Brief Answer:
Hi.

Detailed Answer:
Hello      XXXXXX,
Thanks for your query.

Premature ejaculation is a very common and treatable problem. Premature ejaculation is diagnosed when ejaculation time is less than 3 Min during sex, or both partners are not satisfied with sex. This problem is not diagnosed with poor ejaculation time during masturbation.

Premature ejaculation (PE) is common problem and depends on multiple factors like:

*Psychological factors: most common. The psychological factors may include stress, performance anxiety and depression

*Medical causes: Reflex activity of ejaculatory system, thyroid problems, diabetes, hypertension, excessive alcohol use and neurological causes.

FOLLOWING STEPS WILL BE HELPFUL FOR TREATMENT:

-Treatment of above conditions (if present) after examination.

-Start jogging in morning for 20-30 minutes daily, as it reduces performance anxiety and improve blood circulation.

- Try distracting yourself when you feel you are about to ejaculate. Take a deep breath and stay relaxed during intercourse.

-Stop start technique: In stop start technique, near ejaculation stop all movements, relax and think about something else. Then wait for 1 minute before starting movements. According to number of stops, ejaculation time will come under your control.

-Squeeze- pause technique: squeeze the end or the tip of the penis for 10 to 20 seconds when you are close to ejaculation and then resume stimulation after withholding for half a minute.

-In many persons woman on top position increases ejaculation time, so try this position and experiment with other positions also.

-Condoms with desensitizing creams (marketed as Kohinoor extra time) help in increasing ejaculation time. Just wear this as normal condom and start sex after 30-60 seconds of penile massage, as medicine take some time to act.

Follow all these above methods regularly and your problem will solve in few weeks. As you are in XXXXXXX you can also meet me personally for treatment.

Wish you good health.
Regards.

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Brief Answer:
Then..this will help you.

Detailed Answer:
Hello XXXXXX again,
Thanks for follow up.

You did not mentioned about the already used methods by you in primary query. In treatment of PME, preferred initial treatment is behavior interventions as mentioned above.

In case of poor response or non suitability of some methods (like in your case) I prefer to give following treatment:
-Tab Dapoxetine 30mg: 2 hour before Sex. On demand basis use.
or
-Tab Paroxetine CR 12.5mg, Daily in night.

Wish you good health.
Regards

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