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

You seem to be suffering from two sexual problems:
1) Pre-mature ejaculation
2) A probable genital / proper evaluation will include a detailed medical and sexual history, a thorough physical examination, and certain investigations, as per necessity. This is not only informative to the doctor, but also serves as an opportunity to clarify any doubts of the person, and decreases any anxiety or stress due to the problem. Treatment is then targetted according to the findings on evaluation.

The first problem, pre-mature ejaculation, is a very common problem in young males. Now, the good news is that in more than 90% of persons with this sexual problem, there is no medical abnormality causing this.. Most of the times, the underlying causes are the following:

1) Subconscious anxiety / fears / doubts about inadequate sexual performance (called as "performance anxiety")
and / or
2) A hypersensitive response of the penis

Treatment of premature ejaculation problem can be with behavioural techniques or with medication. Usually medication is kept only as the last resort as most of the problems will resolve with proper behavioural techniques.

I would suggest the following tips to overcome this problem:

1) Firstly get rid of thoughts that you may be sexually inadequate or your doubts that you may not be able to perform properly. Like I mentioned before, performance anxiety, feelings of sexual indequacy, self-doubts, guilt, past negative sexual experiences, poor communication / understanding with the partner, etc. can all affect sexual functioning and performance. So, removing the person's doubts and fears, and improving his self-confidence levels will definitely help in improving sexual performance. Remember that sex is not just a physical act but also a psychological process involving an expression of emotions, intimacy and love. So, just involve yourself in those feelings and stop focussing on your "performance" alone. Once you do that, then I assure you that your sexual performance will automatically improve.

Most importantly, performance anxiety soon becomes a "viscious cycle" That is, anxiety leads to poor performance and poor performance then leads to further anxiety and this keeps on increasing. So, the key is to break this cycle at some point of time and take control of yourself.

2) The second cause for pre-mature ejaculation is hypersensitivity of the penis to touch sensations. Now, there are certain specific sexual techniques which can reduce this hypersensitivity. The "stop-start technique" or "squeeze technique" have been proven to be successful in reducing this hypersensitivity and increasing the ejaculatory time.

In the stop-start technique, the penis is stimulated (by sexual intercourse or by masturbation) till a point when you feel close to orgasm. At that point, the stimulation is stopped for some time and after a small gap, it is continued. This process is repeated repeated a few times.

In the squeeze technique, the penis can be stimulated by hand (by masturbation or by your partner) till a point when you feel close to orgasm. At that 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 is restarted and the process is repeated a few times.

Both these techniques, if practised regularly can increase your time taken for orgasm.

3) One more problem responsible for early ejaculation is inadequate sexual arousal. When the person is not properly aroused, the blood flow to the penis is not maximal, and so, after a few strokes, the erection weakens and ejaculation occurs. The way to tackle this is not to rush into intercourse quickly, but wait till you get fully aroused. So, increase and spice-up your foreplay. Make sure that you initiate penetration only after both of you are fully turned on. Good foreplay not only arouses you but also sparks off the mood in your partner. So, when she is also aroused and involved, then things keep flowing smoothly and effortlessly, and you don't have to be constantly anxious if you are satisfying your partner or not.

4) Improve your communication with your partner - this means both verbal as well as non-verbal communication. Each person has his or her own ways of getting sexually aroused or feeling sexual pleasure. So, this verbal and non-verbal communication will let each of the partners understand each other's needs and thereby make sex both relaxing and enjoyable.

5) Distract yourself stop "monitoring" your sexual performance. Try putting on some romantic music or mild lighting while you make love. Think about the things that turn you on. Taking your mind off of your sexual performance can remove the worries that are stopping you from getting excited.

6) There are also certain medication like Dapoxetine (Prilyxet), which can help you with this specific problem of premature ejaculation. But like I mentioned before, medication should be kept only as a last resort after trying the behavioural methods and sexual techniques.

It is also important to eat a healthy & balanced diet, exercise regularly and try to stay positive and stress-free.

Regarding the discomfort and redness in the penis, this could be indicative of a genito-urinary infection. I would advise you to get yourself examined by a doctor and have a urine test done. If on examination, you are found to have any specific lesions indicative of an STI (sexually transmitted infection), then you need additional tests.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist & Sexologist

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Hello again,

If all your tests are normal, then one option would be to just take symptomatic treatment. I would suggest the following measures:

- Wash the area (with the foreskin retracted) two to three times daily with diluted potassium permanganate solution (potassium permanganate crystals or solution should be available with your local chemist) or diluted betadine solution.

- Certain medication which alkalinize the urine can often provide symptomatic relief from discomfort. e.g. Citralka syrup.

- Drink plenty of fluids. Drinking cranberry juice can also help.

- Keep the genital and groin clean, sweat-free and dry.

- Avoid using any strongly perfumed soap or shower gels.

- Avoid wearing tight clothing and wear loose cotton underwear.


Sometimes, the redness and disconfort can be due to an allergic cause also, for example a reactive urethritis. In such a case, a course of anti-allergy medication can provide relief.

In some cases, where no infection can be specifically detected but the patient continues to have symptoms, an empirical course of a broad-spectrum antibiotic can also be tried.

So, I would advise you to the try symptomatic remedies, and discuss about the above-mentioned treatment options with your doctor.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist & Sexologist

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