Brief Answer:
I do not recommend Japani Capsule or oil

Detailed Answer:
Hello,

Thanks for writing to us.

Japani capsule and oils are so called herbal products! They are not prescribed by doctors. There are no studies or trials showing its effectiveness.

For your problem of erectile dysfunction(ED) and premature ejaculation (PME) I am describing treatment here.

Treatment for ED:

5- PDE inhibitor group of medicines like sildenafil or tadalafil are used for ED. One of them should be used 2 hours prior to sex. They cause headache, stuffy nose nausea and gastric discomfort like common side effects. Proper physical check-up of cardiac system should be done by a doctor before starting the same. These are prescription medicines and you need to consult doctor/psychiatrist/sexologist for the prescription.

You can use medicine cum vitamin supplement containing pyridoxal-5-phosphate, mecobalamin and l-methylfolate (trade name tetrafol plus)is very helpful in my patients. It has shown improvement in 50-60% patients of mine with ED. You may get this medicine over the counter as it is vitamin product.

As you are likely form XXXXXXX I would like to also mention ayurvedic medicine option. Tentex forte is the medicine which is used for sex related problem. No side effects have been reported.

If I were your treating doctor I suggest one tablet of tetrafol plus after meal twice daily for two months and one tablet tentex forte daily at night with a cup of milk for 4 weeks.

There are some natural lifestyle measures which help to improve blood flow to penis and overall sexual performance.

- The most important factor is healthy heart. Blood is pumped in to body by heart. So regular exercise and avoidance of fatty fast food are important measures to prevent heart disease. Regular walking, swimming or running overall improves blood flow to whole body circulation including penis and keep the mind fresh.

- Good healthy food is also an important aspect. Bananas, Garlic, dry fruits(they contains vitamins), eggs, cow milk, cow butter are good food which may help in erectile dysfunction.

- Avoid smoking and alcohol. Low amount of alcohol can help in increasing blood flow but more amount can cause opposite effects. So better to avoid the same.


Now discussion about early ejaculation.

First of all Premature Ejaculation (PME) defined when male partner ejaculates early before the female partner reaches to orgasm. There is no absolute time by which we can diagnose PME. It is relative term and female partner is the best judge.

From your history I guess you do not have PME but still you want to enjoy longer.
For your information I am mentioning treatment aspect 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. Master and XXXXXXX technique can also be learnt from qualified sexologist/Psychiatrist which includes sessions in couple as it is couple sex therapy. It can help in prolongation of time.

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 anesthetic gel/spray. For this you have to consult doctor.

In ayurvedic products confido or tentax royale can be used for premature ejaculation. They are likely available over the counter without prescription.

In my opinion confido will be good option for you among these. You can take it daily one tablet.
Clomipramine or depoxetine just before sex is also good option. This will not cause any significant side effect. But you need to consult doctor to get the prescription.


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

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Brief Answer:
I have already mentioned Medicines

Detailed Answer:
Hello,

Thanks for follow up.

I have described medicines for both problem which you can take without doctor's prescription.

For ED,

I suggest one tablet of tetrafol plus after meal twice daily for two months and one tablet tentex forte daily at night with a cup of milk for 4 weeks.

If no improvement then you should consult doctor for examination and get prescription of 5-PDE inhibitor group of medicines.5 PDE is phosphodiesterase type 5 enzyme which is there in penis muscles responsible for relaxing the muscles and empty the blood fro penis during erection. Inhibitor of this enzyme like sildenafil or tadalfil block this action and allow good erection.

Fro PME,

In my opinion confido will be good option for you among these. You can take it daily one tablet for one month. It is available without prescription.
If no improvement seen clomipramine is to be taken daily for 2 weeks and then just before 3 hours of sex. You need to consult doctor for prescription of clomipramine.

Hope this answers your concern. Feel free to discuss further.

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Brief Answer:
Enjoy sex without being apprehensive

Detailed Answer:
Hello,

Thanks for follow up.

Yes you have understood medicines right.You will feel improvement within 15 days.

Precautions for healthy lifestyle I have already mentioned.

Apart from that understand what is performance anxiety mentioned below.

Sometime due to fatigue, lack of mood, situational problem or environmental changes erection problem occurs and man can fail in sex. It is normal phenomenon. However when this failure makes person apprehensive about erection, sex life is affected. This is called performance anxiety. After such failure when person actively thinks about erection or success of intercourse during sex his mind is likely diverted to such thoughts. For constant erection continuous exciting/romantic/erotic feelings should be there in mind. If mind diverted to concern about erection, erection would not be possible.

If you feel any component of performance anxiety in your case. Try to remove it.

To get rid of performance anxiety help of partner is also an important aspect.
Whenever you go for sex, spare enough time in foreplay. You should not think actively about erection, your mind must be occupied with sexual/romantic feelings. During foreplay your partner should try to arouse you and note that your penis gets erection or not. When she feels that penis is sufficiently erect she herself should try to put erect penis in vagina gradually and you should continue your foreplay feelings without being conscious about erection. You must try to enjoy and only enjoy. Once penis is able to enter in vagina and strokes starts it is easy to complete successful sex.

If your partner is not aware about this situation you can do on your own. You just should try to do sex without being conscious about erection. Enjoy without thinking of your ability to maintain erection.

All the best and take care.

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