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Suggest treatment for premature ejaculation while on Sildenafil

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Posted on Sat, 14 May 2016
Question: Hi,

I am 35 and married since 10 years. Right from start I am facing issue with premature ejaculation. I started masturbating at age of 11 (wasnt aware what it is that time) It usually take not more than 2-3 mins at maximum before I ejaculate no matter how hard I try to prevent it or think of something. Recently (6-7 months)I tried using Sildenafil so that at least I can stay erect for few more minutes and I can satisfy my partner. But I am not sure how safe it is and also want a permanent solution for longer run. I have tried many things, like masturbating 30 mins before the act so that during the intercourse I can hold on longer. The frequency of intercourse is twice a week, and mostly once with occasional twice same day.
doctor
Answered by Dr. Ashok Kumar (8 minutes later)
Brief Answer:
Please elaborate further

Detailed Answer:
Dear XXXXXXX
Thanks for using Healthcaremagic.

I read your query and understand your concerns although they are not clear.

I fail to understand why sildenafil was used as it is not a medication for premature ejaculation but a medication for erectile dysfunction.

Your attempt to try for masturbating before sex is sometime worth but not a great idea. I am delineating few other strategies which is likely to help you in regard to premature ejaculation. Among them exercise part have long term results and need for medications comes down over a period of time.

Premature ejaculation can be treated or controlled with the help of behavioral methods and the medications.
The behavioral techniques need to be practiced during sex and yield results over a time. Even your partner can assist you in some of the techniques like squeeze technique.

The techniques are difficult to explain here but you can just google 'kegel method ' to understand it. For good results it is recommended to have 100 contractions per day which can be divided in three to four times a day as per your convenience.
The other techniques are
1. Squeeze technique
2. Start- stop method
3. Interruption technique
You can choose any of them if they suit you.

Premature ejaculation can also be controlled by medications.

SSRI antidepressant drugs cause delayed ejaculation as a side effect, and this side effect is used therapeutically in the treatment of premature ejaculation. These drugs are as following:
Tablet. Paroxetine
Tablet. Fluoxetine
Tablet. Sertraline .

A person with premature ejaculation need to take any of these drugs regularly and its effect will appear only after 15 to 20 days.

Another strategy is to take drug one hour before sex. The another antidepressant drug dapoxetine is given one hour before sex and it cause delayed ejaculation which gives much needed relief.

I hope this answers your question.
If you need to know more feel free to contact me.
not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386

Thanks and regards
Dr Ashok Kumar

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ashok Kumar (45 minutes later)
Dear Sir,

Thank you for the detailed and prompt answer. I guess the Google has its positives and negatives. I tried Dapoxetine earlier after after some googling in similar way as mentioned by you by taking it 1 hour before sex, it didn't helped much. I would say maybe increased it less than a minute or so, but I had dizzy head after that for long. But never have taken it for longer duration. In total it would have been 2-3 times, just one hour before sex.
Why I tried Sildenafil was that even after ejaculation, it kept me erect for some time, enough to satisfy my partner, and also it helps to get second erection much earlier.
I am not using any medicine now since a month and situation is same, and relying on masturbating in advance as of now. In daily life I am very active physically and do regular cycling/running (say 5-6 hours a week). I am glad that a Psychiatrist answered my situation as I felt its related to my mind. I am known to be a bit edgy person, and restless too, many have noted about high anxiety levels in me, and I keep getting advise on staying calm and not being so impulsive in all situations. I wonder if that has anything to do with premature ejaculation.
If I understood it correctly, I should try the Kegel exercises along with the other techniques first. Shall I try Kegel exercise for a month or so regulalry and see if it improves situation after a month? and if not shall i try the medicines? What would you suggest in terms of medicines, which one to should be taken , the Paroxetine, Fluoxetine, Sertraline for two weeks or the Dapoxetine just an hour before intercourse.
doctor
Answered by Dr. Ashok Kumar (25 minutes later)
Brief Answer:
I think regular treatment with SSRI will be right choice for you

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.

Feeling nervous have very high connection with premature ejaculation and for majority of men this is the single cause for problem of premature ejaculation.

I understand that dopoxetine have side effects but the majority of mentioned side effects are limited for first few days and over a time body develops tolerance toward these side effects.

With added information I feel regular medicine like paroxetine or fluoxetine at night along with behavioral techniques will be right answer to your problem. Although I must make it clear that any choice should be determined after complete physical examination and that needs a visit to doctor. I do not feel dapoxetine on need basis can control both anxiety and PE and so regular treatment is warranted.

I hope this clarifies for you.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ashok Kumar

Psychiatrist

Practicing since :2000

Answered : 3262 Questions

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Suggest treatment for premature ejaculation while on Sildenafil

Brief Answer: Please elaborate further Detailed Answer: Dear XXXXXXX Thanks for using Healthcaremagic. I read your query and understand your concerns although they are not clear. I fail to understand why sildenafil was used as it is not a medication for premature ejaculation but a medication for erectile dysfunction. Your attempt to try for masturbating before sex is sometime worth but not a great idea. I am delineating few other strategies which is likely to help you in regard to premature ejaculation. Among them exercise part have long term results and need for medications comes down over a period of time. Premature ejaculation can be treated or controlled with the help of behavioral methods and the medications. The behavioral techniques need to be practiced during sex and yield results over a time. Even your partner can assist you in some of the techniques like squeeze technique. The techniques are difficult to explain here but you can just google 'kegel method ' to understand it. For good results it is recommended to have 100 contractions per day which can be divided in three to four times a day as per your convenience. The other techniques are 1. Squeeze technique 2. Start- stop method 3. Interruption technique You can choose any of them if they suit you. Premature ejaculation can also be controlled by medications. SSRI antidepressant drugs cause delayed ejaculation as a side effect, and this side effect is used therapeutically in the treatment of premature ejaculation. These drugs are as following: Tablet. Paroxetine Tablet. Fluoxetine Tablet. Sertraline . A person with premature ejaculation need to take any of these drugs regularly and its effect will appear only after 15 to 20 days. Another strategy is to take drug one hour before sex. The another antidepressant drug dapoxetine is given one hour before sex and it cause delayed ejaculation which gives much needed relief. I hope this answers your question. If you need to know more feel free to contact me. not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386 Thanks and regards Dr Ashok Kumar