitsa, Vaidyaratnam P.S Varier Ayurveda College, Kottakkal, Malappuram Dt., Kerala
Download Pdf
ABSTRACT:
Premature ejaculation (PE) is the most common type of ejaculatory dysfunction which is difficult to manage. The global prevalence of PE is estimated as 20 – 40 % and in India it is reported as 8.76%. The inability to control ejaculation associated with unsatisfied experience of orgasm for the couples is a major factor causing psychological distress that leads to inter-personal conflicts. However, psychological interventions provide better results in PE, a combined approach of Psycho-Pharmacological intervention offer superior efficacy.
A 39-year-old male presented with inability to delay ejaculation with a duration of sexual act less than 1 minute associated with resultant significant anxiety that hampered the sexual activity and reduced the sexual desire. On further interrogation, it was revealed that he had a significant stressful event in his life due to financial loss and also had a hurried sexual act which led to rapid ejaculation. However, he had many previous good experiences in his sexual act and also was having a supportive partner.
The case was diagnosed as Premature ejaculation as per DSM V Criteria and as Śukṟagata Vata in Ayurveda purview. The management was planned in OP level, as a combination of a positive psychotherapy technique called Solution Focused Brief Therapy (SFBT) and an Ayurveda formulation Staṃbhanakara yoga for 3 months. Significant improvement was noted in Sexual dysfunction assessment questionnaire (Revised Singh. G et al. 2001) and Solution Focus Inventory recorded before and after the management along with increased Intra Ejaculatory Latency Time (IELT).
KEYWORDS: Premature Ejaculation, Śukṟagata Vata, Solution Focused Brief Therapy (SFBT), Staṃbhanakara yoga
REFERENCE :
- Zhong-Cheng Xin1, Yi-Chen Zhu2, Yi-Ming Yuan1, Wan-Shou Cui1, Zhe Jin1, Wei-Ren Li1 and Tao Liu1. Current therapeutic strategies for premature ejaculation and future perspectives. Asian Journal of Andrology (2011) 13, 550–557; doi:10.1038/aja.2010.130
- Odunayo Kalejaiye, Khaled Almekaty, Gideon Blecher, Suks Minhas. Premature ejaculation: Challenging new and old concepts [version 1; referees: 2 approved]. F1000 Research [Internet]. 2017 Dec 04; 6(F1000 faculty review): 2084. Available from: doi: 10.12688/f1000research.12150.1.
- Sathyanarayana Rao TS, Darshan MS, Abhinav Tandon. An epidemiological study of sexual disorders in south Indian rural population. Indian journal of Psychiatry [Internet]. 2015 April – June; 57(2): 150 – 157. Available from: http://www.indianjpsychiatry.org/doi:10.4103/0019-5545.158143
- American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington VA: American Psychiatric Association; 2013.p 443-444
- Althof SE, McMahon CG, Waldinger MD, et al. An Update of the International Society of Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE). Sex Med 2014;2:60-90.
- Waldinger MD. Recent advances in the classification, neurobiology and treatment of premature ejaculation. Adv Psychosom Med 2008; 29: 50–69.
- Raveendran AV, Agarwal A. Premature ejaculation – current concepts in the management: A narrative review. Int j Reprod BioMed 2021; 19: 5-22. Available from: https://doi.org/10.18502/ijrm.v19i1.8176.
- Rowland DL. Psychological impact of premature ejaculation and barriers to its recognition and treatment. Curr Med Res Opin. 2011; 27: 1509-1518.
- Stanley E. Althof. Psychosexual therapy for premature ejaculation. Transl AndrolUrol2016;5(4):475-481.http://dx.doi.org/10.21037/tau.2016.05.15.
- Althof SE. Psychological treatment strategies for rapid ejaculation: rationale, practical aspects, and outcome. World J Urol. 2005; 23: 89-92.
- Althof SE. Psychological approaches to the treatment of rapid ejaculation. The Journal of Men's Health and Gender. 2006; 3: 180-6.
