How is Premature Ejaculation Diagnosed? Be Alert to These 2 Core Situations

许多男性在性生活中偶尔会遇到射精过快的情况，但这并不一定意味着患有早泄。从医学角度看，早泄的诊断有明确的国际标准。如果您持续遇到以下两个核心情况，并且它们给您带来困扰，那么很可能符合早泄的医学定义，建议寻求专业诊断。

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Many men occasionally experience rapid ejaculation during sexual activity, but this does not necessarily mean they have Premature Ejaculation (PE). From a medical perspective, there are clear international criteria for diagnosing PE. If you consistently encounter the following ​two core situations​ and they cause you distress, it is likely that you meet the medical definition of PE, and seeking professional diagnosis is recommended.

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​核心情况一：射精时间持续过短 | Core Situation 1: Consistently Short Ejaculation Time

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这是最客观的指标之一，医学上称为“阴道内射精潜伏时间”。它指的是从阴茎进入阴道到发生射精的时间。

This is one of the most objective indicators, medically known as “Intravaginal Ejaculatory Latency Time.” It refers to the time from vaginal penetration to ejaculation.

• ​如何判断：​​ 在大多数性交尝试中（通常指超过一半以上），射精总是或几乎总是发生在进入阴道后约1分钟以内。这种情况被称为“终身性早泄”。如果是后来才出现的，时间可能稍长（如3分钟以内），但依然显著短于个人期望。
• ​How to judge:​​ In most attempts at sexual intercourse (typically more than half), ejaculation always or almost always occurs within ​approximately one minute​ after vaginal penetration. This is termed “Lifelong PE.” If it started later in life, the time might be slightly longer (e.g., within 3 minutes) but is still significantly shorter than desired.

​请注意 / Important Note:​​ 这个“1分钟”是一个基于大规模临床研究的参考值，用于帮助医生诊断。关键是“持续”和“重复”发生，而不是偶尔一次。

This “one minute” is a reference value based on large-scale clinical research, used to aid doctors in diagnosis. The key is that it happens consistently and repeatedly, not just occasionally.

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​核心情况二：缺乏控制感，并引发负面情绪 | Core Situation 2: Lack of Control, Leading to Negative Emotions​

这个情况涉及主观感受和心理影响，与第一个情况必须同时存在才能确诊。

This situation involves subjective feelings and psychological impact, and it ​must coexist​ with the first situation for a diagnosis.

1. ​缺乏控制感：​​ 您感到无法主动延迟或控制射精的发生。仿佛射精是一个无法被意志控制的反射动作，一旦兴奋度达到某个点，就必然发生。这种“无力感”是核心特征之一。
2. ​引发负面情绪：​​ 上述情况已经对您造成了明显的困扰和烦恼。您可能会因此感到沮丧、尴尬、自卑，甚至开始焦虑地回避性亲密关系。这种负面情绪是诊断的必要条件。
3. ​Lack of Control:​​ You feel unable to voluntarily delay or control the occurrence of ejaculation. It feels as if ejaculation is an involuntary reflex action that inevitably happens once a certain level of excitement is reached. This sense of “helplessness” is a key feature.
4. ​Causing Negative Emotions:​​ The above situation causes you significant ​distress and bother. You may feel frustrated, embarrassed, inferior, or even begin to anxiously avoid sexual intimacy. This negative emotional impact is a necessary condition for diagnosis.

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​确诊流程：医生还会做什么？ | Confirmation Process: What Else Will the Doctor Do?​​

当您向医生描述以上两个核心情况后，医生并不会立即草率下结论。完整的诊断是一个综合过程，旨在排除其他可能性，确保诊断准确。

When you describe these two core situations to a doctor, they will not make a hasty conclusion. A complete diagnosis is a comprehensive process aimed at ruling out other possibilities and ensuring accuracy.

1. ​深入问诊：​​ 医生会详细询问您的性生活史、整体健康状况、压力水平、伴侣关系等，以判断是终身性还是获得性早泄，以及是否有明显的心理诱因。
2. ​使用评估量表：​​ 可能会让您填写一份简短的标准化问卷（如PEDT），帮助量化您的问题严重程度。
3. ​体格与实验室检查（用于排除）：​​ 这是至关重要的一步。医生可能会建议进行检查，但目的不是为了“证明”早泄，而是为了“排除”其他可能模仿早泄症状的疾病。例如：
   • ​甲状腺激素检查：​​ 甲亢可能导致射精过快。
   • ​前列腺检查：​​ 前列腺炎可能引起类似症状。
   • ​血糖测试：​​ 糖尿病神经病变可能影响控制力。
   • ​评估勃起功能：​​ 确保早泄不是由勃起困难（ED）所继发。因为有时男性会因担心勃起无法维持而匆忙射精，表现为早泄。
4. ​In-depth Interview:​​ The doctor will ask in detail about your sexual history, overall health, stress levels, partner relationship, etc., to determine if it’s lifelong or acquired PE and if there are obvious psychological triggers.
5. ​Using Assessment Scales:​​ You might be asked to complete a brief standardized questionnaire to help quantify the severity of your issue.
6. ​Physical and Lab Tests (for Exclusion):​​ This is a ​crucial step. The doctor may suggest tests, but the ​purpose is not to “prove” PE, but to “rule out” other conditions that can mimic PE symptoms. For example:
   • ​Thyroid Function Tests:​​ Hyperthyroidism can cause rapid ejaculation.
   • ​Prostate Examination:​​ Prostatitis can cause similar symptoms.
   • ​Blood Sugar Tests:​​ Diabetic neuropathy can affect control.
   • ​Erectile Function Assessment:​​ To ensure PE is not secondary to Erectile Dysfunction. Sometimes, men rush ejaculation due to fear of not being able to maintain an erection, presenting as PE.

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​给马来西亚读者的建议 | Advice for Readers in Malaysia​

如果您发现自己同时符合上述两个核心情况，最明智的做法是：

If you find that you meet both of the above ​core situations, the wisest course of action is:

​勇敢咨询医生。​​ 您可以先去看普通科医生，他们会进行初步评估，如果需要，会转介您给泌尿科专科医生。在马来西亚的政府诊所或私人医院都可以获得帮助。请坦然告知医生您的情况，这是解决健康问题的正确第一步。

​Bravely consult a doctor.​​ You can start by seeing a general practitioner, who will conduct an initial assessment and refer you to a urologist if necessary. Help is available at government clinics or private hospitals in Malaysia. Please communicate your situation openly to the doctor; this is the correct first step towards resolving a health issue.

​记住：​​ 早泄是一个有明确诊断标准、且可治疗的医学状况。获得准确的诊断是迈向有效管理和恢复的第一步。

​Remember:​​ Premature Ejaculation is a medical condition with clear diagnostic criteria, and it is treatable. Obtaining an accurate diagnosis is the first step towards effective management and recovery.