Brief Answer:
Hi it can be treated by both drug and councelling.

Detailed Answer:
Hii

I admire you for positive outlook.

I appreciate your concern.

Premature ejaculation can be treated either psychologically and pharmacologically.

Psychological means councelling and sex therapy.
Usually require both the partner with therapist and active participation.
It is multi sessions therapy and timing of therapy is once a week.

But here I would like to explain you about stop and start theray.

In which you have to identify ejaculation and try to postpond it by diverting your thought from sex to some other situations.

Second is sqeez method in which female partner press over galnce penis at just before ejaculation.


Please read about both the methods in details on google.

Certain other factors which is important

Like

Use of condoms.
Lubricated condom with benzocaine jelly.

Female on top position.



Kegel exercise while urinal will help.

Masturbation before sex also helpful.

I prefer medicines likelow dose of SSRI in my patients.

Recently launched depoxetine has excellent results in premature ejaculation.
it can be taken 1 hour before sexual intercourse.

if still have a query than feel free to ask.

Thank you.

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Brief Answer:
Hii glad to see you again.

Detailed Answer:
Hii


1st you have to concentrate over psychological methods that I have told you earlier.

2nd there is some medicines but you have to take daily.

I prefer clomipramine 10 mg or fluoxetine 10 mg daily 1 hour before sexual intercourse.

it usuallu takes time up to 1 week to show desirable benifits.

But along with that medicines you have to take considerations of psychological method

There are systemic review of good results regarding both the methods that I have told you.

still here to help you.

Thank you
Take care.

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Brief Answer:
hii

Detailed Answer:
Hi dear

I appreciate that you took treatment for such a long time.

This medicines required prescription.

It is not available as over the counter drug.

So if posible then consult a doctor and get prescription.

Both the medicines are use as antidepressant but in low dose it is useful in premature ejaculatation.

Thank you
Take care.

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Brief Answer:
HI Thanx for revert back.

Detailed Answer:
Hi

Thanx for asking this question but you need to mention it from beginning because it is both separate problem and can be co exist together.

I understand your concern ab erectile dysfunction.

Erectile problem has many origines

1st is life style
stress and busy life style make u fatigue and secondry to this it makes less desire in sex and erectile problems.
So modification in life style is must.
Regular exercise.
Keep yourself physically fit.
Meditations.
Proper sleep.
Healthy diet.
Avoid drinking and smoking. etc

2nd is relationship
free communicative and mutual understanding will help
sex is mutual act
so try to do mutually and tell your problem to partner
this will reduce your anxiety and able to erect easily

so stress free lifestyle and mutual communication will help

Third is physical health

Routine check up and fit physical health is necessary

Psychological soundness is must. Need to more relax to enjoy sexual intercourse.

I prefer medicines like sildenafil,, tadanafil, tetrafol plus etc but it reqire evaluations.

sildenafil and dapoxetine combination also available in market which are useful to treat both the condition together.
Do take advise from doctors
Get well soon
Thank you
Take care

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Brief Answer:
Hi Thanx for revert back.

Detailed Answer:
Hi

You said that guilt feeling which is one of the psychological reason that interfear with erection.

It is like vicious cycle. So communication with wife and discuss the problem with her.

As I said sex it mutual act. When she understands all this then your anxiety and guilt will go away.

After you will achieve psychological mindedness which help you to do better sex.

I have already mentioned in last answer about drug treatment.
You can try this medicine .

Medicine plus mutual understanding will solve all your problems.

Thank you.

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