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Suggest Treatment For Premature Ejaculation
Question: I suffer from premature ejaculation and also flaccid penis for last year or so despite feeling sexually aroused and having an understanding partner. Initially I thought it was perhaps due to middle age and my blood pressure medication. But I have been on BP treatment for ten years now and in fact I am doing better in terms of overall health and BP control. I exercise daily (40 min-1hr), maintain my weight, have hobbies, relax on weekends and a happy family life. All my reports in health check up done last month were fine and the doctor asked me reduce the dosage of Omega 3 tablets. I want to know if this is only due to middle age or is there something I can do or a medication I can take to enjoy sex at least occasionally. Thanks
Brief Answer:
Clarification
Detailed Answer:
Hello,
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
Although you have mentioned things quite well with all the required details a sexologist requires but one small thing which I would like to seek clarification for is your statement "I suffer from premature ejaculation and also flaccid penis"
Does it mean
1) That there is a desire and an erection but after there is a premature ejaculation, the penis becomes flaccid and then you are not able to have sex further
or
2) That there is some times premature ejaculation with a good erection befor ejaculation and sometimes there is a flaccid penis even before the ejaculation takes place leading to the inability to have sex.
Further there are couple of other things I would like to know:
a) Do you get morning stiffness in your penis?
b) How is your experience while masturbation?
c) Is there any substance abuse like alcohol or tobacco?
getting these clarifications solved will help me in understanding your case better and will wait for your reply.
Kind regards
Dr. Srikanth Reddy MD
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy
Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.
Clarification
Detailed Answer:
Hello,
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
Although you have mentioned things quite well with all the required details a sexologist requires but one small thing which I would like to seek clarification for is your statement "I suffer from premature ejaculation and also flaccid penis"
Does it mean
1) That there is a desire and an erection but after there is a premature ejaculation, the penis becomes flaccid and then you are not able to have sex further
or
2) That there is some times premature ejaculation with a good erection befor ejaculation and sometimes there is a flaccid penis even before the ejaculation takes place leading to the inability to have sex.
Further there are couple of other things I would like to know:
a) Do you get morning stiffness in your penis?
b) How is your experience while masturbation?
c) Is there any substance abuse like alcohol or tobacco?
getting these clarifications solved will help me in understanding your case better and will wait for your reply.
Kind regards
Dr. Srikanth Reddy MD
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
In future if you wish to contact me directly, you can use the below mentioned link:
bit.ly/dr-srikanth-reddy
Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks you Dr XXXXXXX
From the options you mention, the option 1 seems closer to my experience:1) That there is a desire and an erection but after there is a premature ejaculation, the penis becomes flaccid and then you are not able to have sex further.
Also to answer your other questions:
a) Yes, I get morning stiffness in the penis
b) Experience in masturbation reflects a little bit of sexual experience. It takes a long to get erection and it doesn't last long.
c) I don't smoke. I drink a couple of glasses of wine on weekends.
thank you for your help.
The question I have is: Can't I just occasionally use tablets like viagra or cialis?
Looking forward to your response.
From the options you mention, the option 1 seems closer to my experience:1) That there is a desire and an erection but after there is a premature ejaculation, the penis becomes flaccid and then you are not able to have sex further.
Also to answer your other questions:
a) Yes, I get morning stiffness in the penis
b) Experience in masturbation reflects a little bit of sexual experience. It takes a long to get erection and it doesn't last long.
c) I don't smoke. I drink a couple of glasses of wine on weekends.
thank you for your help.
The question I have is: Can't I just occasionally use tablets like viagra or cialis?
Looking forward to your response.
Brief Answer:
Premature ejaculation
Detailed Answer:
Hello
Thanks for all the clarifications.
From the details that you have given it appears that you have an illness of premature ejaculation (PE) and the occasional erectile dysfunction (ED) is secondary to the psychological effect of PE.
