I'm suffering from sps
I want to increase my sex time (Premature ejaculation)
Dr.
Hi xxxx , Dr. xxxx will take up your case.
Thanks! Doctor has received your payment
Dr.
Good Afternoon xxxx ! I am here to help you, please tell me more about your problem.
Dr.
Do you want to discuss on call or chat?
actually ma penis is small ...and I end up so soon while intercourse...it's like in seconds I'm done.
Dr.
I need more information.
Dr.
Do you want to discuss on call or chat?
Dr.
1... Are you married?
If yes duration of marriage?
If not married, provide details about sex life with girlfriend.
2... Is morning erection present when you wake up from sleep ?
3... Is there any difficulty in urinating?
4... Is there any history of masturbation? If yes, how was pleasure/orgasm during masturbation?
5... How many times you do sex and masturbation per week or per month?
6... How much duration do you last before ejaculation? Do you ejaculate before your partner reaches orgasm?
7..what is your size of penis in flaccid (normal) state and in erect state?
1.long back I tried twice with my girlfriend with in seconds I mean down
2.yes morning erection is there.
3.sometimes
4.i do a masturbation a lot like once in every 2 days before it was nothing now it's paining after masturbating.
5.as I told I tried doing sex twice after end up so soon I dint had sex because of embarassment.. masturbation I do once in 2days.
6.its in seconds I guess.
1st time it was like that but 2nd time I controlled for longer time..7.2.5 inches normal and during erection 4.5 inches
Dr.
Thanks for information, your problem is Premature ejaculation.
It means early ejaculation.. Means your ejaculation (coming out of semen /sperms) so early that the partner is not able to enjoy /satisfy
It is not a pathological problem but it is only physiological problem.
It can be treated with medicines and behavioural modifications.
Behavioral approaches are as follows to prevent early ejaculation
1. Stop and start 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).I will explain in next msg.
2. Kegel exercise also helps in some cases. You can learn the same from internet.
3. Sex counselling 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 3 hours before or same day in morning). 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 use of condom, while sex, helps in delaying ejaculation by reducing sensitivity of glans penis . even condom with anesthetic gel is also available - long lasting condom.
You can learn stop and start technique gradually
After insertion of penis when you start stroking there will be feeling when you feel that ejaculation will be initiated soon. At that moment you have to stop stroking for 30 seconds, keep penis inside and divert your mind to something else other than sex. When you feel that ejaculation impulse gone you can restart stroking and same thing can be repeated again and again to extend the time. However for this you need to last at least 1 minute after insertion. It requires practice.
Dr.
Medicines for premature ejaculation : 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 0-30 days daily after dinner and later on just on the day when you do the sex. One molecule called dapoxetine has been used specifically for PME and should be taken before sex when required. One ayurvedic supplement confido is also helpful in some patients.
Dr.
your size of penis is absolutely normal
Dr.
Let me clarify about size of penis.
Normal size of penis in flaccid(normal) state is 2 to 4 inches (5 to 10 cm)... sometime it can be 1.5 inches also.... while in erect position 3.5 to 6 inches (9 to 15 cm). It varies according to body structure, genetics and race. It is not related to height or masturbation habit..
Size of penis does not matter much for satisfying partner.
Maximum anterior 3 inches of female vaginal wall is sensitive to sexual stimuli. Only 3.5 inches of erect penis is more than sufficient to satisfy female.
As such there are lots of creams and pills are marketed for penis enlargement. But nothing is scientifically approved and useful in reality.
In this field I am working since many years but till date only surgery and testosterone therapy are useful for this.
As such there is no medicine which can increase basic natural size of penis.
Note: There are pills which can increase size of penis if there is erectile dysfunction(means erection is not proper)
5- PDE inhibitor group of medicines are used for this purpose which includes sildenafil or tadalafil. It is proven drug for male erectile dysfunction.
Dr.
Minimum 3.5 inches required for sex life. Average indian size is 4 to 5 inches. Your size is normal. With this size you can have normal sex life. Not to worry.
Dr.
Many males suffer initially due to over excitation and arousal during begining of sex life. In most of the males this problem is automatically solved after regular sex life like after marriage.
Dr.
Considering your history I recommend
Dr.
xxxxx and xxxxx in your case
Dr.
Please read all msgs carefully and ask your queries if any. I will prescribe medicine after your all queries answered.
Dr.
if you are comfortable we can discuss on call also
Dr.
premature ejaculation
when should I have these medicines and till when
Dr.
It will be likely avaible at big medical store or chemists near to any big general hospital or psychiatrist's clinic.
Dr.
After one month we can evaluate situation and decide further course of medicines.
ok if the size of my penis is normal but not much hard last time I can't able to put inside only
so I have to continuexxxxxxxx?!!
Dr.
that happens initially due to performance anxiety
Dr.
