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Suffering from premature ejaculation. What is the required treatment?

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Practicing since : 2004
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I have what I feel is surley premature ejaculation. Been married 17 years and am 37. We have tried everything non med. suggested to stop and start. But within a min almost everytime I ejaculate. This may sound strange but I feel inadequate size wise at about 5.5" and 5" in circumference so I was wondering somewhat embarrased if due to this feeling it may be leading to it. My wife says different. I did at one time have paxill for anxeity many years ago and would last over 30 min and we would stop from going so long. I rarely last two min. anything you may suggest for an embarassed 37 year man
Posted Tue, 9 Oct 2012 in Premature Ejaculation
Answered by Dr. Ashish Mittal 4 hours later
Thanks for your query.

Premature ejaculation (PE) is common problem and depends on multiple factors like:

*Psychological factors: most common. The psychological factors may include stress, performance anxiety and depression. In your case you already has history of anxiety and improvement with Paxil.

*Medical causes: Reflex activity of ejaculatory system, thyroid problems, diabetes, hypertension and neurological causes.

Following steps will be helpful for treatment:
- Try distracting yourself when you feel you are about to ejaculate. Take a XXXXXXX breath and stay relaxed during intercourse.
- Do not worry about performance and talk to your partner openly about any apprehensions if you have. Conversation with partner during sex also delay ejaculation.
- If the symptoms persist then condoms with desensitizing creams (marketed as LONG LAST) and SRRI (selective serotonin reuptake inhibitors) like dapoxetine 30mg will be helpful, which you can get after prescription from physician.
-Long term treatment of anxiety (if present currently) with paxil. For that you can visit psychiatrist for evaluation.
-Do not worry about size as normal penis length may wary 4-10 inches.

Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.

Above answer was peer-reviewed by
Follow-up: Suffering from premature ejaculation. What is the required treatment? 4 hours later
Dr. thank you for your resoonse.

One thing in your response that caught my eye was thyroid isees. I was diagnosed 5 years ago with Hypothyroid and now it has become Hashimotos Disease with a small nodule on one of the lobes. How does this play a factor into premature ejaculation? Thanks
Answered by Dr. Ashish Mittal 6 hours later
Hello again,
Thanks for follow up.

Thyroid problems increases chances of having anxiety disorders which leads to premature ejaculation.

Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.

Wish you good health.
Above answer was peer-reviewed by
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