First you can try the start stop technique. Your wife is supposed to start stimulating you and the moment you are about to ejaculated she is supposed to stop all the stimulaton and and hold your penis head hard. This will reduce the erction for time being but will not let the ejaculation occur. Now this should be repeated.
Perineal exercises also help. These are the muscle exercises that occur when you contract the perineal muscles like when you are trying to stop the urine or feces. You have to do this contrations repeatedly daily to tone up the perineal muscles.
One solution is medications. Some patients are not willing to wait for these acts to produce results and instead demand medicines. I prescribe them 12.5 mg paroxetine at night and they are doing good. Normally one should try until 25mg of Paroxetine every night. If paroxetine is not effective then Dapoxetine is an option. It has to be given 1 hour before having sex and will prolong the sexual interval.
Cialis and Viagra may not help in these situations as they are all together different drugs.
Hope this helps,
If you have any further query, do let me know.
Kind regards
Dr. Srikanth Reddy
Premature ejaculation
Detailed Answer:
Hello
Thanks for all the clarifications.
From the details that you have given it appears that you have an illness of premature ejaculation (PE) and the occasional erectile dysfunction (ED) is secondary to the psychological effect of PE.
First you can try the start stop technique. Your wife is supposed to start stimulating you and the moment you are about to ejaculated she is supposed to stop all the stimulaton and and hold your penis head hard. This will reduce the erction for time being but will not let the ejaculation occur. Now this should be repeated.
Perineal exercises also help. These are the muscle exercises that occur when you contract the perineal muscles like when you are trying to stop the urine or feces. You have to do this contrations repeatedly daily to tone up the perineal muscles.
One solution is medications. Some patients are not willing to wait for these acts to produce results and instead demand medicines. I prescribe them 12.5 mg paroxetine at night and they are doing good. Normally one should try until 25mg of Paroxetine every night. If paroxetine is not effective then Dapoxetine is an option. It has to be given 1 hour before having sex and will prolong the sexual interval.
Cialis and Viagra may not help in these situations as they are all together different drugs.
Hope this helps,
If you have any further query, do let me know.
Kind regards
Dr. Srikanth Reddy
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you doctor.
Are Paroxetine and Dapoxetine OTC drugs? Can I get them without prescriptions?
Your style of explanation is very clear and I appreciate the time you have given to giving me the response.
I will try both remedies. If they don't work, maybe I will get back to you.
thanks again.
Are Paroxetine and Dapoxetine OTC drugs? Can I get them without prescriptions?
Your style of explanation is very clear and I appreciate the time you have given to giving me the response.
I will try both remedies. If they don't work, maybe I will get back to you.
thanks again.
Brief Answer:
You may still get it.
Detailed Answer:
Hello
Paroxetine and Dapoxetine are not OTC drugs. Moreover as health care magic is an online forum, legally we are not supposed to prescribe medications without physically examining you. Such regulation are primarily meant for the safety of the patients as well as the Doctor. Sincere apologies for the same.
However you may get it prescribed by any local GP after discussing the issue and he would be happy to do so. Moreover in certain pharmacies, a prescription is not a compulsion. So you may simply go ahead.
YOu may try one of the drugs (paroxetine / dapoxetine) along with the non-drug advices that I have given. You will surely benefit from it.
In case you have any doubts, please do let me know.
Kind regards
Dr. Srikanth Reddy
You may still get it.
Detailed Answer:
Hello
Paroxetine and Dapoxetine are not OTC drugs. Moreover as health care magic is an online forum, legally we are not supposed to prescribe medications without physically examining you. Such regulation are primarily meant for the safety of the patients as well as the Doctor. Sincere apologies for the same.
However you may get it prescribed by any local GP after discussing the issue and he would be happy to do so. Moreover in certain pharmacies, a prescription is not a compulsion. So you may simply go ahead.
YOu may try one of the drugs (paroxetine / dapoxetine) along with the non-drug advices that I have given. You will surely benefit from it.
In case you have any doubts, please do let me know.
Kind regards
Dr. Srikanth Reddy
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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