Brief Answer:
Depends on the cause of his failure to continue intercourse.

Detailed Answer:
Hello XXXXXXX

I am wondering if you can clarify some things for me. Is your partner reaching orgasm too early (premature ejaculation), or is the problem that he loses his erection during intercourse and cannot continue?


Also, can you tell me the approximate age of your partner and if he has any health problems or is on any medications?

Any further information you can provide will help me to answer - thanks.

---

Brief Answer:
SSRI antidepressants may be helpful for treating premature ejaculation.

Detailed Answer:
Hello XXXXXXX

What you are describing sounds like he has premature ejaculation (pe). This is a common problem. We call it premature ejaculation when a man ejaculates within one minute of beginning intercourse or is unable to delay ejaculation all or nearly all of the time he has intercourse.

You ask specifically about medications for this so I will talk about that first.

A particular class of antidepressants called SSRIs have been studied to help premature ejaculation. These are taken on a daily basis. Medications of this type that have been used for pe include sertraline (Zoloft), paroxetine (Paxil), fluoxetine (Prozac) and escitalopram (Lexapro).

Of these SSRIs, the medication with the fewest unwanted side effects is escitalopram, but all of these medications are fairly well tolerated. They take a few weeks to start working well (usually at least 2 weeks).

Of note, if you are wanting to try to conceive a baby, he should be off of these prior to trying as there is some evidence that (at least with escitalopram), they can lower the sperm count while on it, possibly making getting pregnant more difficult.

Side effects of SSRIs can include in some people, decreased libido (less sexual desire) and nausea. The nausea, if it occurs, usually decreases or goes away after a person is on it a couple of weeks.

Aside from SSRIs, other medications that can be used are:

1. Tramadol - a narcotic-like pain killer. This is sometimes used if an SSRI is not helpful. It can cause nausea and headaches though, in some people.

2. This may be surprising, but medications that help maintain erection have also been used to help premature ejaculation. These include sildenafil (Viagra, Revatio), tadalafil (Cialis, Adcirca) or vardenafil (Levitra, Staxyn). Side effects that happen in some people (not all) include nasal congestion and headache.

Premature ejaculation can have both psychological and physical causes.

Some of the psychological causes are having a fear of losing the erection (and therefore hurrying thru intercourse) and also anxieties in general.

Some of the physiological causes are abnormal hormone levels, thyroid problems, abnormal reflex activity of the ejaculatory system, and genetic causes (inherited).

Behavioral treatments include:

1. Switching to non-intercourse types of sexual activity to take the pressure off of performance for awhile.

2. The "Pause-Squeeze" technique. How to do it:
When your partner is almost ready to ejaculate (if he can, ask him to tell you), squeeze the penis where the head joins the shaft, and maintain the squeeze for several seconds, until the urge to ejaculate passes. Stop squeezing and wait for 30 seconds, then go back to foreplay. Squeezing the penis may cause it to become less erect, but when sexual stimulation is started again, it will soon regain full erection. You can repeat this technique as necessary.

This technique can be done during non-intercourse sexual activity and can help your partner learn to control ejaculations. It can also be done during intercourse to help delay ejaculation.

I hope this helps. Do you have any further questions about this that I can help you with? If not, please go ahead and close this transaction and rate me.

Best wishes to you!
Bonnie Berger-Durnbaugh, MD

---