by Sexual Health Experts and Research Scientists.

Go to BOTTOM
For medical professional who want to do in depth study on diagnosis and treatment of Premature Ejaculation:

References

1. Carson C,
   Gunn K. Premature ejaculation: definition and prevalence. Int J
   Impot Res 2006; 18 (Suppl 1): S5–13. | Article | PubMed |

2. American
   Psychiatric Association. Diagnostic and statistical manual of
   mental disorders, 4th edition. Text Revision. Washington, DC:
   American Psychiatric Association 2000.

3. Montague
   DK, Jarow J, Broderick GA, Dmochowski RR, Heaton JP, Lue TF, et
   al. AUA Erectile Dysfunction Guideline Update Panel. AUA
   guideline on the pharmacological management of premature
   ejaculation. J Urol 2004; 172:
   290–4. | Article | PubMed | ISI |

Go to BOTTOM

4. World
   Health Organization The ICD-10 classification of mental and
   behavioral disorders: diagnostic criteria for research. Geneva:
   World Health Organization, 1993.

5. Waldinger
   MD, Zwinderman AH, Olivier B, Schweitzer DH. Proposal for a
   definition of lifelong premature ejaculation based on
   epidemiological stopwatch data. J Sex Med 2005; 2:
   498–507. | Article | PubMed | ISI |

6. Semans JH.
   Premature ejaculation: a new approach. South Med J 1956; 49:
   353–8. | PubMed | ChemPort |

7. Masters
   WM, Johnson VE. Human Sexual Inadequacy. Boston: Little, Brown;
   1970.

Go to TOP | Go to BOTTOM

8. Hawton K,
   Catalan J, Martin P, Fagg J. Long-term outcome of sex therapy.
   Behav Res Ther 1986; 24:
   665–75. | Article | PubMed | ISI | ChemPort |

9. Rowland
   DL, Motofei IG. The aetiology of premature ejaculation and the
   mind-body problem: implications for practice. Int J Clin Pract
   2007; 61: 77–82. | Article | PubMed | ChemPort |

10. Perelman
    MA. A new combination treatment for premature ejaculation: a
    sex therapist’s perspective. J Sex Med 2006; 3:
    1004–12. | Article | PubMed |

11. Althof S.
    The psychology of premature ejaculation: therapies and
    consequences. J Sex Med 2006; 3 (Suppl 4):
    324–31. | Article | PubMed |

12. Schapiro
    B. Premature ejaculation: a review of 1 130 cases. J Urol 1943;
    3: 374–9.

Go to TOP | Go to BOTTOM

13. Xin ZC,
    Chung WS, Choi YD, Seong DH, Choi YJ, Choi HK. Penile
    sensitivity in patients with primary premature ejaculation. J
    Urol 1996; 156: 979–81. | Article | PubMed | ChemPort |

14. Vanden
    Broucke H, Everaert K, Peersman W, Claes H, Vanderschueren D,
    Van Kampen M. Ejaculation latency times and their relationship
    to penile sensitivity in men with normal sexual function. J
    Urol 2007; 177: 237–40. | Article | PubMed |

15. Atikeler
    MK, Gecit I, Senol FA. Optimum usage of prilocainelidocaine
    cream in premature ejaculation. Andrologia 2002; 34:
    356–9. | Article | PubMed | ChemPort |

16. Busato W,
    Galindo CC. Topical anesthetic use for treating premature
    ejaculation: a double-blind, randomized, placebo-controlled
    study. BJU Int 2004; 93:
    1018–21. | Article | PubMed | ISI | ChemPort |

Go to TOP | Go to BOTTOM

17. Choi HK,
    Jung GW, Moon KH, Xin ZC, Choi YD, Lee WH, et al.
    Clinical study of SS-cream in patients with lifelong premature
    ejaculation. Urology 2000; 55:
    257–61. | Article | PubMed | ChemPort |

18. Tian L,
    Xin ZC, Xin H, Fu J, Yuan YM, Liu WJ, et al. Effect of
    renewed SS-cream on spinal somatosensory evoked potential in
    rabbits. Asian J Androl 2004; 6: 15–8. | PubMed | ChemPort |

19. Dinsmore
    WW, Hackett G, Goldmeier D, Waldinger M, Dean J, Wright P, et
    al. Topical eutectic mixture for premature ejaculation
    (TEMPE): a novel aerosol-delivery form of lidocaine-prilocaine
    for treating premature ejaculation. BJU Int 2007; 99:
    369–75. | Article | PubMed | ChemPort |

