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    Unable to maintain erection and have premature ejaculation problem. Cause and cure?

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Posted on Thu, 4 Apr 2013 in Erectile Dysfunction
Question: Premature ejaculation even by sensation/ even before coitus.

Inability to maintain erection, although some improvement since last 5-6 years.

Once urinating urge to urinate more and more

Thick white fluid after iI complete urinating
doctor
Answered by Dr. Jasvinder Singh 10 minutes later
Hello,

Thanks for your query. Premature ejaculation(PE) is not uncommon and depends on multiple factors , the most common being psychological factors. The psychological factors may include stress and anxiety in daily life and depression due to personal, professional , financial and other social issues.

Medical causes of premature ejaculation include abnormal hormone level, reflex activity of ejaculatory system, thyroid problems, diabetes, hypertension and neurological causes.

Try distracting yourself when you feel you are about to ejaculate. Take a XXXXXXX breath and stay relaxed during intercourse. Also do not worry about performance and talk to your partner openly about any apprehensions if you have.

Other treatment methods which can be followed are stop-start or squeeze-pause technique. In stop start technique, near ejaculation withdraw from your partner and relax and think about something else.

In squeeze- pause technique, squeeze the end or the tip of the penis for 10 to 20 seconds when you are close to ejaculation and then resume stimulation after withholding for half a minute.

If the symptoms persist then desensitizing creams and SRRI (selective serotonin reuptake inhibitors) may need to be prescribed for which you have to consult a urologist.

A urologist will be the best person to guide you through this. You may need to undergo certain medical tests like for diabetes, thyroid profile and hormonal assay.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jasvinder Singh 9 minutes later
Dear doctor,

I have tried both the techniques but without any success. Further I have also tried to be calm to the best extent during sexual activity.

I have been also improving on my diet and taking items supposed to help in this problem like ginger, garlic etc.

There is some improvement say 10-15% otherwise I used to ejaculate even my the thoughts of sexual intercourse leave alone doing it.

doctor
Answered by Dr. Jasvinder Singh 16 hours later
Hello,

Thanks for writing back to me.

Your doctor may prescribe one of several selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft), paroxetine (Paxil) or fluoxetine (Prozac), to help delay ejaculation. It may take up to 10 days for these drugs to take effect.

If the timing of your ejaculation doesn't improve, your doctor may prescribe the tricyclic antidepressant clomipramine (Anafranil). You may not need to take these medications every day to prevent premature ejaculation. Taking a low dose several hours before you plan to have sexual intercourse may be enough to improve your symptoms.

Moreover cognitive behavior therapy also helps.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jasvinder Singh 12 hours later
Are there any SSIRs in the cream form which can be applied on the organ considering the SSRIs tablets may be having many side effects.
doctor
Answered by Dr. Jasvinder Singh 26 hours later
Hi,

Almost all medications do have side effects of varying intensity. The same applies to SSRIs too.

I am sorry to say that the SSRIs are not available in creams.

You can use Topical prilocaine/lidocaine cream (EMLA) which is known to delay the ejaculation provided if there is a good erection.

Hope I answered your query.

Wish you good health.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Jasvinder Singh

Internal Medicine Specialist

Practicing since :1998

Answered : 1578 Questions

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