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Orgasmusstörungen (Ejaculatio praecox und verzögerte Ejakulation)

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Sexualmedizin für die Praxis

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Zusammenfassung

Die vorzeitige (EP) und verzögerte (VE) Ejakulation stellen hinsichtlich der Ejakulationslatenzzeit extreme Pole eines Verteilungskontinuums und die quantitativ bedeutendsten Orgasmusstörungen dar. Darüber hinaus zählen unter anderem noch einige seltenere Störungsbilder wie der anhedonische Orgasmus (EWO – Ejaculation without orgasm) und das Post-orgasmic illness syndrome (POIS) zu dieser Störungsgruppe. Verglichen mit der erworbenen sekundären EP sehen wir die lebenslange primäre Erscheinungsform der EP in der Praxis häufiger, während bei der VE die erworbenen sekundären Subtypen häufiger Konsultationsanlass sind. EP und VE sind für die Betroffenen mit einem hohen Leidensdruck verbunden und haben destruktiven Einfluss auf die Paarbeziehung. Gemeinsam ist beiden Ejakulationsstörungen, dass die Ätiologie am ehesten multifaktoriell und in vielen Aspekten noch unklar ist, wobei allerdings bei der EP deutlichere Hinweise zur Genese dahingehend vorhanden sind, dass eine Dysbalance im serotonergen System gemeinsam mit einer Koordinationsstörung des autonomen Nervensystems in Form einer Neigung zu allgemeiner sympathikotoner Überaktivierung und -erregung (mit-)verursachend ist. EP und VE führen seit Langem ein sexualmedizinisches Schattendasein, aus dem die vorzeitige Ejakulation in den letzten Jahren allerdings durch die Entwicklung neuer oraler und topischer medikamentöser Therapieoptionen, deren Effektivität jedoch nicht an die der bei der ED zur Verfügung stehenden Pharmaka heranreicht, ein wenig herausgetreten ist. Daher haben bei vorzeitiger und verzögerter Ejakulation psychoedukatorische und sexualtherapeutische Interventionen sowie Erfahrungsübungen im Einzel- oder Paarsetting mit guten Erfolgsaussichten einen hohen Stellenwert.

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Authors and Affiliations

  1. Sexualmedizinisches Kompetenzzentrum, Hannover, Deutschland

    Christian Neuhof

  2. Klinische Psychologie und Sexualmedizin, Hannover Medical School, Hannover, Deutschland

    Uwe Hartmann

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  1. Christian Neuhof
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Editors and Affiliations

  1. Klinische Psychologie und Sexualmedizin, Hannover Medical School, Hannover, Deutschland

    Uwe Hartmann

  2. Klinische Psychologie und Sexualmedizin, Hannover Medical School, Hannover, Deutschland

    Tillmann Krüger

  3. Sexualmedizinisches Kompetenzzentrum Hannover, Hannover, Deutschland

    Viola Kürbitz

  4. Sexualmedizinisches Kompetenzzentrum, Hannover, Deutschland

    Christian Neuhof

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Neuhof, C., Hartmann, U. (2021). Orgasmusstörungen (Ejaculatio praecox und verzögerte Ejakulation). In: Hartmann, U., Krüger, T., Kürbitz, V., Neuhof, C. (eds) Sexualmedizin für die Praxis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62512-5_22

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