Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Premature Ejaculation
Question: Erection is for short duration after starting the intercourse.
Brief Answer:
provide more details
Detailed Answer:
Hello XXXXXXX
Thanks for writing to us. I can understand your concern.
If you lose erection with ejaculation within short duration, it is premature ejaculation and if you lose erection without ejaculation it is erectile dysfunction. Please clarify what is your problem from either of these?
Also let me know more details:
- Are you married?
If yes duration of marriage?
If not married, provide details about sex life with girlfriend. Where and in which circumstances you do sex?
- How did problem start? Any specific incidence was there?
- Do you pay more attention to erection while trying for intercourse?
- Do you have any physical illness?
- How is relationship with your partner? Any emotional or social problem is there?
- Is morning erection present?
- Is there any history of smoking or alcohol?
- Is there any difficulty in urinating?
- When did you do successful intercourse last?
- Is there any history of masturbation? If yes, how was pleasure/orgasm during masturbation?
I will be happy to help further after your response.
Regards,
Dr.Chintan Solanki.
provide more details
Detailed Answer:
Hello XXXXXXX
Thanks for writing to us. I can understand your concern.
If you lose erection with ejaculation within short duration, it is premature ejaculation and if you lose erection without ejaculation it is erectile dysfunction. Please clarify what is your problem from either of these?
Also let me know more details:
- Are you married?
If yes duration of marriage?
If not married, provide details about sex life with girlfriend. Where and in which circumstances you do sex?
- How did problem start? Any specific incidence was there?
- Do you pay more attention to erection while trying for intercourse?
- Do you have any physical illness?
- How is relationship with your partner? Any emotional or social problem is there?
- Is morning erection present?
- Is there any history of smoking or alcohol?
- Is there any difficulty in urinating?
- When did you do successful intercourse last?
- Is there any history of masturbation? If yes, how was pleasure/orgasm during masturbation?
I will be happy to help further after your response.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hello Doctor
From description, my case is premature ejaculation.
Yes I am married 6 months back.
PLease find rest of the answer inline:
How did problem start? Any specific incidence was there?
everytime time during intercourse, it is Premature ejaculation.
- Do you pay more attention to erection while trying for intercourse?
Yes I do pay attention to erection.
- Do you have any physical illness?
No physical illness.
- How is relationship with your partner? Any emotional or social problem is there?
No problem with partner.
- Is morning erection present?
Yes sometimes.
- Is there any history of smoking or alcohol?
No smoking, occasionally alcohol.
- Is there any difficulty in urinating?
NO
- When did you do successful intercourse last?
Not yet
- Is there any history of masturbation? If yes, how was pleasure/orgasm during masturbation?
Yes earlier I used to do a lot of masturbation.
From description, my case is premature ejaculation.
Yes I am married 6 months back.
PLease find rest of the answer inline:
How did problem start? Any specific incidence was there?
everytime time during intercourse, it is Premature ejaculation.
- Do you pay more attention to erection while trying for intercourse?
Yes I do pay attention to erection.
- Do you have any physical illness?
No physical illness.
- How is relationship with your partner? Any emotional or social problem is there?
No problem with partner.
- Is morning erection present?
Yes sometimes.
- Is there any history of smoking or alcohol?
No smoking, occasionally alcohol.
- Is there any difficulty in urinating?
NO
- When did you do successful intercourse last?
Not yet
- Is there any history of masturbation? If yes, how was pleasure/orgasm during masturbation?
Yes earlier I used to do a lot of masturbation.
Brief Answer:
PME is treatable. avoid performance anxiety
Detailed Answer:
Hi,
Thanks for information.
Your problem is likely psychosexual rather than physical. it is absolutely treatable. I want to clarify about performance anxiety and treatment of premature ejaculation.
Sometime due to fatigue, lack of mood, situational problem or environmental changes man can fail in sex. It is normal phenomenon. This is called performance anxiety. After such failure when person actively thinks about erection/ejaculation or success of intercourse during sex/masturbation his mind is likely diverted to such thoughts. For constant erection continuous exciting/romantic/erotic feelings should be there in mind. If mind diverted to concern about erection/ejaculation, ejaculation occurs fast.