- Althof SE. Treatment of Premature Ejaculation: Psychotherapy, Pharmacotherapy, and Combined Therapy. Binik YM, Hall KS. Principles and Practice of Sex Therapy, Fifth Edition. New York: Guilford Press, 2014:112-37.
- Perelman MA. Sex coaching for physicians: combination treatment for patient and partner. Int J Impot Res. 2003; 15(5): S67-74.
- Perelman MA. A new combination treatment for premature ejaculation: a sex therapist's perspective. J Sex Med 2006; 3:1004-1
- Terry S Trepper, Sophia Treyger, Jenifer Yalowitz and Jeff Ford. Solution-Focused Brief Therapy for the Treatment of Sexual Disorders. Journal of Family Psychotherapy [Internet]. 2010; 21(1): 34 – 53. Available from: http://dx.doi.org/10.1080/08975350902970360.
- Khader A, Singh G. Concept of sexuality in Ayurveda. Journal of Ayurveda and Holistic Medicine. 2014; 2(4): 35-43.
- Srikantha Murthy KR. Vagbhata’s Ashtanga hridayam: Vol 2. Varanasi: Chowkambha Krishnadas Academy; 2013. p.150. 82.
- Ram Karan Sharma, Vaidya Bhagwan Dash. Agnivesa’s Charaka Samhitha: Vol 5. Varanasi: Chowkambha Sanskrit series Office; 2013. p. 29.
- Srikantha Murthy KR. Illustrated Susrutha Samhitha: Vol 1. Varanasi: Chowkambha Krishnadas Academy; 2012. p. 464.
- P Mangalasseri, M S Bhagel. A clinical study on ShukragataVata with special reference to premature ejaculation and its management by Akarakarabhadi Yoga and Yapana Basti [Pg Dissertation]. Jamnagar: Gujarat Ayurved University; 2002
- A M Grant, M J Cavanagh, Sabina Kleitman, Gordon Spence, Michaela Lakota and Nickolas Yu. Development and validation of the solution-focused inventory. The Journal of Positive Psychology. 2012 July;7(4):334–348.
- Babu Haridas Vaidya. Chikitsa Chandrodaya. 10th ed. Varanasi: Chaukambha Publication; 1984. p. 147
- Prasad V Kulkarni, Harimohan Chandola. Evaluation of Stambhanakara Yoga and counseling in the management of ShukragathaVata (premature ejaculation). AYU [Internet]. 2013 January – March; 34(1): 42 – 48. Available from: http://www.ayujournal.org/doi:10.4103/0974-8520.115445.
- Mark Beyebach. European Brief Therapy Association Outcome Study: Research Definition. 26 May 2000.
- Steve de Shazer, Yvonne Dolan, Harry Korman, Terry Trepper, Eric McCollum, Insoo Kim Berg. More Than Miracles, The State of the Art of Solution-Focused Brief Therapy. Binghamton. The Harmworth Press: 2007; p7,8
- Zhong-Cheng Xin, Yi-Chen Zhu, Yi-Ming Yuan, Wan-Shou Cui, Zhe Jin, Wei-Ren Li, Tao Liu. Review: Current therapeutic strategies for premature ejaculation and future perspectives. Asian Journal of Andrology [Internet]. 2011; 13: 550–557. doi:10.1038/aja.2010.130.
- Sharma P. V. Introduction to Dravyaguna (Indian Pharmacology), 1st Ed: Vol 2. Varanasi: Chowkambha Krishnadas Academy; 1976. p. 88.
- Sharma P. V. Introduction to Dravyaguna (Indian Pharmacology), 1st Ed: Vol 3. Varanasi: Chowkambha Krishnadas Academy; 1976. p. 681.
- Sharma P. V. Introduction to Dravyaguna (Indian Pharmacology), 1st Ed: Vol 2. Varanasi: Chowkambha Krishnadas Academy; 1976. p. 780-781