20. Eaton H.
    Clomipramine in the treatment of premature ejaculation. J Int
    Med Res 1973; 1: 432–4.

Go to TOP | Go to BOTTOM

21. Waldinger
    MD, Zwinderman AH, Schweitzer DH, Olivier B. Relevance of
    methodological design for the interpretation of efficacy of
    drug treatment of premature ejaculation: a systematic review
    and meta-analysis. Int J Impot Res 2004; 16:
    369–81. | Article | PubMed | ISI | ChemPort |

22. Waldinger
    MD, Zwinderman AH, Olivier B. On-demand treatment of premature
    ejaculation with clomipramine and paroxetine: a randomized,
    double-blind fixed-dose study with stopwatch assessment. Europe
    Urol 2004; 46: 510–5. | PubMed | ISI | ChemPort |

Go to TOP | Go to BOTTOM

23. Rowland
    DL, Tai WL, Brummett K, Slob AK. Predicting responsiveness to
    the treatment of rapid ejaculation with 25 mg clomipramine as
    needed. Int J Impot Res 2004; 16:
    354–7. | Article | PubMed | ISI | ChemPort |

24. Balon R.
    SSRI-associated sexual dysfunction. Am J Psychiatry 2006; 163:
    1504–9. | Article | PubMed |

Go to TOP | Go to BOTTOM

25. Wang WF,
    Chang L, Minhas S, Ralph DJ. Selective serotonin reuptake
    inhibitors in the treatment of premature ejaculation. Chin Med
    J (Engl) 2007; 120: 1000–6. | PubMed | ChemPort |

26. Waldinger
    MD, van De Plas A, Pattij T, van Oorschot R, Coolen LM, Veening
    JG, et al. The selective serotonin re-uptake inhibitors
    fluvoxamine and paroxetine differ in sexual inhibitory effects
    after chronic treatment. Psychopharmacology (Berl) 2002; 160:
    283–9. | Article | PubMed | ChemPort |

Go to TOP | Go to BOTTOM

27. Kilic S,
    Ergin H, Baydinc YC. Venlafaxine extended release for the
    treatment of patients with premature ejaculation: a pilot,
    single-blind, placebo-controlled, fixed-dose crossover study on
    short-term administration of an antidepressant drug. Int J
    Androl 2005; 28: 47–52. | Article | PubMed | ISI | ChemPort |

28. Halperin
    D, Reber G. Influence of antidepressants on hemostasis.
    Dialogues Clin Neurosci 2007; 9: 47–59. | PubMed |

29. Dent LA,
    Brown WC, Murney JD. Citalopram-induced priapism.
    Pharmacotherapy 2002; 22: 538–41. | Article | PubMed |

Go to TOP | Go to BOTTOM

30. Raeder
    MB, Bjelland I, Emil Vollset S, Steen VM. Obesity,
    dyslipidemia, and diabetes with selective serotonin reuptake
    inhibitors: the Hordaland Health Study. J Clin Psychiatry 2006;
    67: 1974–82. | PubMed | ChemPort |

31. Haney EM,
    Chan BK, Diem SJ, Ensrud KE, Cauley JA, Barrett-Connor E, et
    al. For the Osteoporotic Fractures in Men Study Group.
    Association of low bone mineral density with selective
    serotonin reuptake inhibitor use by older men. Arch Intern Med
    2007; 167: 1246–51. | Article | PubMed |

32. Montejo
    AL, Llorca G, Izquierdo JA, Rico-Villademoros F. Incidence of
    sexual dysfunction associated with antidepressant agents: a
    prospective multicenter study of 1 022 outpatients. Spanish
    Working Group for the Study of Psychotropic-Related Sexual
    Dysfunction. J Clin Psychiatry 2001; 62 (Suppl 3):
    10–21. | PubMed | ISI | ChemPort |

Go to TOPGo to BOTTOM

33. Waldinger
    MD. Premature ejaculation: definition and drug treatment. Drugs
    2007; 67: 547–68. | Article | PubMed | ChemPort |

34. van
    Geffen EC, Hugtenburg JG, Heerdink ER, van Hulten RP, Egberts
    AC. Discontinuation symptoms in users of selective serotonin
    reuptake inhibitors in clinical practice: tapering versus
    abrupt discontinuation. Eur J Clin Pharmacol 2005; 61: 303–7.
    Epub 2005 May 20. | Article | PubMed | ChemPort |

