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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Erectile Dysfunction And Premature Ejaculation

i am 40, i hardly get tight erection , once in a month. My penis is also small 4.5". I ejacuate early . Which leaves my wife unhappy. I am unable to control my ejacuation. I feel that my wife is unhappy with our sex life as she express. Almost every time i am leaving her unhappy during sex, so she is not showing interest in our sex. It hurts me lot. Some time i feel guilty that with such in-ability, i shoulnt have married. I feel depressed, with low level of confidence. I request for your valuable medical advice with lots of hope.... Karri
Thu, 2 Jun 2016
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Psychiatrist 's  Response
Dear service user
Thank you for contacting Healthcaremagic.
I have gone through your question and understand your concerns.
It Is very unfortunate to know that you are going through emotional disturbance secondary to 'early' ejaculation and perceived 'small' penis size.
There is no 'specific' time period defined for ejaculatory delay. It greatly varies from person to person.
When clients with similar problems approach me, I recommend them a behavior exercise called start-stop technique.
In this technique, during initial days, the man starts masturbation and stops just prior to orgasmic inevitability. He allows arousal level to decline and re-stimulates. One should continue this 'start-stop' sequence for about 15 minutes. This is how you one gains ejaculatory control gradually.
Later on, this technique can be performed with partner's co operation during coitus in following stages:
Stage 1: The man lies down on his back allowing woman to masturbate him asking her to stop when he feels orgasmic inevitability. When arousal level declines, ask her to re-stimulate, repeating same for 15 to 20 minutes.
The man should be more concerned about his own desires and not to be anxious about partner's need during this behavior therapy. After fifteen minutes the man reaches orgasm, appreciates and enjoys it fully. He can now move to next stage 2 hence second part of exercise.
Stage 2: Female partner repeats the exercise of stage 1, but instead of allowing the male partner to reach extra vaginal orgasm, she stimulates him to get an erection and mounts him in female on top position. When he is inside her, she becomes still, motionless just like a statue. Here, man learns to get acquainted with vaginal sensation. During this act, if he feels that the orgasm is impending then, he tells her and she gets off him.
When arousal subsides, both should repeat the last exercise for about 15-20 minutes.
Stage 3: This is akin to stage 2 and female is on the top again getting him inside. This time she moves. The man holds her pelvis to move her to and fro. If he feels orgasm approaching, he stops her movements. Once again when arousal feelings decline, he restarts the movements slowly and gradually so as to learn not to aroused too fast.

Two partners should engage in this exercise until both of them are satisfied with performance. When one masters these stages, one can proceed to enjoy sexual intercourse in any comfortable position.
When clients with similar problems approach me, in addition to above exercise, I also prescribe medicine like Dapoxetine 15 mg to 30 mg to be taken 1 hour prior to sex, or Paroxetine 20 mg to be taken 4 to 5 hour before sex.
Size of penis has nothing to do with sexual satisfaction of the partner.
Hope, I have answered your question. If you have any further questions I will be happy to help. Wish you good health.
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Suggest Treatment For Erectile Dysfunction And Premature Ejaculation

Dear service user Thank you for contacting Healthcaremagic. I have gone through your question and understand your concerns. It Is very unfortunate to know that you are going through emotional disturbance secondary to early ejaculation and perceived small penis size. There is no specific time period defined for ejaculatory delay. It greatly varies from person to person. When clients with similar problems approach me, I recommend them a behavior exercise called start-stop technique. In this technique, during initial days, the man starts masturbation and stops just prior to orgasmic inevitability. He allows arousal level to decline and re-stimulates. One should continue this start-stop sequence for about 15 minutes. This is how you one gains ejaculatory control gradually. Later on, this technique can be performed with partner s co operation during coitus in following stages: Stage 1: The man lies down on his back allowing woman to masturbate him asking her to stop when he feels orgasmic inevitability. When arousal level declines, ask her to re-stimulate, repeating same for 15 to 20 minutes. The man should be more concerned about his own desires and not to be anxious about partner s need during this behavior therapy. After fifteen minutes the man reaches orgasm, appreciates and enjoys it fully. He can now move to next stage 2 hence second part of exercise. Stage 2: Female partner repeats the exercise of stage 1, but instead of allowing the male partner to reach extra vaginal orgasm, she stimulates him to get an erection and mounts him in female on top position. When he is inside her, she becomes still, motionless just like a statue. Here, man learns to get acquainted with vaginal sensation. During this act, if he feels that the orgasm is impending then, he tells her and she gets off him. When arousal subsides, both should repeat the last exercise for about 15-20 minutes. Stage 3: This is akin to stage 2 and female is on the top again getting him inside. This time she moves. The man holds her pelvis to move her to and fro. If he feels orgasm approaching, he stops her movements. Once again when arousal feelings decline, he restarts the movements slowly and gradually so as to learn not to aroused too fast. Two partners should engage in this exercise until both of them are satisfied with performance. When one masters these stages, one can proceed to enjoy sexual intercourse in any comfortable position. When clients with similar problems approach me, in addition to above exercise, I also prescribe medicine like Dapoxetine 15 mg to 30 mg to be taken 1 hour prior to sex, or Paroxetine 20 mg to be taken 4 to 5 hour before sex. Size of penis has nothing to do with sexual satisfaction of the partner. Hope, I have answered your question. If you have any further questions I will be happy to help. Wish you good health.