Brain has sex centre which sends signals to penis for erection. This sex center is stimulated by any visual stimuli, fantasies or with partner touch. Erection to be remaining constant sex center should be in stimulated mode. While doing sex if any kind of thoughts like “Will I be able to satisfy my partner today? Will my erection be last proper? Is my erection is there or not? Is it proper erection?” etc as well as more than 30-45 seconds transition time from foreplay to insertion penis is there then sex center loses its stimulation due to lack of arousal. So signals for erection to penis are also lost and penis becomes loose.
Dr.
To overcome this problem you should not remove your underwear during foreplay. When you feel that there is sufficient erection or your partner feels the same just proceed for the insertion without delay after removing underwear. If you are using condom, keep condom in ready to wear position near to bed before starting the sex so no time is wasted in getting condom and opening it. After removing underwear, during wearing condom and till you insert completely and start stroking keep your sex center aroused by touching your partners parts(breast) or whatever the way you comfortable or your partner can do something like kissing you or touching your some body part by which you feel aroused. During this process try to enjoy and avoid thinking about erection or success of sex or watching erection consciously or feeling erection consciously with attention. Even after insertion of penis continue the same feelings and your both hands are free so you can have more chance to arouse yourself by touching your partner the way you like. After few strokes it will be easy to maintain erection. Ultimately try to enjoy without apprehension of erection or success of sex.
ok I have high BP due to hypertension
does anything related to this?
Dr.
any medicine is going on?
Dr.
yes it may affect erection
no I don't take much medicine when I feel but heavy or headache than I takeXXX40
Dr.
smoking can affect overall health and erection
Dr.
You must reduce and stop smoking.
Dr.
consult physician for blood pressure and take regular medication
ok I'll try doing that ...like stop smoking...I did that before for an year .
but after breakup depression started again...for nearly more than a year I dint sleep in the night I used to get nightmares deadly once
Dr.
still depression there?
don't noe I guess it's still there inside ..I love to sit alone don't talk to anyone much...I always keep on thinking something and other
Dr.
Among these symptoms which are there in your case and since when? Please narrate briefly.
1..Sad mood/low mood,
2..lack of interest in routine/pleasurable activities,
3..reduce or increase appetite or change in weight,
4..excessive fatigue or weakness,
5..lack of confidence,
6..lack of concentration,
7...sleep disturbances,
8..irritability-anger or very silent - withdrawn
9...death wishes, suicidal ideas
1. low mood
2 lack of interest in routine
3.increase appetite,change in weight also it's flatuating after joining job
4. sometimes weakness
5.yes lack of confidence.
6.yes lack of concentration.
7.sleep disturbances I have from long time when I used drink I don't get sleep more than 1-2 hrs
8 before anger now very silent.
9.no nothing like death wish nd sucidal idea...
Dr.
depression seems to be there
Dr.
You seem to be in depression with anxiety features. You should be treated for the same.
Treatment includes medicines as well as psychotherapy.
Medicines include some anti anxiety medicines like etizolam to make you relax and reduce your thoughts and give some immediate relief.
And other medicine is antidepressant like Desvenlafexine which will gradually improve your mood, and reduce anxiety and will make you stable to take proper decision about future.
In psychotherapy
CBT- Cognitive behaviour therapy will help you. I have suggested following links and book for the same.
Even psychologist/psychiatrist who can provide you psychotherapy he/she can provide the CBT also.
Yes if you are comfortable through phone you can ask to customer care docsapp to provide you the same as few psychologists are available or you can consult someone locally.
Approximately 4 to 6 sessions one per week or 15 days will be needed at most.
Even if you feel some improvement after 10 days of medicines you can continue with only medicines also. We can then increase the dose to optimum level. We can stop the medicines when you feel complete improvement by tapering the dose.
Feeling Good by David burns a self help book for depression
You can try online CBT with following links
https://moodgym.anu.edu.au/welcome
http://serene.me.uk/
Or you can also take counselling sessions through DocsApp
You can use some measures called 'sleep hygiene' which would help in sleep. You can find the same in below link.
sleepfoundation.org/ask-the-expert/sleep-hygiene
Drinking a cup of warm milk before going to bed helps in 30-40% of patients and they do not need medicines as per my clinical experience.
Follow healthy lifestyle. This includes regular daily exercise (walking or running), hygienic food habits (no junk food, no fatty food, preferably only home-made food with law salt and fat with more fruits and vegetables) and timely scheduled sleep. Yoga- meditation can also help.
actually I'm staying outside so daily have to eat outside.
Dr.
you can use Desvenlafexine for a while
so in total which and all medicine have to take
Dr.
xxxxx only before sex
Dr.
xxxxxxx regular for depression
anything else I should do?
when I should have the depression medicine
Dr.
at bed time before going to bed
for CBT and all have to visit psychiatrist or by going through the link and video that is enough
Dr.
go for Feeling Good book for a while
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