35. Cohen D.
    Should the use of selective serotonin reuptake inhibitors in
    child and adolescent depression be banned? Psychother Psychosom
    2007; 76: 5–14. | Article | PubMed |

Go to TOPGo to BOTTOM

36. Gibbons
    RD, Brown CH, Hur K, Marcus SM, Bhaumik DK, Mann JJ.
    Relationship between antidepressants and suicide attempts: an
    analysis of the Veterans Health Administration data sets. Am J
    Psychiatry 2007; 164: 1044–9. | Article | PubMed |

Go to TOPGo to BOTTOM

37. Waldinger
    MD, Zwinderman AH, Schweitzer DH, Olivier B. Relevance of
    methodological design for the interpretation of efficacy of
    drug treatment of premature ejaculation: a systematic review
    and meta-analysis. Int J Impot Res 2004; 16:
    369–81. | Article | PubMed | ISI | ChemPort |

38. Waldinger
    MD. Premature ejaculation: definition and drug treatment. Drugs
    2007; 67: 547–68. | Article | PubMed | ChemPort |

39. Waldinger
    MD, Zwinderman AH, Olivier B. SSRIs and ejaculation: a
    double-blind, randomized, fixed-dose study with paroxetine and
    citalopram. J Clin Psychopharmacol 2001; 21:
    556–60. | Article | PubMed | ISI | ChemPort |

Go to TOP | Go to BOTTOM

40. Safarinejad
    MR, Hosseini SY. Safety and efficacy of citalopram in the
    treatment of premature ejaculation: a double-blind
    placebo-controlled, fixed dose, randomized study. Int J Impot
    Res 2006; 18: 164–9. | Article | PubMed | ISI | ChemPort |

Go to TOPGo to BOTTOM

41. Safarinejad
    MR. Safety and efficacy of escitalopram in the treatment of
    premature ejaculation: a double-blind, placebo-controlled,
    fixed-dose, randomized study. J Clin Psychopharmacol 2007; 27:
    444–50. | Article | PubMed | ChemPort |

42. Posternak
    MA, Zimmerman M. Dual reuptake inhibitors incur lower rates of
    tachyphylaxis than selective serotonin reuptake inhibitors: a
    retrospective study. J Clin Psychiatry 2005; 66:
    705–7. | PubMed |

Go to TOP | Go to BOTTOM

43. Dresser
    MJ, Kang D, Staehr P, Gidwani S, Guo C, Mulhall JP, et al.
    Pharmacokinetics of dapoxetine, a new treatment for premature
    ejaculation: Impact of age and effects of a high-fat meal. J
    Clin Pharmacol 2006; 46:
    1023–9. | Article | PubMed | ChemPort |

44. Hellstrom
    WJ, Heintz JW. Treatment of premature ejaculation: new drugs
    and treatment strategies. Curr Urol Rep 2006; 7:
    473–8. | Article | PubMed |

Go to TOPGo to BOTTOM

45. Waldinger
    MD, Zwinderman AH, Olivier B, Schweitzer DH. The majority of
    men with lifelong premature ejaculation prefer daily drug
    treatment: an observation study in a consecutive group of Dutch
    men. J Sex Med 2007; 4 (4 Pt 1):
    1028–37. | Article | PubMed | ChemPort |

46. Safarinejad
    MR, Hosseini SY. Safety and efficacy of tramadol in the
    treatment of premature ejaculation: a double-blind,
    placebo-controlled, fixed-dose, randomized study. J Clin
    Psychopharmacol 2006; 26:
    27–31. | Article | PubMed | ChemPort |

Go to TOPGo to BOTTOM

47. Salem EA,
    Wilson SK, Bissada NK, Delk JR, Hellstrom WJ, Cleves MA.
    Tramadol HCL has promise in on-demand use to treat premature
    ejaculation. J Sex Med 2007; 14; Epub ahead of
    print. | Article | PubMed | ChemPort |

48. Laumann
    EO, Paik A, Rosen RC. The epidemiology of erectile dysfunction:
    results from the National Health and Social Life Survey. Int J
    Impot Res 1999; 11 (Suppl 1): S60–4. | Article | PubMed | ISI |