While doing sex keep yourself relax.
Whenever you go for sex, spare enough time in foreplay. You should not think actively about erection or ejaculation, your mind must be occupied with sexual/romantic feelings. During foreplay your partner should try to arouse you and note that your penis gets erection or not. When she feels that penis is sufficiently erect she herself should try to put erect penis in vagina gradually and you should continue your foreplay feelings without being conscious about ejaculation. You must try to enjoy and only enjoy.
If your partner is not aware about this situation you can do on your own. You just should try to do sex without being conscious about erection. Enjoy without thinking of ejaculation and you will succeed or not.
In any case in future you will fail after multiple attempts; medicines are there to get confidence.
Treatment for PME:
Medicines:
Clomipramine and paroxetine are choice of medicines which are used as antidepressants (For depression dose is higher).
I prefer clomipramine for PME. No significant side effects with these medicines. Initially say for 0-30 days daily after dinner and later on just on the day when you do the sex.
Paroxetine is more potent but it may cause side effects like headache, gastric discomfort, giddiness and sedation. In patients with blood pressure it should be used in consultation with physician/cardiologist.
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.
Behavioral approaches are as follows for your information:
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. Kegel exercise also helps in some cases. You can learn the same from internet.
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. It reduces sensitivity of glans penis and delays the ejaculation.
- Topical application of lignocaine anesthetic gel/spray. For this you have to consult doctor.
In ayurvedic products confido can be used for premature ejaculation. It is likely available over the counter without prescription.
If I were your treating doctor I would recommend clomipramine and confido.
Take care.
PME is treatable. avoid performance anxiety
Detailed Answer:
Hi,
Thanks for information.
Your problem is likely psychosexual rather than physical. it is absolutely treatable. I want to clarify about performance anxiety and treatment of premature ejaculation.
Sometime due to fatigue, lack of mood, situational problem or environmental changes man can fail in sex. It is normal phenomenon. This is called performance anxiety. After such failure when person actively thinks about erection/ejaculation or success of intercourse during sex/masturbation his mind is likely diverted to such thoughts. For constant erection continuous exciting/romantic/erotic feelings should be there in mind. If mind diverted to concern about erection/ejaculation, ejaculation occurs fast.
While doing sex keep yourself relax.
Whenever you go for sex, spare enough time in foreplay. You should not think actively about erection or ejaculation, your mind must be occupied with sexual/romantic feelings. During foreplay your partner should try to arouse you and note that your penis gets erection or not. When she feels that penis is sufficiently erect she herself should try to put erect penis in vagina gradually and you should continue your foreplay feelings without being conscious about ejaculation. You must try to enjoy and only enjoy.
If your partner is not aware about this situation you can do on your own. You just should try to do sex without being conscious about erection. Enjoy without thinking of ejaculation and you will succeed or not.
In any case in future you will fail after multiple attempts; medicines are there to get confidence.
Treatment for PME:
Medicines:
Clomipramine and paroxetine are choice of medicines which are used as antidepressants (For depression dose is higher).
I prefer clomipramine for PME. No significant side effects with these medicines. Initially say for 0-30 days daily after dinner and later on just on the day when you do the sex.
Paroxetine is more potent but it may cause side effects like headache, gastric discomfort, giddiness and sedation. In patients with blood pressure it should be used in consultation with physician/cardiologist.
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.
Behavioral approaches are as follows for your information:
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. Kegel exercise also helps in some cases. You can learn the same from internet.
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. It reduces sensitivity of glans penis and delays the ejaculation.
- Topical application of lignocaine anesthetic gel/spray. For this you have to consult doctor.
In ayurvedic products confido can be used for premature ejaculation. It is likely available over the counter without prescription.
If I were your treating doctor I would recommend clomipramine and confido.
Take care.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
