Brief Answer:
Advice given...

Detailed Answer:
Hello and thanks for writing in.

From the description of your problems, it appears that you are suffering from premature ejaculation, secondary to stress and anxiety. It is indeed true that psychological factors like stress, anxiety, subconcious fears, etc. are responsible for a majority of cases of sexual problems such as premature ejaculation.

I would like to give you the following advise to overcome your problem:

1) Firstly stop becoming more anxious about this problem - because if you feel more anxious and worried or if you keep having doubts that you may not be able to perform properly, then this anxiety itself will worsen the problem. So, during sexual intercourse try to stop worrying and "monitoring" your sexual performance. Just try to be relaxed and enjoy yourself. Don't keep on thinking "How long am I going to last?" "Will I ejaculate too quickly?" "Will I be able to satisfy my parrtner?, etc. One more suggestion is to arouse your partner well before starting intercourse. So, you can increase and spice-up your foreplay and make sure that you start penetration only after your partner is fully turned on. When your partner is fully aroused and involved, then things keep flowing smoothly and effortlessly, and you don't have to be constantly anxious if you are satisfying your partner or not.

2) The second solution for pre-mature ejaculation is to reduce the "hypersensitivity" of the penis. For this, there are certain specific sexual techniques which can reduce this hypersensitivity. The "stop-start technique" or "squeeze technique" have been proven to be successful in reducing this hypersensitivity and increasing the ejaculatory time.

In the stop-start technique, the penis is stimulated (by sexual intercourse or by masturbation) till a point when you feel close to orgasm. At that point, the stimulation is stopped for some time and after a small gap, it is continued. This process is repeated repeated a few times.

In the squeeze technique, the penis can be stimulated by hand (by masturbation or by your partner) till a point when you feel close to orgasm. At that point, the lower part of the head of the penis is squeezed tightly with the index finger and thumb around for a few seconds till the erection decreases. Then the stimulation is restarted and the process is repeated a few times.

Both these techniques, if practised regularly can definitely prolong the time for ejaculation.

3) The third solution is to try medication. There are certain medication like Dapoxetine (Prilyxet), which can help you control premature ejaculation. The usually recommended dosage of Prilyxet is 30mg, once a day and can be taken for a short period of time till your problem improves.

4) I would also advice that you see a psychiatrist in person for a few counselling sessions and if necessary, a mild anti-depressant / anti-anxiety medication to help you cope up with your stress in a better way.

If you follow these suggestions, then I'm sure that you will be able to overcome your problem of premature ejaculation very soon.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist & Sexologist

---