Go to TOP

49. Abdel-Hamid
    IA, El Naggar EA, El Gilany AH. Assessment of as needed use of
    pharmacotherapy and the pause-squeeze technique in premature
    ejaculation. Int J Impot Res 2001; 13:
    41–5. | Article | PubMed | ISI | ChemPort |

Go to TOPGo to BOTTOM

50. Wang WF,
    Wang Y, Minhas S, Ralph DJ. Can sildenafil treat primary
    premature ejaculation? A prospective clinical study. Int J Urol
    2007; 14: 331–5. | Article | PubMed | ChemPort |

51. McMahon
    CG, Stuckey BG, Andersen M, Purvis K, Koppiker N, Haughie S, et
    al. Efficacy of sildenafil citrate (Viagra) in men with
    premature ejaculation. J Sex Med 2005; 2:
    368–75. | Article | PubMed | ISI | ChemPort |

Go to TOPGo to BOTTOM

52. Atan A,
    Basar MM, Tuncel A, Ferhat M, Agras K, Tekdogan U. Comparison
    of efficacy of sildenafil-only, sildenafil plus topical EMLA
    cream, and topical EMLA-cream-only in treatment of premature
    ejaculation. Urology 2006; 67:
    388–91. | Article | PubMed | ISI |

Go to TOPGo to BOTTOM

53. Chen J,
    Mabjeesh NJ, Matzkin H, Greenstein A. Efficacy of sildenafil as
    adjuvant therapy to selective serotonin reuptake inhibitor in
    alleviating premature ejaculation. Urology 2003; 61:
    197–200. | Article | PubMed |

54. Li X,
    Zhang SX, Cheng HM, Zhang WD. Clinical study of sildenafil in
    the treatment of premature ejaculation complicated by erectile
    dysfunction. Zhonghua Nan Ke Xue 2003; 9: 266–9. | PubMed |

Go to TOPGo to BOTTOM

55. Fein RL.
    Intracavernous medication for treatment of premature
    ejaculation. Urology 1990; 35:
    301–3. | Article | PubMed | ChemPort |

56. Kim SW,
    Lee SH, Paick JS. In vivo rat model to measure
    hypogastric nerve stimulation-induced seminal vesicle and vasal
    pressure responses simultaneously. Int J Impot Res 2004; 16:
    427–32. | Article | PubMed | ChemPort |

Go to TOPGo to BOTTOM

57. Cavallini
    G. Alpha-1 blockade pharmacotherapy in primitive psychogenic
    premature ejaculation resistant to psychotherapy. Eur Urol
    1995; 28: 126–30. | PubMed | ChemPort |

Go to TOP

58. Basar MM,
    Yilmaz E, Ferhat M, Basar H, Batislam E. Terazosin in the
    treatment of premature ejaculation: a short-term follow-up. Int
    Urol Nephrol 2005; 37: 773–7. | Article | PubMed | ChemPort |

59. Optale G,
    Pastore M, Marin S, Bordin D, Nasta A, Pianon C. Male sexual
    dysfunctions: immersive virtual reality and multimedia therapy.
    Stud Health Technol Inform 2004; 99: 165–78. | PubMed |

60. Jan Wise
    ME, Watson JP. A new treatment for premature ejaculation: case
    series for a desensitizing band. Sex and Relation Ther 2000;
    15: 345–50. | Article |

Go to TOPGo to BOTTOM

61. Kim JJ,
    Kwak TI, Jeon BG, Cheon J, Moon DG. Effects of glans penis
    augmentation using hyaluronic acid gel for premature
    ejaculation. Int J Impot Res 2004; 16:
    547–51. | Article | PubMed | ChemPort |

62. Mulhall
    JP. Current and future pharmacotherapeutic strategies in
    treatment of premature ejaculation. Urology 2006; 67:
    9–16. | Article | PubMed |

Go to TOP

63. Looney C,
    Thor KB, Ricca D, Marson L. Differential effects of
    simultaneous or sequential administration of paroxetine and
    WAY-100, 635 on ejaculatory behavior. Pharmacol Biochem Behav
    2005; 82: 427–33. | Article | PubMed | ChemPort |

64. Williamson IJ, Turner L, Woods K,
    Wayman CP, Van Der Graaf PH. The 5-HT1A receptor antagonist
    robalzotan enhances SSRI-induced ejaculation delay in the rat.
    Br J Pharmacol 2003; 138 (Suppl 1): PO32.

