Brief Answer:
increase frequency, your problem is treatable

Detailed Answer:
Hello Mr. XXXXXXX

Thanks for writing to us.

You are suffering from 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.As your frequency of sex has been reduced, there is likely possibility that this is the big reason for your problem. Increase in frequency of sex/masturbation will surely help.


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.

In ayurvedic products confido can be used for premature ejaculation. It is likely available over the counter without prescription.

If I were your treating doctor I would recommend clomipramine and confido.

You can ask your GP to write prescription for clomipramine.

With below link you may find psychiatrist near to you. By degree psychiatrist is sexologist and can help you personally.

http://doctor.healthcaremagic.com/doctors/Psychiatrists-in-Gorakhpur/L19398S35

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

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