
What Causes Premature Ejaculation?

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Detailed Answer:
Hello and welcome to Healthcare Magic. Thanks for your query.
I will certainly help and advise you regarding your problem. In order to guide you better, can you please provide the following clarifications...
- How long have you been having this problem?
- How frequently does this problem happen? Does it happen only in certain situations or everytime you are sexually aroused?
- How long are you able to perform sexual intercourse?
- Do you have any problems or stress in your relationship?
- Do you suffer from anxiety, negative thoughts or low mood?
- What medication are you taking for your hypertension currently?
Please get back to me with these details, so that I can advise you in a better way.
Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist & Sexologist


I am having this problem since 1st experience of my sex with my wife after marriage in APR-2011. And due to this problem, I was not much interested and don't do sex regularly.
I don't have any problem and stress with my relationship; we are happy with each other and share our all problems. She understand me and very supportive.
I am a software engineer in MNC and currently based in Australia since APR-2013 for long term and there is not much stress in my job as well. But these days I have stress due PE problem, because now we are seriously planning for a Kid as soon as possible.
I think yes, I am suffering from anxiety.
I am not taking any medicine for hypertension or anything else and trying to control myself as much as possible. I am a vegetarian and try to eat healthy food. My father passed away in 2002 and after that I am taking care of my whole family (my mother, 3 brothers and 3 sisters). I am elder in my family. Due to family responsibility I think have suffered from hypertension and I was short temper, but now everything is ok and family situation is fine. My brothers and sisters are doing well in their life in XXXXXXX
I hope, I have given answer of all the questions, Hope you understand my problem and give you valuable feedback and solution.
Thank you so much sir.
Advised to try medication
Detailed Answer:
Hello again and thanks for your clarifications.
I can understand that you are quite distressed by your problem of Premature ejaculation. Now, this is actually a common problem in young males and in most of the cases, there is no major medical abnormality causing this. In most cases there are two main causes:
1) A hypersensitive response of the penis
2) Subconscious anxiety / fears / doubts about inadequate sexual performance (called as "performance anxiety")
Since you have mentioned that you have tried several techniques unsuccessfully, I think you may benefit from a short course of medication. I usually advise my patients to take a medication called Dapoxetine and most have reported significant improvement and better control of premature ejaculation. The recommended dosage of Dapoxetine is 30mg, once a day and can be safely taken for a short period of time till your problem improves.
Another simple solution, which can sometimes be helpful, is to try local application of a small quantity of Lignocaine gel on the glans (head) of the penis just prior to intercourse. This will help in reducing the "hypersensitivity" of the penis and thus delay the time taken to reach ejaculation.
I also would like to give you the following important advise to overcome your problem:
1) Try to stop becoming more anxious about this problem - because if you feel more anxious and worried or if you keep having doubts that you may not be able to perform properly, then this anxiety itself will worsen the problem. So, during sexual intercourse try to stop worrying and "monitoring" your sexual performance. Just try to be relaxed and enjoy yourself. Don't keep on thinking "How long am I going to last?" "Will I ejaculate too quickly?" "Will I be able to satisfy my parrtner?, etc. One more suggestion is to arouse your partner well before starting intercourse. So, you can increase and spice-up your foreplay and make sure that you start penetration only after your partner is fully turned on. When your partner is fully aroused and involved, then things keep flowing smoothly and effortlessly, and you don't have to be constantly anxious if you are satisfying your partner or not.
2) Another suggestion to reduce the hypersensitive response of the penis is to try specific sexual techniques. You have mentioned that you have tried some techniques before. But when these techniques are tried along with medication, then the response rates are better. The "stop-start technique" or "squeeze technique" have been proven to be successful in reducing this hypersensitivity and increasing the ejaculatory time.
In the stop-start technique, the penis is stimulated (by sexual intercourse or by masturbation) till a point when you feel close to orgasm. At that point, the stimulation is stopped for some time and after a small gap, it is continued. This process is repeated repeated a few times.
In the squeeze technique, the penis can be stimulated by hand (by masturbation or by your partner) till a point when you feel close to orgasm. At that point, the lower part of the head of the penis is squeezed tightly with the index finger and thumb around for a few seconds till the erection decreases. Then the stimulation is restarted and the process is repeated a few times.
Both these techniques, if practised regularly (along with medication) can definitely help you overcome your problem of premature ejaculation.
Wish you all the best.
Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist & Sexologist

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