THANKS TO ASIAN JOURNAL OF ANDROLOGY AND nature.comGo to TOP

DEFINITION OF PREMATURE EJACULATION

DEFINITION PE

Premature ejaculation (PE) is recognized to be the most common male sexual disorder. PE provides difficulties for professionals who treat this condition because there is neither a universally accepted definition nor a medication approved by the Food and Drug Administration (FDA). Despite these shortcomings, physicians continue to diagnose their patients with PE according to major guidelines and treat them with either behavioral therapies or off-label medications. This review focuses on current and emerging treatment options and medications for PE. Advantages and limitations of each treatment option are discussed in the light of current published peer-reviewed literature.

SOURCE

Premature ejaculation: CURRENT AND FUTURE TREATMENTS

Levent Gurkan, Matthew Oommen and Wayne J G Hellstrom
Section of Andrology, Department of Urology, Tulane University Health Sciences Center, New Orleans, LA 70112, USA
Correspondence: Wayne J G Hellstrom, MD, FACS, Section of Andrology, Department of Urology, Tulane University Health Sciences Center, 1430 Tulane Ave., SL-42, New Orleans, LA 70112, USA. Fax: +1-504-988-5059. E-mail: whellst@tulane.edu
Asian Journal of Andrology (2008) 10, 102–109; doi:10.1111/j.1745-7262.2008.00369.x

ARE YOU A WORKAHOLIC?

You wrote:

Case File 1

Hi,
I had a healthy sex life till sometime back.Recently my sex drive has decreased majorly.I get a hard on but when i proceed to have sex it goes down in a few seconds.I went to a doctor that prescribed Viagra(penegra) to me.It helped a bit.But I dont wanna be depndent on a drug to have sex.My fiance is greatly dissapointed at me.Also I come really fast.Sum and substance I have never been able to satisfy her.Though a year back we were doin it up to 4 times a day.I am not bored of her.and very sexualy attracted to her but i fail to perform.Please help!!

Case File 2

Dear Sir

My name is xxx raju xxx,
Aged 32
Married have 1 baby.

I have a problem of premature Ejaculation. Ejaculation occures after 1 or 2 strokes or some time its even before insertion.

I have tried many treatments. I am not statisfied with the result.

Please help me getting goog treatment.

Regards…

Reply:
High Excitement
–>
Early ejaculation
—>
Nervousness, shame, disappointment of male.
incomplete, sex should be for longer time says female
—>
He tends to avoid/postpone sexual intercourse in order not to face shameful situation “I can’t do it.” “I can’t satisfy her.”
—>
Long gap between love making.
Meaning, frequency of sex is less.
It was 5 times a week, now it is 1 or 2 times a month.
—->
His excitement goes on rising. He also thinks that he has to fulfill her sexual need and cannot avoid sex.
—>
High excitement
—->

Early ejaculation
—>
vicious cycle
Thus, he is more disappointed, scared.
This causes UNTOLD suffering. Either he

• is further tricked by quack or

• bears the sorrow.

• He compensates by pampering female partner in all other areas.

• He has aches and pains. Example, he may complain of backache that causes difficulty in doing sex.
• This dampens his desire.
• Consequently his erection is not as it used to be.
• “The size of my penis is small.”
• He becomes workaholic.

Case File 3

am 28 yrs old young man, my weight is 95, i am married 2yrs back, duirng first year my weight was 75, even i had a happy sex no problem, but now a days i find some problems of early ejacuation during sex, after intercorse i get ejected with in 2 min, also i am finding my penis size is also geting smaller, please help me with this problem.

PREMATURE EJACULATION

People with ‘Early Discharge’, ‘Premature Ejaculation’ or ‘Early Orgasmic Response’, if given proper treatment get satisfactory results.

Two aspects weigh on the mind of the guy:

I.

What if I am not able to satisfy her?
(Fear that she may seek extramarital relation.)

II.

How can I prolong so that ejaculation is delayed?

IMPORTANT TIPS
Of FOREMOST importance is to know what is normal time.
Do you have realistic expectation?
If his expectation is to last for 30 minutes, he will get frustrated and would be visiting ‘n’ number of doctors.

To know the proper management of Premature Ejaculation please see this.

