Hi XXXXXXX
Welcome to Healthcare Magic and thanks for your query.

You seem to have a problem of pre-mature ejaculation. Now, the most important step in the management of any sexual problem is a comprehensive evaluation. A proper evaluation will include a detailed medical and sexual history, and a thorough physical examination. This is not only informative to the doctor, but also serves as an opportunity to clarify any doubts of the person, and decrease any anxiety or stress due to the problem. Treatment is then targetted according to the findings on evaluation.

I would also like to let you know that in more than 90% of cases of pre-mature ejaculation in young males, psychological factors play a major role in causing or aggravating the problem. One of the important problems which young men having during their initial few sexual experiences have is a subconscious performance anxiety. This can result from the following doubts or fears.
- Doubts that you won't perform well and satisfy your partner.
- Anxiety or fear about ejaculating prematurely.
- Worries about your attractiveness or body image or penis size

Soon this subconscious performance anxiety becomes a viscious cycle" - that is, anxiety leads to poor performance and poor performance then leads to further anxiety and this keeps on worsening.

So, I would advise you to try the folowing suggestions:

1) First get rid of thoughts that you may be sexually inadequate or dobts that you may not be able to get an proper erection. 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.

2) There are certain certain specific sexual techniques like "stop-start technique" or "squeeze technique" which have been proven to be successful in increasing the ejaculatory time. Practising these techniques regularly will prevent your penis from being 'hypersensitive' to sensations and thus avoid pre-mature ejaculation.

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.

3) There are certain medication like Dapoxetine (Prilyxet), which can help you with this specific problem of premature ejaculation. But I would advise you to keep this only as a last resort and like I mentioned before, you need a detailed evaluation before starting any medication.

So, you can try the above suggestions which I have given and if you follow them correctly - reduce your performance anxiety, improve your confidence and try the sexual techniques, you will be able to get rid of your problem. In case, you still continue to have the problem, then you need to see a sexologist or psychiatrist for a dtailed evaluation.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Pychiatrist

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