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Suggest treatment for premature ejaculation

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Posted on Mon, 7 Dec 2015
Question: Dear sir i'm 30 years old i got married 6 years back i have a 4 year old baby but before marriage i had habit of maturbation daily after marriage I can't hold for a minute during intercourse and some times when my wife touches my parts i'll ejaculate before intercourse and my penis is very small & thin, we both are not satisfy in our sexual life so, please help me to increase duration of intercourse and how to take care of my penis size, i'm very depressed please guide & help me out from this problems.
doctor
Answered by Dr. Chintan Solanki (2 hours later)
Brief Answer:
you are suffering from Premature Ejaculation, it can be treated

Detailed Answer:
Hello XXXX,

Thanks for writing to us. I can understand your concern. From history it seems that you are suffering from Premature Ejaculation (PME).

First of all clarification about masturbation.

Masturbation is natural and normal thing. It is done by 95% of the males in the world, mostly before marriage as well as when wife is away, in menses or pregnant after marriage. It is not at all harmful. Frequency of masturbation done by an individual varies from once a day to once a week. It depends upon individual libido, wish and timing. It neither causes any weakness nor any problem in sexual activity.
Your problem is not related to masturbation.

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.

According to the latest diagnostic criteria by DSM 5, premature ejaculation should be defined when there is ejaculation within one minute after entering tin to vagina or even before penetration.

Treatment 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 lignocaine 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
doctor
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Follow up: Dr. Chintan Solanki (2 days later)
Thank You sir for your valuable reply but i want to know that any medicine or any excercise for increase pennis size beacause my pennis is very thin & short , i want to increase my pennis size ,
doctor
Answered by Dr. Chintan Solanki (8 minutes later)
Brief Answer:
no medicine can increase size of penis, Only surgery can help

Detailed Answer:
Hi,

Thanks for follow up.

As such there is no medicine or exercise which can increase size of penis. Only surgical intervention can increase the size of penis.

Let me know your size of penis in flaccid and in erect phase so I can guide you further.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (21 hours later)
Thank you sir

actually my pennis size is 2 to XXXXXXX 5inch,with this size any problems to sexual certify to my partner ? and plz tell me the medicine which can help to increase the timing during intercourse, which is available in every medicine store .
doctor
Answered by Dr. Chintan Solanki (19 minutes later)
Brief Answer:
size is appropriate

Detailed Answer:
Hi,

Thanks for information.

Normal size of penis in flaccid state is 2 to 4 inches while in erect position 4 to 6 inches. It varies according to body structure and race. Size of penis does not matter much for satisfying partner.
Anterior 3 inches of female vaginal wall is sensitive to sexual stimuli. Only 3.5 inches of erect penis is sufficient to satisfy female. Hope you are clear about concern of size of penis now. You can satisfy your partner.

There are pills which can increase size of penis if there is erectile dysfunction. 5- PDE inhibitor group of medicines are used for this purpose which includes sildenafil or tadalafil. It is proven drug for male erectile dysfunction. One of them should be used 2 hours prior to sex. They cause headache, stuffy nose nausea and gastric discomfort like common side effects. Proper physical check-up of cardiac system should be done by a doctor before starting the same. These are prescription medicines and you need to consult doctor/psychiatrist/sexologist for the prescription.

If still any query there, I will be happy to answer. If not, you can close the discussion and if feasible give your feedback and rating so I can improve my service. In future you can contact me directly on this site if you wish with this link:
XXXX
by clicking on 'Ask me a question' on same page.

All the best and take care.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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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: you are suffering from Premature Ejaculation, it can be treated Detailed Answer: Hello XXXX, Thanks for writing to us. I can understand your concern. From history it seems that you are suffering from Premature Ejaculation (PME). First of all clarification about masturbation. Masturbation is natural and normal thing. It is done by 95% of the males in the world, mostly before marriage as well as when wife is away, in menses or pregnant after marriage. It is not at all harmful. Frequency of masturbation done by an individual varies from once a day to once a week. It depends upon individual libido, wish and timing. It neither causes any weakness nor any problem in sexual activity. Your problem is not related to masturbation. 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. According to the latest diagnostic criteria by DSM 5, premature ejaculation should be defined when there is ejaculation within one minute after entering tin to vagina or even before penetration. Treatment 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 lignocaine 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.