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Suggest Treatment For Premature Ejaculation

Posted on Fri, 24 Oct 2014

Question: hi doctors,
This is XXXXXXX M having blood pressure taking telmisartan 40 mg. 42 year old married for more than 13 years. having problem of ED and PE. Had used lots of anxiety tablets earlier for PE (SSRI). Now from two years having problem of ED. blood reports are all normal. at present using Himalaya tentex and confido. But feels like my blood pressure increasing ( headache and dizziness). Please help me for ED and PE so that my blood pressure also not increased. two to three years back used Nano leo also. cholesterol level is fine. I take tadafil 10 mg or Sildenafil 50 mg along with depoxtine 30 mg than also not getting proper erection.

Answered by Dr. Chintan Solanki (2 hours later)

Brief Answer:
Clomipramine for PE, tetrafol/testosterone for ED

Detailed Answer:
Hi XXXXXXX

Thanks for writing to us.

You have provided very well details of your problem.

For premature ejaculation-PME, I suggest clomipramine 10-25 mg daily at night.In most of the patients with PE I use it as first line and get the response.I use SSRI as second choice.

For erectile dysfunction,
I will check testosterone.
If testosterone level is low, oral or injectable form of testosterone can be taken under medical supervision.However it has its own side effects.

One recent molecule containing methylfolate and pyridoxal phosphate(vitamins, trade name tetrafol plus) taken to be two times daily after meal is also useful in some patients particularly with homocystiene deficiency.In 40-50% of my patients with ED associated with diabetes and hypertension had good response.If you get some response in 20 days ,you should continue it for 2 months.

Other medicines are trazodone and yohimbine which are useful in many patients in erectile dysfunction.But secondary choice.

Another option is intracavernous (in penis vein) injection of papaverine which must be used under medical supervision.Which is last resort if above not works.

Non medicinal approach also useful in many cases if couple is motivated.
Psycho sexual counselling cum psychotherapy for sex:
Sex is act of two.So preferably your partner should be involved in counseling, that's why it is called couple therapy.
Master & XXXXXXX technique is specifically useful which can be learnt from psychiatrist/qualified sexologist.It will help for ED and PME.
Another technique stop & squeeze is useful in PME.

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

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Chintan Solanki (18 hours later)

Thanks Doctor

Regarding my testosterone and prolactine level is fine. It is within the range. I am using yohimate capsules( yohimbine) twice a day. But I feel because of it my blood pressure increases.
Please suggest me medicine for ED and PE which will not increase my blood pressure.

Thanks

Answered by Dr. Chintan Solanki (1 hour later)

Brief Answer:
Clomipramine and trazodone

Detailed Answer:
Hello,

Thanks for follow up query.

Clomipramine for PME as I described and it is not going to affect your blood pressure.

Trazodone to start with 50 mg can be useful for ED. Hypotension (decrease in blood pressure) is the side effect of it. So it will be rather helpful in controlling your blood pressure.

Also try tetrafol plus as it is vitamin, no effect in blood pressure.

Hope this will be useful.

regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Chintan Solanki (27 hours later)

Thanks for your prompt reply,

Only question is that below mentioned medicine increases blood pressure
1) yohimbine
2) L-Arginine
3) Himalaya Tentex forte
4) Himalaya Confido tablets

Also M using Himalayas Himcolin gel for oral massage of my penis. will it help to solve ED .

As I have these medicine for my ED treatment.
Thanks

Answered by Dr. Chintan Solanki (13 hours later)

Brief Answer:
You can consult good ayurvedik practitioner

Detailed Answer:
Hello,

Welcome back.Sorry for delayed reply.

Yohimbine can cause increase in blood pressure while arginine is used for lowering blood pressure.

I have used himalaya tentex forte in some patients but they were not suffering from hypertension.
Confido and himcolin gel I have never prescribed to any patient.

So for all above himalaya product detail, you can once consult some god ayurvedik doctor who can explain you detail about the drugs.
Himcolin gel might help in ED.

Regards,
Dr.Chintan Solanki.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Yogesh D