A. Non Medicinal Methods
B. Methods that use Medicine
C. FemaleSatisfaction

ADDITIONAL INFORMATION

ALSO SEE http://doctortells.blogspot.com . . . .sex matters.

On Fast Track
With
Dr. Ashok Koparday
Samadhan India
Center for Therapy, Education, Research in
Sex, Marriage, Relationships.

TO STOP PREMATURE EJACULATION

1. HAVE REALISTIC EXPECTATION
2. FEMALE SATISFACTION
3. MEDICAL METHODS TO DELAY EJACULATION
4. NON MEDICAL METHODS TO STOP PREMATURE EJACULATION
5. GO TO SEX THERAPIST

[1.]HAVE REALISTIC EXPECTATION

Know what is normal time for ejaculation. Be clear how long you wish to delay ejaculation? This is important because UNREALISTIC expectations (example 30 minutes) is common as people compare with what is shown in blue films.

[2.] HOW TO SATISFY FEMALE PARTNER To satisfy your partner is an important reason why you want to stop premature ejaculation.
1. Do not hurry to insert.
2. Do foreplay. You can even bring her to climax with foreplay alone.
3. Do after play. To satisfy female partner foreplay and after play are of paramount importance.
4. Do not just sexual intercourse, but sexual outer course too.
5. Learn and use non penile methods for female satisfaction. Female can have sexual satisfaction using non penile methods, such as her or partner’s finger, and knowing where and how much stimulation to give to get maximum sexual satisfaction. This takes away major burden off the mind of the man and treatment to stop Premature Ejaculation is easier.

FEMALE SATISFACTION AND DELAYING EJACULATION ARE TWO ESSENTIAL ASPECTS OF STOPPING PREMATURE EJACULATION. THEY ARE LIKE TWO SIDES OF SAME COIN

SATISFYING FEMALE AND DELAYING EJACULATION

[4.] WHAT ARE THE NON MEDICAL METHODS TO STOP PREMATURE EJACULATION

1. Masturbate before actual sexual intercourse.
2. Use condom.
3. Do not remove penis after ejaculation. Do rubbing action so that the vulva with clitoris is stimulated.
4. Do pubococcygeous muscle exercise couple of times a day. To do this imagine you have a strong urge to defecate, but there is no toilet around. In such a situation person contracts anal sphincter. Contract and release repeatedly. Do this for about 2 minutes every day.
5. Correct relationship discord. Understanding, indifferent or empathetic partner is beneficial in treatment of Premature Ejaculation.
6. Do not feel defeated and crest fallen if you ejaculate quickly. It is not a crime. Ejaculation quickly means your sexual arousal is high. Nothing bad in having high libido.
7. Increase frequency of sexual intercourse. This helps stop premature ejaculation. On the contrary, if you do sex infrequently (‘infrequently’ is a single word, not two words- ‘in frequently’) desire mounts resulting in premature ejaculation.
8. Use different sexual position or change sexual position during intercourse. However, there is no scientific proof to substantiate this.
9. Use which ever food, time, place, technique that works for you. For you that is the method to stop Premature Ejaculation.
10. If premature ejaculation does not trouble either of you do not trouble the trouble, or the trouble will double and trouble others too.

[5.] GO TO SEX THERAPIST if Premature Ejaculation is a major problem in your life.

Image Courtesy
http://www.flickr.com/people/blue-moose/

ranks among the TOP 5 sex problems.
What is the normal time from insertion of penis in the vagina to ejaculation?
You think, “She is not satisfied.”, is it not?

You must also know
the SECRET or the keys to bring a woman to the height of sexual excitement.

CAUSE OF PE
Many sex problems arise due to misconceptions that result from lack of scientific, correct knowledge about sex. Consequently, in Premature Ejaculation (PE)the most common cause of suffering due to unrealistic expectations.

PE Problem
People seeking medical help for Premature Ejaculation PE invariably say that
the sexual intercourse must last long enough to satisfy the female partner. Hence, treatment necessarily consists of methods

A How to delay ejaculation?
B How to satisfy the female partner?
What is the normal time from insertion of penis in vagina to ejaculation [Medical Term]? IELT
Intra Vaginal Ejacualation Latency Time
What does medical science offer for delaying ejaculation?

TREATMENT OF PE

A
HOW CAN I DELAY THE DISCHARGE?
B
HOW TO SATISFY THE FEMALE PARTNER?
This is topic merits exclusive separate chapter.

