Brief Answer:
premature ejaculation is there, medicine can treat

Detailed Answer:
Hello,

Thanks for writing to us. I can understand your concern.

If you ejaculate within 3 minutes before your wife is satisfied it is likely premature ejaculation.

Premature Ejaculation (PME) or early discharge 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.

There are medicinal and non medicinal approaches to treat 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 counseling 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 using condom while sex helps in delaying ejaculation by reducing sensitivity of glans penis.

--Topical application of anesthetic gel/spray. For this you have to consult doctor.

If I were your treating doctor I would recommend clomipramine for you with suitable behavioral approach.

Size of penis varies according to individual.In flaccid state it ranges from 2-4 inches and in erect state 3.5-6 inches. Normally minimum 3-3.5 inches (8-9cm) penis in erection stage is required to satisfy female partner.

There is no approved medicine/procedure which can increase penis size in normal state.Only surgery can do the same but that is only indicated for medical reason not for cosmetic or sex purpose.

- If you have any difficulty in getting sufficient erection then let me know.

- Tell me size of penis in flaccid and erect state.

Take care.

Hope I have answered your query.Feel free to discuss further about doubts.

Regards,
Dr.Chintan Solanki.

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