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Suggest treatment for premature ejaculation

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Posted on Thu, 14 May 2015
Question: Off late, I have noticed that I'm unable to control for longer and ejaculate prematurely. And at times, I'm able to control it for longer duration as I wish as well.

My Partner seems to be unsatisfied with this problem most of the time, Can I do something to avoid this immediately and also some long term plans.
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Answered by Dr. Chintan Solanki (1 hour later)
Brief Answer:
yes treatment of premature ejaculation is there

Detailed Answer:
Hello,

Thanks for writing to us.

Premature Ejaculation (PME) or early discharge defined when male partner ejaculates early before the female partner reaches to orgasm. There is no absolute time by which we can diagnose PME. It is relative term and female partner is the best judge.So you are suffering from the same.

There are few behavioral approaches as well as medicines which can help to treat PME.

There are medicinal and non medicinal approaches to treat PME.

Medicines:
Clomipramine and paroxetine are choice of medicines which are used as antidepressants(For depression dose is higher).
I prefer clomipramine for PME. No significant side effects with these medicines. Initially say for 20-30 days daily after dinner and later on just on the day when you do the sex.
Paroxetine is more potent but it may cause side effects like headache, gastric discomfort, giddiness and sedation.
One molecule called depoxetine has been used specifically for PME and should be taken before 2 hours of sex when required.
These medicines are prescription medicines and you need to consult doctor/psychiatrist/sexologist for prescription.

Another option is ayurvedic medicine. You can get them over the counter mostly.
Tentex royale is used for PME and no side effects have been observed.


Behavioral approaches are as follows:

1. Stop and Squeeze technique can be applied which you can learn from internet and ask me if any query in that.(In brief, method suggests that you should try to divert your mind for a moment when you feel ejaculation arousal and penis should be tightly squeezed with hand inwards by your partner preferably).

2. Master and XXXXXXX technique can also be learnt from qualified sexologist/Psychiatrist which includes sessions in couple as it is couple sex therapy. It can help in prolongation of time.

3. Sex counselling of your sexual behaviour and methods. Like if you are down and female partner on top, gravity is going to help you for lengthening the time.

4. You should do masturbation before sex(at least 2 hours before ). It will make seminal vesicles somewhat empty and at time of sex semen will take more time to come out.

Another approach:
-Use of condoms. Sometime using condom while sex helps in delaying ejaculation by reducing sensitivity of glans penis.

--Topical application of anesthetic gel/spray. For this you have to consult doctor.

If I were your treating doctor I would like to evaluate you with your wife and first would like to go for behavioral approach with condoms. If at all that fails, medicines can be started. However ultimately choice of your matters.If immediate solution is needed , medicine will sure help.

Hope I have answered your query.I will be happy to help further.

Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Suggest treatment for premature ejaculation

Brief Answer: yes treatment of premature ejaculation is there Detailed Answer: Hello, Thanks for writing to us. Premature Ejaculation (PME) or early discharge defined when male partner ejaculates early before the female partner reaches to orgasm. There is no absolute time by which we can diagnose PME. It is relative term and female partner is the best judge.So you are suffering from the same. There are few behavioral approaches as well as medicines which can help to treat PME. There are medicinal and non medicinal approaches to treat PME. Medicines: Clomipramine and paroxetine are choice of medicines which are used as antidepressants(For depression dose is higher). I prefer clomipramine for PME. No significant side effects with these medicines. Initially say for 20-30 days daily after dinner and later on just on the day when you do the sex. Paroxetine is more potent but it may cause side effects like headache, gastric discomfort, giddiness and sedation. One molecule called depoxetine has been used specifically for PME and should be taken before 2 hours of sex when required. These medicines are prescription medicines and you need to consult doctor/psychiatrist/sexologist for prescription. Another option is ayurvedic medicine. You can get them over the counter mostly. Tentex royale is used for PME and no side effects have been observed. Behavioral approaches are as follows: 1. Stop and Squeeze technique can be applied which you can learn from internet and ask me if any query in that.(In brief, method suggests that you should try to divert your mind for a moment when you feel ejaculation arousal and penis should be tightly squeezed with hand inwards by your partner preferably). 2. Master and XXXXXXX technique can also be learnt from qualified sexologist/Psychiatrist which includes sessions in couple as it is couple sex therapy. It can help in prolongation of time. 3. Sex counselling of your sexual behaviour and methods. Like if you are down and female partner on top, gravity is going to help you for lengthening the time. 4. You should do masturbation before sex(at least 2 hours before ). It will make seminal vesicles somewhat empty and at time of sex semen will take more time to come out. Another approach: -Use of condoms. Sometime using condom while sex helps in delaying ejaculation by reducing sensitivity of glans penis. --Topical application of anesthetic gel/spray. For this you have to consult doctor. If I were your treating doctor I would like to evaluate you with your wife and first would like to go for behavioral approach with condoms. If at all that fails, medicines can be started. However ultimately choice of your matters.If immediate solution is needed , medicine will sure help. Hope I have answered your query.I will be happy to help further. Regards, Dr.Chintan Solanki.