Suggest treatment for premature ejaculation

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Posted on Wed, 10 Jun 2015 in Sexual Health
Question: i am a girl of 29 years and married for 6 months. my husband is not establishing physical relationship- intercourse. his penis gets erected and he discharges without penetrating into vagina. he had some problem with his legs and some operation was performed and he was advised not to undertake skiing etc, we now suspect he is not capable of penetration and usual
stokes of intercourse. is it possible to have intercourse when penis gets erection and discharge comes out, pl advise
doctor
Answered by Dr. Chintan Solanki 1 hour later
Brief Answer:
you can modify sex position, you are on top will be preferable

Detailed Answer:
Hi Mrs. XXXXXXX

Thanks for writing to us.

I can understand your concern.

From history I think there are two problems. One is difficulty in physical movement while sex due to past operations of leg of your husband. And second is he might have early ejaculation.

Positive points are he is able to erect penis well and ejaculation is there.
As time progresses ejaculation time automatically lengthen in many cases.

You can discuss with his operating doctor that which position and which type of movements he can perform without discomfort during sex.

In my opinion you should be on top while sex and husband lying supine will be favorable.In this position you have to do movement not your husband and it will help also in delaying ejaculation due to gravity.

I also want mention about premature ejaculation.
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.

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. In patients with blood pressure it should be used in consultation with physician/cardiologist.

One molecule called depoxetine (duralast)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.


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 counseling of your sexual behavior 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.

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

Regards,

Dr.Chintan Solanki.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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