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Dr. Andrew Rynne

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Suggest treatment for premature ejaculation

Answered by
Dr.
Dr. Jonas Sundarakumar

Psychiatrist

Practicing since :2003

Answered : 2190 Questions

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Posted on Sat, 30 Aug 2014 in Sexual Health
Question: Hi,
During intercourse I ejaculate early, if I'm not using a condom. It's because I feel more sensation without condom.
How can I prevent it without having any side effect? Is there any natural or herbal remedy?
Thanks.
doctor
Answered by Dr. Jonas Sundarakumar 14 minutes later
Brief Answer:
Need more details...

Detailed Answer:
Hello and welcome to Healthcare Magic. Thanks for your query.

I will certainly help and advise you regarding your problem. In order to guide you better, can you please provide the following clarifications...

- How long have you been having this problem?

- How frequently does this problem happen? Does it happen only in certain situations or everytime you are sexually aroused?

- How long are you able to perform sexual intercourse?

- Are you married? Do you have any problems or stress in your relationship?

- Do you suffer from anxiety, negative thoughts or low mood?

- Do you smoke or consume alcohol or any other drugs?

- Do you have any other medical problems or are you on any medication currently?

Please get back to me with these details, so that I can advise you in a better way.

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jonas Sundarakumar 13 minutes later
Please find the answers below-
1. From starting itself.
2. Every time.
3. Less than a minute.
4. Yes, I'm married and don't have any stress in relationship or in any form. While intercourse only I feel some what regarding this problem only.
5. No.
6. Not now, used to smoke and drink before 3 years.
7. Don't have any known medical problem except hepatitis b and a little indigestion.
doctor
Answered by Dr. Jonas Sundarakumar 24 hours later
Brief Answer:
Advice given...

Detailed Answer:
Hello again and thanks for your clarifications.

Your sexual problem of pre-mature ejaculation is actually a very common problem in young males. In your case, since you have mentioned that you are able to perform sexual intercourse for only less than a minute, it appears that your problem of premature ejaculation is significant and distressing.

Now, the good news is that in most of the cases, there is no major medical abnormality causing this. The common causes for premature ejaculation are:
1) A hypersensitive response of the penis
2) Subconscious anxiety / fears / doubts about inadequate sexual performance (called as "performance anxiety")

Don't worry, your problem of premature ejaculation can be controlled by regularly practicing certain sexual techniques or by taking medication for a short period.


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.

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

Wish you all the best.

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jonas Sundarakumar 48 hours later
I tried but can't stop thinking about it.

I've heard about some desensitizing gels.
Can I use them without any side effects and where to get it?
Where can I get dapoxetin 30 mg, is it available medical stores?
doctor
Answered by Dr. Jonas Sundarakumar 7 hours later
Brief Answer:
Both are available in medical stores.

Detailed Answer:
Hi,

Desensitizing gels can be partially effective in delaying ejaculation. But the problem is that they can also decrease the pleasurable sensations during intercourse. You can get Xylocaine gel 2% from any medical store and try applying a very thin layer to the head of the penis before starting intercourse.

Dapoxetine is also available in medical stores. It is marketed under the brand names Duralast, Sustinex and Dapox. The usual recommended dose is 30mg.

Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist & Sexologist
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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