Brief Answer:
yes premature ejaculation can be treated

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us. I can understand your concern.

According to the latest diagnostic criteria by DSM 5, premature ejaculation (PME) should be defined when there is ejaculation within one minute after entering tin to vagina or even before penetration.

It can be treated. In this young age , reason of this problem is psychological and can be treated even without medicines.

To help you further I need more information.

You are not married, provide details about sex life with girlfriend. Where and in which circumstances do you do sex?

- How did problem start? Any specific incidence was there?

- Do you pay more attention to erection while trying for intercourse?

- Do you have any physical illness?

- How is relationship with your partner? Any emotional or social problem is there?

- Is there any history of smoking or alcohol?

- Is there any difficulty in urinating?

- When did you do successful intercourse last?

- Is there any history of masturbation? If yes, how was pleasure/orgasm during masturbation?

Erection in sleep is an absolutely normal phenomenon. it occurs due to physiological condition in REM stage sleep. In general when man wakes up from sleep erection is there. Is it associated with ejaculation?

I will be happy to help further after your response.
Regards,
Dr.Chintan Solanki.

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Brief Answer:
it is night fall, just increase the frequency of masturbation

Detailed Answer:
Hello,

Thanks for information.

Your concern is about night fall.It is also called nocturnal emission.

Nocturnal emission is natural phenomenon. First of all clarification about night fall:

In all boys when puberty starts around age of 3 to 7, production of testosterone increased. This leads to increase in body hair, beard and moustache as well as production semen and physical body changes.

Semen is produced regularly after puberty by prostate and testicles and stored in seminal vesicles. This semen in general is expelled by masturbation or sex. When someone does not actively expel semen through masturbation or sex, there is excess semen in seminal vesicles.
When production rate exceeds capacity of storage of seminal vesicles stored semen has to come out to give space to newly produced semen.
This excess stored semen comes out during sleep, urination or defecation.
In sleep during dreams or excitement with slight force excess semen comes out and it is known as night fall.
If you are not doing masturbation regularly or not involved in sexual activities, night fall would be there. It is absolutely normal phenomenon and not a problem/disease.

- Let me know your frequency of masturbation/sex?

For your information I want mention treatment of Premature ejaculation.

Treatment for PME:

Medicines:
Clomipramine and paroxetine are choice of medicines which are used as antidepressants (For depression dose is higher).
I prefer clomipramine for PME. No significant side effects with these medicines. Initially say for 0-30 days daily after dinner and later on just on the day when you do the sex.
Paroxetine is more potent but it may cause side effects like headache, gastric discomfort, giddiness and sedation. In patients with blood pressure it should be used in consultation with physician/cardiologist.

One molecule called depoxetine has been used specifically for PME and should be taken before 2 hours of sex when required.
These medicines are prescription medicines and you need to consult doctor/psychiatrist/sexologist for prescription.


Behavioral approaches are as follows for your information:

1. Stop and Squeeze technique can be applied which you can learn from internet and ask me if any query in that.(In brief, method suggests that you should try to divert your mind for a moment when you feel ejaculation arousal and penis should be tightly squeezed with hand inwards by your partner preferably).

2. Kegel exercise also helps in some cases. You can learn the same from internet.

3. Sex counselling of your sexual behavior and methods. Like if you are down and female partner on top, gravity is going to help you for lengthening the time.

4. You should do masturbation before sex (at least 2 hours before). It will make seminal vesicles somewhat empty and at time of sex semen will take more time to come out.

Another approach:
-Use of condoms. It reduces sensitivity of glans penis and delays the ejaculation.

- Topical application of lignocaine anesthetic gel/spray. For this you have to consult doctor.

Clomipramine can help in preventing night fall.

I would like to guide you further after your response.

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