Brief Answer:
more details about your problem are needed.

Detailed Answer:
Hello
Welcome to HCM.
I have read your query and understand your concerns.
But here i would request you to please give the following details as a follow-up query:
1. How many times in a week do you have intercourse?
2. You feel you ejaculate early. Does your partner also feels that you ejaculate early?
3. The symptoms which you have mentioned, do they occur after every act of intercourse? For how long these symptoms persist? And since how long are you facing this problem?
4. Your symptoms occur only after intercourse or otherwise also you get frequent headaches, anger outbursts, mood swings etc?
5. Do you have any other medical illnesses like diabetes, hypertension? Undergone any surgeries in past or suffered any trauma?
5. Do you smoke or drink alcohol or any other addiction?
6. What medications or other sort of therapies have you tried in past for your problem?

I know this might appear as a long list of question to you, but your replies would help me to understand your health issues better and find a concrete solution.

Hope to hear from you soon.
Thanks.

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Brief Answer:
Cause can be both biological and psychological.

Detailed Answer:
Thank you for providing the details.

I have gone through them thoroughly.

I can give you the possible explanations for such kind of behavior after sexual excitation:

1. Biologically, the symptoms which you have mentioned are mostly normal after sexual activity. But these usually resolve in few hours after intercourse or sexual excitation. However you have mentioned that your symptoms persist for 8-10 days. I feel that the behavioral agitation and your other symptoms are not a result of intercourse or emission and is an independent psychopathology. Sexual excitation just acts as a precipitant for this behavior.

2. Psychologically, the possible explanation would be that as you are having premature ejaculation, this can lead to hidden (unconscious) fears of inability to perform an intercourse or inability to satisfy your partner. And since the illness is of 8-10years, this is manifesting even after nocturnal emissions.

As we believe that both biological and psychological factors determine normal human behavior and also the occurrence of disorders, the management of your problem would require an integrated approach.

a. Drug management: i think the most appropriate drug treatment for you would be SSRIs (paroxetine). This will help you in problems of early ejaculation and other symptoms of thought disturbances and behavioral agitation. The drug can also reduce frequency of nocturnal emissions. (This specific use is from clinical experience and not from literature).
Tablet inderal taken before intercourse can also help to reduce headaches.

b. Psychological management: therapies like cognitive behavior therapy will help you to resolve faulty cognitions and modify your behavior. Also relaxation therapies like biofeedback can be very effective to keep you calm.

c. Family support: please involve your wife in your treatment plans. You would need a positive emotional support from her too.

d. Home remedies: continue with your jogging and exercises. Eat healthy food and include eggs, walnuts and fruits in your diet.

I think the multivitamins which you received were just a kind of placebo.

Sexual relationship is necessary for healthy married life. Once your symptoms begin to improve, you will start enjoying the sexual relationship with your wife. There won’t be any need to cut down on frequency of intercourse gradually.

I would advise you to consult a psychiatrist and a psychotherapist for the management. Please do not take any drugs without doctor's supervision.

Hope this helps.
Any further queries are welcome.
Thanks.

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Brief Answer:
yes you can go for a neurologist.

Detailed Answer:
Thanks for writing in again.

You can a neurologist as per your wish.

Hope my suggestions were of some help to you.

Wish you good health.

Take care.

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