Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Loss Of Libido And Premature Ejaculation
Question: I am aged 40 married abt 10 years ago. I lost my sex apetite and ejacuate fast as such my wife is not satisfied. I have sex rarely. My erections are fine. I know size doesn't matter but it appears to be shrinked. Kindly advice. Thanks
Brief Answer:
increase frequency of sex/masturbation
Detailed Answer:
Hello XXXXXXX
Thanks for writing to us. I can understand your concern.
Your erections are fine that is good. Fast ejaculation can be premature ejaculation.
Due to decrease frequency in sex early ejaculation is likely there. Your problem is likely physiological.
If frequency of sex is 2-3 times a month or less and 1-2 times masturbation in a month or less, there is likely excessive semen in seminal vesicles. So when you go for sex, with little excitation or arousal ejaculation occurs.
Solution is simple: Frequency of sex should be increased or 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.
About decrease desire I need some information.
- Since when problem is there?
- Is there any stress (social, economical, occupational or emotional) in your life?
- How much size is shrinked, let me know current and previous size?
- Do you have any physical illness?
- Do you have habit of smoking, tobacco chewing or alcohol?
- Your wife is not satisfied with, 1) early ejaculation,2) decrease desire of yours, 3) decrease frequency, 4) Shrink size or all ?
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
increase frequency of sex/masturbation
Detailed Answer:
Hello XXXXXXX
Thanks for writing to us. I can understand your concern.
Your erections are fine that is good. Fast ejaculation can be premature ejaculation.
Due to decrease frequency in sex early ejaculation is likely there. Your problem is likely physiological.
If frequency of sex is 2-3 times a month or less and 1-2 times masturbation in a month or less, there is likely excessive semen in seminal vesicles. So when you go for sex, with little excitation or arousal ejaculation occurs.
Solution is simple: Frequency of sex should be increased or 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.
About decrease desire I need some information.
- Since when problem is there?
- Is there any stress (social, economical, occupational or emotional) in your life?
- How much size is shrinked, let me know current and previous size?
- Do you have any physical illness?
- Do you have habit of smoking, tobacco chewing or alcohol?
- Your wife is not satisfied with, 1) early ejaculation,2) decrease desire of yours, 3) decrease frequency, 4) Shrink size or all ?
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Regards to decrease in desire
1. The problem is since about 6-8 months.
2. Stress is not regular but rarely (I think thats common) but more often more occupied at office with lot of work.
3. Regarding size I cant say exact size but I feel myself weak. My testicles seems to be shrinked.
4. I dont have physical illness but suffers from acute sinusitus. I donot smoke, donot take alcholol neither chew tobacco
5.Wife not satisfied with (a) decrease desire and (b) shrink size (c) early ejaculation
6. Decrease in frequency of sex -(My wife is equally responsible for this as she is not that interested at times)
7. I am bit sensitive also to my private parts
1. The problem is since about 6-8 months.
2. Stress is not regular but rarely (I think thats common) but more often more occupied at office with lot of work.
3. Regarding size I cant say exact size but I feel myself weak. My testicles seems to be shrinked.
4. I dont have physical illness but suffers from acute sinusitus. I donot smoke, donot take alcholol neither chew tobacco
5.Wife not satisfied with (a) decrease desire and (b) shrink size (c) early ejaculation
6. Decrease in frequency of sex -(My wife is equally responsible for this as she is not that interested at times)
7. I am bit sensitive also to my private parts
Brief Answer:
couple counseling is needed
Detailed Answer:
Hi XXXXXXX
Thanks for information.
It seems that you and your wife both are not able to enjoy sex life. To have successful intercourse in couple , romance should be present in other areas of life. After few years of marriage it is natural phenomenon that either of coupe or both have less interest in sex due to responsibilities as well not being able to provide sufficient time for each other.
To rule out basic cause of male sexual dysfunction I recommend going for investigation of serum testosterone level.
For improvement in desire I recommend Tentex Forte from himalaya company. It is herbal product without side effects.One capsule at night with one cup of milk.
For early ejaculation I want to clarify about premature ejaculation.
According to the latest diagnostic criteria by DSM 5, premature ejaculation should be defined when there is ejaculation within one minute after entering tin to vagina or even before penetration.
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 20-30 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. Sometime use of condom while sex helps in delaying ejaculation by reducing sensitivity of glans penis.
--Topical application of lignocaine anesthetic gel/spray. For this you have to consult doctor.
I recommend clomipramine in your case.
To have good sex life overall marital life should be fine. Why you both are not interested in sex that aspect should be evaluated by detail couple history and counselling. You both need to give time to each other and spare quality romantic time with other apart from sex.
Hope this answer will help.
Feel free to discuss further.
couple counseling is needed
Detailed Answer:
Hi XXXXXXX
Thanks for information.
It seems that you and your wife both are not able to enjoy sex life. To have successful intercourse in couple , romance should be present in other areas of life. After few years of marriage it is natural phenomenon that either of coupe or both have less interest in sex due to responsibilities as well not being able to provide sufficient time for each other.
To rule out basic cause of male sexual dysfunction I recommend going for investigation of serum testosterone level.
For improvement in desire I recommend Tentex Forte from himalaya company. It is herbal product without side effects.One capsule at night with one cup of milk.
For early ejaculation I want to clarify about premature ejaculation.
According to the latest diagnostic criteria by DSM 5, premature ejaculation should be defined when there is ejaculation within one minute after entering tin to vagina or even before penetration.
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 20-30 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. Sometime use of condom while sex helps in delaying ejaculation by reducing sensitivity of glans penis.
--Topical application of lignocaine anesthetic gel/spray. For this you have to consult doctor.
I recommend clomipramine in your case.
To have good sex life overall marital life should be fine. Why you both are not interested in sex that aspect should be evaluated by detail couple history and counselling. You both need to give time to each other and spare quality romantic time with other apart from sex.
Hope this answer will help.
Feel free to discuss further.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
