Hello and welcome to Healthcare Magic. Thanks for your query.

I will certainly help and advise you regarding your problem. In order to guide you better, can you please provide the following clarifications...

- How long have you been having this problem? Does is have any co-relation with your accident?

- How frequently does this problem happen? Does it happen everytime you are sexually aroused?

- Do you have any problems with your erection?

- Do you practise masturbation? Do you have any problems associated with it?

- Have you had any sexual relationship before? If so, did you have any problems in your sexual performance?

- Do you suffer from anxiety, negative thoughts or low mood?

- Do you smoke or consume alcohol or any other drugs?

- Do you have any other medical problems or are you on any medication currently?

Please get back to me with these details and we shall take it forward.

Regards,
- Dr. Jonas Sundarakumar
Consultant Pychiatrist

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Hello again and thanks for your clarifications,

Since you say that this problem has been present only after the accident, it is likely that this problem may be related to the spinal trauma which you had sustained. The nerves responsible for the ejaculation are located in the lower part of the spinal cord, namely the scaral nerve roots. When there is any injury or inflamation or irritation to these nerve roots, there can be problems in ejaculation such as what you have mentioned.

Now, since you do not seem to have any other neurological deficits, it is likely that even if there is a spinal problem, it has to be a mild or a transient one. Sometimes, it may take a few months for the edema (swelling) after the acute injury to settle down. So, hopefully, your problem should gradually improve with time.

In the meantime, if your problem is causing you a lot of distress, then I would suggest that you report this to your neurologist and have a physical / neurological examination done. There are remedies available for your problem, in the form of medication or certain sexual techniques. There are certain medication like Dapoxetine (Prilyxet), which can help you with this specific problem of premature ejaculation. You can also try certain specific sexual techniques like "stop-start technique" or "squeeze technique" which have been proven to be successful in increasing the ejaculatory time.

In the stop-start technique, the penis can be stimulated (by masturbation) till a point when you feel close to orgasm. Then the stimulation is stopped for a while and again the process is repeated a few times.
In the squeeze technique, the penis can be stimulated (by masturbation) till a point when you feel close to orgasm. At this point the lower part of the head of the penis is squeezed tightly with the index finger and thumb around for a few seconds till the erection decreases. Then the stimulation can be restarted and the process is repeated a few times.

So, please try these techniques regularly and also have a review consultation with your neurologist. In case your problem is persisting, then you may need medication to help you with this problem.

- Dr. Jonas Sundarakumar
Consultant Pychiatrist

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