Facing Premature Ejaculation And Erectile Dysfunction Problem. How To Cure This?

Hello,

Thanks for writing to us. I am trying to solve your problem.

According to your clinical presentation, you are probably suffering from Premature Ejaculation. It can cause sexual dissatisfaction in married life, specially to your partner.

In this condition, male ejaculate within 1 min or prior to intimate/sexual intercourse with partner. If it combines with erectile dysfunction in later years, then they can cause impotency/ loss of libido / infertility after married life.

Premature ejaculation is mostly due to psychological causes (stress/ anxiety/ nervousness) rather than physical. Though we need to rule out some underlying causative factors in this context like hypogonadism with low level of testosterone, habit of smoking/ alcohol, some drugs, prostatitis/ urethritis, varicocele/ hydrocele, any autoimmune disorder, High BP, Diabetes,thyroid disorder, neurological causes etc.

A complete clinical examination & some investigation are needed to be carried out by to confirm diagnosis. Please consult with urologist/ sexologist regarding this to take suggestive measures & medication accordingly.

Following things are helpful to prevent above condition:

1) Quit smoking and alcohol. You may need psychotherapy /counseling.
2) Decrease frequency of masturbation if you have the habit.
3) Take healthy diet, do physical exercise regularly and maintain personal hygiene.
4) Avoid stress/psychological upset/depression by regular XXXXXXX breathing/ yoga.

5) Specific Treatment for Premature Ejaculation:

a) Some Controlling Method:

Master & XXXXXXX / Stop & Start Technique- It is very much helpful.

Squeeze technique: In this type, female partner needs to start arousing the man. When the man feels that he is almost at the point of ejaculation, she should stop arousing him. She then needs to squeeze the head for between 10 to 20 seconds. She then lets go and waits for another 30 seconds before resuming masturbation. This process is carried out several times before ejaculation is allowed to occur.

Stop-go technique- It is similar to the squeeze technique except that the woman does not squeeze the penis.

b) Kegel exercise or strengthening of PC muscle by contraction and relaxation as on holding & releasing urine. Practice it several times (20-30 times daily): Here, you need to repeatedly contract and relax the muscles you use when you need to hold back urine. This needs to be done sitting on your chair when you are actually not trying to hold back urine.

c) Use anaesthetic gel to desensitize penis or condom for temporary delay. You can get a prescription for this from your physician.

d) Certain drug like Dapoxetine, a class of SSRI,short acting and well approved. This is required only if the exercises don't work. Please try the exercises for 1-2 months before this.

e) Give more time on foreplay to heighten partner's excitation and do actual intercourse (vaginal penetration) at the time of partner climax. Here both of you can get satisfaction/ pleasure.

f) Need proper sleep (at least 6-8 hrs daily) and avoid hot working place and tight underwear.

7) Proper psychological counseling and further follow up if you need.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish you good health in future.

Regards,
Dr Soumen.

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