Brief Answer:
reduce weight,stop smoking and drinking, no major problem is there

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us.
You have problem of early ejaculation. With masturbation we cannot diagnose premature ejaculation (PME).

First of all Premature Ejaculation (PME) 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.

Masturbation and intercourse differs in stimulation of penis. In masturbation penis is stimulated by hand while in intercourse by friction with vaginal wall. So it is possible that after marriage you may take long time for ejaculation during sex.

Many of young men before marriage are anxious about their sex life. This may create performance anxiety.

Understand the basic fact that masturbation and sex are almost equal process only technique differs. If you can enjoy one, you can enjoy other also as machinery for both process are same and normal. If you have anxiety regarding your sex life after marriage, I assure you that it will be absolutely fine. Just reassure yourself that you a re normal and can sex normally with partner if given a chance in relax environment.

Smoking and alcohol cause negative impact on sex life better to stop the same.

Your weight is more than the required. It can also affect sex life. With exercise you also try to change your food habits. Less fat and junk food with more protein is key factor. Daily calorie deficit of 500 will help to lose 0.5-1 kg weight per week. Your target weight should be 80 kg.

In my opinion you do not need any medicine right now.
For your information I am mentioning treatment aspect for 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 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 for your information:

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 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 use of 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.

You wrote, "During masturbation if i remove my hand immediately my penis becomes softer." This is normal, no need to worry about the same. For constant erection continuous exciting/romantic/erotic feelings must be present in mind. If your and is diverted to something else (like thinking actively about avoiding ejaculation during masturbation) penis is going to lose the erection. Read more about Stop and Squeeze technique on internet for this problem.

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

Regards,
Dr.Chintan Solanki.

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Brief Answer:
yes ayurvedic product and supplement are available

Detailed Answer:
Hello,

Thanks for follow up.

Tentex forte is the ayurvedic medicine which is used for sex related problem. No side effects have been reported. One tablet daily at night with a cup of milk should be taken for 4 weeks.
And likewise confido or tentax royale can be used for premature ejaculation. They are likely available over the counter without prescription.

In my opinion confido will be good option for you among these.

You can use medicine cum vitamin supplement containing pyridoxal-5-phosphate, mecobalamin and l-methylfolate (trade name tetrafol plus) which is very helpful in my patients. You should take it after meal once a day for 2 months. You may get this medicine over the counter as it is vitamin product.

Considering your history there is no need of any specific check up from sex point of view. Considering your weight, habit of smoking and alcohol I recommend to visit doctor for routine health check up and thyroid function testing.

Feel free to discuss further.

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Brief Answer:
all the best

Detailed Answer:
Hi,

Yes you can move forward as you mentioned.

Wish you good health and take care.

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