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Suggest treatment for premature ejaculation

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Posted on Thu, 24 Dec 2015
Question: hello , i am 33 year old male. father to a 3 year old daughter and one month old son. I cannot perfom in bed for a longer time. Usually i ejaculate within seconds of penetration and also cannot hold erection for a long time . I think this may be due to bad diet irregular sleeps ,stress etc. but what should i do medically to have a better sex life besides excersie etc.
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Answered by Dr. Chintan Solanki (24 minutes later)
Brief Answer:
medicine and behavioral approach would help

Detailed Answer:
Hello Mr. XXXX,

Thanks for writing to us.

I can understand your concern. You seem to be suffering from early ejaculation. In medical language it is called premature ejaculation.

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. Kegel exercise also helps in some cases. You can learn the same from internet.

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.

Physical and mental fitness is also important aspect.

To improve health you need to maintain healthy lifestyle. This includes regular daily exercise (walking or running), hygienic food habits (no junk food, no fatty food, preferably only home-made food with law salt and fat with more fruits and vegetables) and timely scheduled sleep. Yoga- meditation can also help.

If I were your treating doctor I would like to start clomipramine at this point.

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.


Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Chintan Solanki (1 hour later)


1. depoxetine and clomipramine are drugs or medicine name ? if drugs then which meds to buy ? will need a prescription for the same ?

2. Will meds like revital or similar meds help in the long run ?

3. also if i masturbate , it will affect the erection then again same problem
doctor
Answered by Dr. Chintan Solanki (9 minutes later)
Brief Answer:
they are the name of the medicine contents, masturbation is safe

Detailed Answer:
Hi,

Thanks for information.

Depoxetine and clomipramine are name of the content of drug (generic name). You need written prescription of a doctor to bu the same. I suggest clomipramine which is available with different names like clonil, clofranil, ocifril.

Revital or other multivitamin medicine would not help in your problem in particular however they would help in overall health but do not take the same for long as more vitamins are also not useful.

Masturbation is safe. Masturbation is natural and normal thing. It is done by 70-95% of the males and 30-45% females in the world. 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. In your case doing masturbation will rather help in premature ejaculation.

Feel free to discuss further.


Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Chintan Solanki (14 hours later)
ok please give me prescription for the same so I can buy the same. also hat power should be bought 10 mg 25 mg ? and what should be the dosage per day ? are these ayurvedic meds vita ex ,vigorex etc helpful
doctor
Answered by Dr. Chintan Solanki (2 hours later)
Brief Answer:
in ayurvedic I recommend confido

Detailed Answer:
Hi,

Thanks for follow up. Clomipramine is prescription drug. You need to consult doctor to take the prescription. Online prescription is not valid. I am sorry for limitation from our side. It is better to take medicine after consulting local doctor so any side effect occurs by chance doctor can provide immediate help. It is recommended in 10 mg dose daily initially for a month and after improvement before sex only.

In ayurvedic products confido can be used for premature ejaculation. It is likely available over the counter without prescription. It should be taken daily at night with a cup of milk.

I am not aware about vigorex and vita ex effectiveness.

If I were your treating doctor I would recommend clomipramine and confido.

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 at the same cost with three follow up questions.

All the best.

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

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Practicing since :2007

Answered : 2406 Questions

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Suggest treatment for premature ejaculation

Brief Answer: medicine and behavioral approach would help Detailed Answer: Hello Mr. XXXX, Thanks for writing to us. I can understand your concern. You seem to be suffering from early ejaculation. In medical language it is called premature ejaculation. 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. Kegel exercise also helps in some cases. You can learn the same from internet. 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. Physical and mental fitness is also important aspect. To improve health you need to maintain healthy lifestyle. This includes regular daily exercise (walking or running), hygienic food habits (no junk food, no fatty food, preferably only home-made food with law salt and fat with more fruits and vegetables) and timely scheduled sleep. Yoga- meditation can also help. If I were your treating doctor I would like to start clomipramine at this point. Hope I have answered your query, I will be happy to help further. Regards, Dr.Chintan Solanki.