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Suffering from premature ejaculation. How to cure this?

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Psychiatrist
Practicing since : 2004
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Hi Doctor,

I am suffering with premature ejaculation since from the beginning. I never been satisfied with opposite sex (I also don’t have sex with same sex in the past so many years, except I had in my childhood). This is the reason, I always been disturb and hesitate talking to someone about this problem. My spouse is however satisfied since I do all she require and most of the time (weekly) we both get released at the same time I put my penis inside, other wise we satisfied our self separately. We do foreplay so that orgasm is having 99% time. I have started masturbating at a very early age. After having released my self, I don’t feel satisfied (100% if I keep my penis inside opposite sex partner). I feel very lazy and have pain in my lower side of legs. My family is very supportive (have one daughter and one son), I am an intelligent person, understand things so there is a struggle in my mind always. I speak a lot, some time its goes against me whereas I don’t have any bad intention for any one ever. I need your help to increase my sex time and have a more material release with more time with a satisfaction.
Posted Thu, 11 Apr 2013 in Mental Health
 
 
Answered by Dr. Ashish Mittal 20 hours later
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Premature ejaculation is diagnosed when ejaculation time is less than 3 Min, or both partners are not satisfied with sex. In your case although both partners are satisfied after act, but ejaculation time is very short (few seconds only), which is major cause dissatisfaction in sexual life.

Premature ejaculation (PE) is common problem and depends on multiple factors like:
*Psychological factors: most common. The psychological factors may include stress, performance anxiety and depression. Stress may also lead to somatic symptoms in form of laziness and pain due to muscle spasm. Same time poor satisfaction in sexual life increases stress further.

*Medical causes: Reflex activity of ejaculatory system, thyroid problems, diabetes, hypertension and neurological causes.

Following steps will be helpful for treatment:

-Treatment of above conditions (if present) after examination.

-Start jogging in morning and meditation as it reduces stress and performance anxiety.

- Try distracting yourself when you feel you are about to ejaculate. Take a deep breath and stay relaxed during intercourse.

- Do not worry about performance and talk to your partner openly about any apprehensions if you have. Conversation with partner during sex also delay ejaculation.

- Stop-start or squeeze-pause technique- In stop start technique, near ejaculation stop all movements, relax and think about something else. Then wait for 1 minute before starting movements. According to number of stops, ejaculation time will come under your control.

-Squeeze- pause technique: squeeze the end or the tip of the penis for 10 to 20 seconds when you are close to ejaculation and then resume stimulation after withholding for half a minute.

-In many persons woman on top position increases ejaculation time.

- If the symptoms persist then condoms with desensitizing creams (marketed as Kohinoor extra time) increases ejaculation time.

-Medicines of SSRI group (selective serotonin reuptake inhibitors) are used to increase ejaculation time. This is prescription medicine, which you can get after prescription from psychiatrist.

Normal semen volume is 2-5 ml when ejaculation is done after 5 days of abstinence. If you suspect low semen volume in your case, then it is better to have semen analysis done.

Steps to increase semen volume:
-Avoid smoking and alcohol (if present).
-Wear loose underwear.
-Avoid heavy exercise
--Do Take Nutritional Supplements – The following supplements have been recommended to enhance sperm production:Vitamin C, Vitamin E, Selenium, Zinc, Coenzyme Q-10, L–Carnitine, B-Complex, Folic Acid.
-Stay Healthy and Fit – Moderate exercise will always help.
-Drink plenty of liquids.
-Minimize stress

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,
Above answer was peer-reviewed by
 
Follow-up: Suffering from premature ejaculation. How to cure this? 1 hour later
Thanks Dr. XXXXXXX My ejaculation time is just few seconds. Semen value is also very low. Unanswered issue : no attraction for opposite sex, always think about same sex an not getting the same, its distrubing me a lot. I request you to suggest some medicine to come out of this problem. With best regards XXXXXX
 
 
Answered by Dr. Ashish Mittal 12 hours later
Hello again,
Thanks for follow up.

Sexual orientation can be of three types:
•     Heterosexuality: liking for opposite sex
•     Homosexuality: liking for same sex
•     Bisexuality: comfortable with both sex

You appear to have Bisexual orientation from the information provided by you, as you are able to have sex with your wife. Bisexuality/homosexuality is not physical and psychological disorders because of these laws are being change in all word gradually to provide it legal status. It is just a sexual orientation.

Prevalence of Bisexual orientation is around 1-2% in India and in some western countries it is more than 3%. Sexual orientation cannot be change and as this is not a disorder, so do not worry about its treatment. But it is commonly associated with anxiety, depression, adjustment disorder, self harm and isolation because of social complication if orientation is disclosed to others. So accept yourself as you are naturally.

There is no treatment available to change orientation. It is better to balance your life according to social situation and sexual orientation, which is very difficult most of the time.

Wish you good health.
Regards.
Above answer was peer-reviewed by
 
Follow-up: Suffering from premature ejaculation. How to cure this? 9 hours later
Thanks Doctor, Please advice medicine to avoid premature ejaculation and increase semen. With best regards XXXXXX
 
 
Answered by Dr. Ashish Mittal 32 minutes later
Hello again,
Thanks for follow up.

Medicines of SSRI group (selective serotonin reuptake inhibitors) like dapoxetine are used to increase ejaculation time. This is prescription medicine, which you can get after prescription from psychiatrist.

Normal semen volume is 2-5 ml when ejaculation is done after 5 days of abstinence. If you suspect low semen volume in your case, then it is better to have semen analysis done, to confirm the problem and to know extent of problem. After this test, if semen volume is low, then there is need to investigate cause of low semen volume by hormonal/biochemical lab investigation and ultrasound examination of urogenital tract. After that treatment will depend on the cause of the problem. Till that time, follow above natural steps given in primary reply to increase semen volume.

Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.

Wish you good health.
Regards.
Above answer was peer-reviewed by
 
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