If a person is experiencing PE, they should visit a physician as soon as possible for diagnosis and reassurance. A good doctor will also help identify possible reasons behind why it may be happening.
Urologists can recommend various treatment options to address the problem, such as anesthetic creams and sprays to delay ejaculation and psychological therapy or sexual therapy, among others.
Behavioral Therapy:
Behavioral therapy is often an effective form of premature ejaculation treatment when combined with medication, especially when combined with other therapies such as cognitive behavioral therapy or yoga. It can help alleviate anxiety and stress while improving sexual satisfaction; behavioral therapy may also teach techniques to delay or prevent ejaculation altogether, such as the "stop-start" technique (i.e. stopping just short of ejaculation before continuing) which could prevent it altogether.
An initial step for any doctor when diagnosing penis issues should be taking a comprehensive medical history to identify any underlying conditions that could be contributing. For example, some medications may cause loss of sensation in the penis. If this is indeed the case, your physician will likely suggest either switching up medications or altering dosage levels accordingly.
Some SSRI medications such as clomipramine, fluoxetine and sertraline can be effective treatments for premature ejaculation, working by increasing serotonin production in the brain. Numbing cream like lidocaine (EMLA cream) may also help lessen feelings associated with ejaculating. Phosphodiesterase-5 inhibitors used to treat erectile dysfunction also prove useful and can be prescribed off-label for this condition - these include sildenafil (Viagra), Tadalafil (Cialis) and Avanafil (Stendra).
Men with PE often suffer from severe sexual dissatisfaction due to its rapid and frequent ejaculation, leading them to seek therapy with medications, delay techniques and local desensitization methods, as well as counseling and sex therapy in combination. Such approaches can often prove successful.
Medications:
Medications can be an invaluable aid to behavioral therapy for delaying ejaculation. Over-the-counter or prescription anesthetic creams/sprays (like lidocaine/prilocaine) can temporarily numb the head of the penis to decrease sensitivity temporarily and may help delay orgasm; while selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine and paroxetine can alter serotonin levels to decrease orgasm; doctors have discovered that PDE5Is such as sildenafil, tadalafil, and Vardenafil can increase time to orgasm for best sex medicine in pakistan.
Psychological treatment, such as sex therapy, may help decrease anxiety and improve sexual performance while also addressing relationship and emotional issues that contribute to sexual disorder.
Men who do not respond to traditional SSRI therapy or numbing medications may benefit from short-acting selective serotonin reuptake inhibitor dapoxetine hydrochloride for use as needed 1-2 hours prior to sexual activity.
Additional options to treat orgasm include tramadol, topical creams and sprays to numb the area around orgasming, prilocaine/lidocaine gel and Onabotulinumtoxin (Botox) to decrease muscle contractions that lead to orgasm. Some researchers have demonstrated their efficacy while many need to be taken daily for maximum impact.
Penile biothesiometry, nerve conduction studies, and somatosensory nerve latency testing may be employed as means of diagnosing PE but do not treat the disorder directly. Hormonal tests such as serum testosterone or prolactin evaluations may be performed if there is evidence of low libido or hypogonadism in an individual's medical history.
Counseling:
Premature Ejaculation (PE) is one of the most prevalent male sexual disorders, having serious implications for quality of life, sexual function and psychosocial wellbeing. The disorder results in inability to postpone ejaculation following vaginal penetration: either permanently (lifelong PE), or for approximately one minute following penetration during sexual activity with partner and clinically significant reduction of latency time from desired point of climax (acquired PE).
Treatment typically begins with primary care clinicians then mental health professionals with expertise in treating male sexual disorders.
Counseling is an integral component of treating premature ejaculation. At each consultation appointment, your physician will ask several questions regarding frequency and duration. He or she may also inquire into any existing medical conditions, medications (including over-the-counter supplements and herbal remedies), alcohol consumption or drug abuse which might contribute to this problem.
Therapists provide their patients with a safe space where underlying psychological and relationship issues can be explored safely. Therapists will teach behavioral methods that can increase sexual tolerance and postpone man power medicine in pakistan, such as thought distraction (for instance thinking of names of players on your sports team). Therapists can also help a patient recognize and overcome distortions that contribute to PE such as catastrophizing or overgeneralization of events.
Sex Therapy:
Most individuals can manage PE through at-home treatments; however, seeing a physician for accurate diagnosis and treatment options may be necessary to find relief from it. Urologists can be especially useful in pinpointing potential medical causes for their condition.
Your doctor will also conduct a physical exam and collect more details regarding your history with PE. He or she may ask how frequently this occurs during intercourse or masturbation, as well as which sexual activities usually cause it.
A sex therapist can teach techniques that may delay or prevent PE, including "stop-start" techniques and the "squeezing the penis" method. You could also try topical anesthetic spray available without prescription from pharmacies to reduce sensation in the area surrounding the head of your penis. They could also advise using other distraction techniques during sexual stimulation, such as visualizing names of players from your favorite sports team as thought diversion strategies.
Psychiatric treatment, including sex therapy, may help ease performance anxiety and other emotional issues related to PE. Counseling sessions may teach healthy ways of managing stress and relationships. Patients may find that combining several online sex medicine- behavioral therapy combined with sex counseling as well as taking an antidepressant like Celexa (Celexa), Lexapro (Lexapro), Prozac (Prozac), Paroxetine (Paxil) or Sertraline (Zoloft) have all been successful at treating PE although this practice may violate FDA guidelines; other effective medications include Dapoxetine hydrochloride/tadalafil.