Suggest Treatment For Premature Ejaculation

Brief Answer:
I prefer clomipramine or paroxetine

Detailed Answer:
Hello Mr. XXXXXXX

Thanks for writing to us.

First of all Premature Ejaculation (PME) defined when male partner ejaculates early before the female partner reaches to orgasm. There is no absolute time by which we can diagnose PME. It is relative term and female partner is the best judge.

Treatment:

Medicines:
Clomipramine and paroxetine are choice of medicines which are used as antidepressants (For depression dose is higher). Prozac (Fluoxetine) may help in some cases but not so much effective as clomipramine.
I prefer clomipramine for PME. No significant side effects with these medicines. Initially say for 20-30 days daily after dinner and later on just on the day when you do the sex.
Paroxetine is also potent but it may cause side effects like headache, gastric discomfort, giddiness and sedation.

One molecule called depoxetine has been used specifically for PME and should be taken before 2 hours of sex when required.
These medicines are prescription medicines and you need to consult doctor/psychiatrist/sexologist for prescription.

In your case if I were your treating doctor I will prefer clomipramine.

For your information I would like to mention other approaches to treat PME.

Behavioral approaches are as follows:

1. Stop and Squeeze technique can be applied which you can learn from internet and ask me if any query in that.(In brief, method suggests that you should try to divert your mind for a moment when you feel ejaculation arousal and penis should be tightly squeezed with hand inwards by your partner preferably).

2. Master and XXXXXXX technique can also be learnt from qualified sexologist/Psychiatrist which includes sessions in couple as it is couple sex therapy. It can help in prolongation of time.

3. Sex counselling of your sexual behavior and methods. Like if you are down and female partner on top, gravity is going to help you for lengthening the time.

4. You should do masturbation before sex (at least 2 hours before ). It will make seminal vesicles somewhat empty and at time of sex semen will take more time to come out.

Another approach:
-Use of condoms. Sometime use of condom while sex helps in delaying ejaculation by reducing sensitivity of glans penis.

--Topical application of anesthetic gel/spray. For this you have to consult doctor.

In ayurvedic products confido or tentax royale can be used for premature ejaculation. They are likely available over the counter without prescription.

Hope I have answered your query, I will be happy to help further.

Regards,
Dr.Chintan Solanki.

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Brief Answer:
online prescription is not valid, you can take confido with clomipramine

Detailed Answer:
Hi,

Thanks for follow up.

As a policy we do not describe dose online.For your information I want to mention that 10-25 mg dose is needed. Initially for 20 days daily and then on required basis only.For prescription you have to consult doctor.

Clomiprramine and confido can be taken together but it may cause delayed ejaculation. So better to take confido alone. If not effective add clomipramine.

Depoxetine is totally different drug from clomipramine. Depoxetine is only used for PME. And it should be taken only when required.

By a degree Psychiatrist is sexologist. Very few sexologist are there with degree of MBBS with PhD/fellowship in sexology. So better to consult psychiatrist or sexologist with at least degree of MBBS.

Hope your all questions are answered.
If still any query there, I will be happy to answer. If not, you can close the discussion and if feasible give your feedback and rating so I can improve my service. In future you can contact me directly on this site if you wish with this link:
http://bit.ly/drchintansolanki
by clicking on 'Ask me a question' on same page.

All the best.

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