Brief Answer:
Below steps will help you in treatment.

Detailed Answer:
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     45 year old male
•     Known case of Premature ejaculation and anxiety after penetration.
•     History of good response to FELIZ-S, CLONIL-10, DULOT 20 AND MEGALIS. Stopped due to side effects.

Premature ejaculation is a very common and treatable problem. Premature ejaculation is diagnosed when ejaculation time is less than 3 Min, or both partners are not satisfied with sex.

Premature ejaculation (PE) is common problem and depends on multiple factors like:
*Psychological factors: most common. The psychological factors may include stress, performance anxiety and depression

*Medical causes: Reflex activity of ejaculatory system, thyroid problems, diabetes, hypertension, excessive alcohol use and neurological causes.

FOLLOWING STEPS WILL BE HELPFUL FOR TREATMENT:

-Treatment of above conditions (if present) after examination.

-Start jogging in morning for 20-30 minutes daily, as it reduces performance anxiety and improve blood circulation.

-Stop start technique: In stop start technique, near ejaculation stop all movements, relax and think about something else. Then wait for 1 minute before starting movements. According to number of stops, ejaculation time will come under your control.

-In many persons woman on top position increases ejaculation time, so try this position and experiment with other positions also.

-Condoms with desensitizing creams (marketed as Kohinoor extra time) help in increasing ejaculation time. Just wear this as normal condom and start sex after 30 seconds of penile massage, as medicine take some time to act.

-As you already had improvement with FELIZ-S, CLONIL-10, DULOT 20 AND MEGALIS, then monotherapy only with low dose FELIZ-S 5mg daily in morning time under psychiatrist supervision will be helpful in your case. Single medicine will also not cause side effects (nausea and heaviness of head) like you experienced in past.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,

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Brief Answer:
Hi

Detailed Answer:
Hello again,
Thanks for follow up.

1. For how long do I take Feliz-S. Will it have any side effect? What will be its effect in solving my problem.
Ans: Duration of treatment depend treatment response. Usually it can be taken for 6 months. There is long list of side effect like with every medicine but clinically it is safe and not associated with any irreversible side effect.

2. I have had fully body check and there is no problem of sugar, thyroid, hypertension, alcohol or neuro.
Ans: Good.

3. I have visited some blogs referring to anxiety drugs. There were so many names Priligy, Paxil, Prozac etc. Are they of any use?
Ans: They are useful but there is no significant difference in treatment response. For any of these medicine (including feliz S) you require doctor prescription.

4. If continuing Feliz-S, is there any better drug than this with combination of 1-2 more to have proper effect?
Ans: Feliz S is good and you already have good response in past. You can follow other methods as mentioned in primary reply with Feliz S for better response.

Please accept my answer and give feedback in case there is no further query and you found reply helpful. In case of doubt, I am here to help you.

Wish you good health.
Regards

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Brief Answer:
Hi

Detailed Answer:

Thanks XXXXXXX

Please accept my answer and give feedback in case there is no further query and you found reply helpful. In case of doubt, I am here to help you.

Wish you good health.
Regards

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