Brief Answer: Premature ejaculation is usually psychological Detailed Answer: Hi there, Thanks for your query. Premature ejaculation has nothing to do with foreskin or circumcision. The reasons are mostly psychological, such as, lack of self-confidence, unfounded apprehensions, baseless myths, fear about your inability to satisfy your partner; fear of being taunted; or, underlying mental stress. The secret to a mutually enjoyable and satisfying sex, is to GO SLOW. Spend adequate time in foreplay; continue with foreplay till your sex partner is completely aroused sexually and about to reach climax. That is the right time to go in for intercourse. That way, both partners will have an orgasm and therefore be sexually satisfied. Quite often, the male gets fully aroused prematurely, out of sheer excitement and thereby, has difficulty in controlling himself from ejaculating. If that occurs, simply divert your mind to some unrelated incident, which will curb your desire to ejaculate. Lastly, regain your confidence, drive away your unfounded fears and apprehensions, feel confident of your sexual ability and, above all, convince yourself that you have no sexual problem of premature ejaculation. By following the "Rules of successful sex' as mentioned above, both partners will derive great sexual satisfaction, which will give a great boost to your self-confidence. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Take care, Dr. Rakesh Karanwal

---

Brief Answer: There is no FULLY effective medical treatment. Detailed Answer: Hi there, Nice hearing back from you. Almost 90% cases of premature ejaculation have psychological reasons. Since you have possible psychological problems, further evaluation is required. You may therefore get certain investigations done and try the following treatment:- 1. Firstly, get Blood Testosterone and Prolactin tests done and intimate me the reports. 2. Start with Escitalopram 10mg daily after dinner for 15 days; thereafter, increase the dose to 10mg TWICE daily. Please note that the effect will be observed only AFTER three weeks. 3. You may also try using a combination of Lidocaine 2.5% + Prilocaine 2.5% ointment. Apply approx., 1" long strip of cream evenly over the penis and put on a condom, about 30 minutes BEFORE sexual intercourse. You may remove the condom just before sex. The cream is effective only in some cases, but is worth trying. There is no other treatment for your problem. If you don't find relief after 6-8 weeks of taking Escitalopram, an alternative drug can be tried. Take care, Dr. Rakesh Karanwal

---