These are the two aspects we have to consider.
A
[1] What is the usual time in normal healthy men from insertion of penis in vagina to discharge, also called as IELT?

TOP OF THIS POST
[2] What do the Sex Therapists World over say?
Most Sex Therapists shy away or avoid telling this normal time and the shroud of mystery and consequent misconception prevails. The Sex Therapists cannot specify the time in minutes or in the number of strokes because it varies. All men are not of the same height. Would your answer be right if you were to specify, “5 feet, 6 inches” that is 5 and 1/2 feet, is the normal height of healthy male adult. This is incorrect. A man of 4 feet 11 inches could be as capable and absolutely normal as any other man in all areas of human life.
You cannot say that a man of height 6 feet is abnormal. Hence, your definition becomes tricky.
Dr. Prakash Kothari roars
Dr. Prakash Kothari’s patent answer to the question is, “If you were to measure the temperature of all people sitting here, would their temperatures be exactly 37 degrees Celsius or 98.7 degrees Fahrenheit. Similarly we cannot specify a particular time as normal time. If you label it as premature ejaculation, what is mature ejaculation, is another favorite question that Prof. Prakash Kothari asks. Dr. Prakash Kothari is hell bent on changing the word premature ejaculation to Early Orgasmic Response for good reasons. Medical Science knows conditions in which ejaculation is absent but orgasm present.
Example: Retrograde ejaculation following Trans Urethral Resection (TUR) of Prostrate.

When most of the times ejaculation occurs after one or two strokes following insertion or even before insertion than the Sex Therapist considers that he has Premature Ejaculation (PE) and he qualifies for treatment.
A
[3] Treatment to delay ejaculation consist of
# non medicine methods and/or
# use of appropriate medicines.
You can also send your detailed query by
clicking here.
Note
Early Orgasmic Response is a term favored over the term Premature Ejaculation by my teacher and colleague Dr. Prakash Kothari [Premature Ejaculation]. Intra Vaginal Ejaculation Latency Time IELT is the medical term useful for scientific analysis and statistical studies.
TOP OF THIS POST
Medicines used for delaying ejaculation
&
[4] Comparison of Effect of Medicines
Name of Medicine — IELT fold-increase
Paroxetine — 8.8(5.9-13.2)
Clomipramine 4.6(3.0-7.4)
Sertraline — 4.1(2.6-7.0)
Fluoxetine — 3.9(3.0-5.4)
Placebo — 1.4(1.2-1.7)
Marcel D. Waldinger MD PhD
has reported the results of comparative study (PsychologyTimes.com)
Suggested Reading about PE

TOP OF THE POST
[5] New Medicine
Dapoxetine 30mg –0.92-2.78 min
Dapoxetine 60mg –0.91-3.32 min
Placebo –0.9 -1.75 min

Adverse Effects of Dapoxetine
Common Side Effects
Nausea (30mg = 8.7%)(60mg = 20.1%)
Headache(30mg = 5.9%)(60mg = 6.2%) resulting
Discontinuation of
Medicine 30mg = 4%) (60mg = 10%)

Giuliano F and team published the above study in Eur Urol Supp. 6(13):780-6, July 2007

All the above mentioned Medicines (except Placebo) belong to group called SSRI, , Selective Serotonin Reuptake Inhibitors. These medicines are used in the treatment of Major Clinical Depression, termed as Phoenix Disease by Dr. Ashok Koparday due to dramatic recovery of a person who is handicapped by Endogenous Depression when SSRI are given in adequate dose. SSRI correct the Serotonergic 5-hydroxytrymptamine (5-HT) neurotransmission in the brain.
A side effect of SSRI is to delay ejaculation.
This side effect is used as Therapy in people having Premature Ejaculation.

The benefit of the newer medicine Dapoxetine is that it has quick action unlike all other SSRI . Maximum Plasma Concentration is achieved in 1 hour. The Plasma Concentration of Dapoxetine 24 hours after taking the swallowing the medicine is less than 5% of the Maximum Plasma Concentration.

SUMMARY

1. Dapoxetine because of its rapid action has the advantage of ‘on demand’ medicine unlike the other medicines in this genre, namely,
2. Paroxetine
3. Clomipramine
4. Sertraline
5. Fluoxetine

TOP OF THIS POST
B
Secret keys of FEMALE SEXUAL SATISFACTION
Look forward for the elaborate details that are to come soon about the above topics