What are the effective ways to manage premature ejaculation?

Question

Hello doctor,

I am a 33-year-old single male. I have been experiencing poor erections for the past two years and premature ejaculation since the beginning. I tried Sildenafil, which was effective, but it caused headaches and a feeling of heaviness in my head. I also noticed an increase in my blood pressure.

I have also tried herbal or Ayurvedic products, but after taking them, I experienced head heaviness and excessive gas. Additionally, I tried other supplements as prescribed by a doctor, but they did not work well, although they had no side effects.

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

Before I proceed, I would like to know the following important details: the dosage and duration of each medication you have tried to date, any medical conditions such as hypertension, diabetes, heart disease, asthma, or others. Do you experience early morning erections? If so, how frequent are they, and how intense?

Please answer so I can guide you better.

Answer 2

Hello,

Welcome back to icliniq.com.

Kindly send me the reports from your yearly check-up. If you have multiple reports, please attach the following: CBC (complete blood count), blood sugar, urea creatinine, LFT (liver function test), lipid profile, serum testosterone, serum prolactin, LH (luteinizing hormone), and FSH (follicle-stimulating hormone).

Answer 3

Hello,

Welcome back to icliniq.com.

We will make the final decision after reviewing the reports, but considering the situation, I believe an abdominal and pelvic ultrasound (USG) is also necessary. Please request the diagnostic center to perform a USG of the abdomen and pelvis.

Answer 4

Hello,

Welcome back to icliniq.com.

First of all, I would like to state that the problem is organic and requires treatment, not psychological. The causes of the problem are multiple, but possible factors include high cholesterol, high stress, low testosterone, and high oxidative stress, which may lead to endothelial dysfunction as evidenced by the penile Doppler study.

For management, I suggest the following:

Medication: Take one tablet of Coenzyme Q10 (100 mg) per day along with multivitamin supplements twice a day. Consider using a low dose of Tadalafil (2.5 mg per day) to address erectile issues. This is a prescription-only medication, so you will need to see a doctor for a prescription. Although Tadalafil may cause headaches, a 2.5 mg dose is unlikely to cause this side effect. I also recommend Paroxetine 12.5 mg at bedtime to manage premature ejaculation and depression. This medication also requires a prescription. Consult your specialist doctor, discuss with him or her, and take the medicines with take the medicines with their consent.
Diet and lifestyle: Avoid fatty foods to manage cholesterol levels. Although your cholesterol is high, dietary management can help normalize it. Engage in regular physical exercise and stay hydrated by drinking plenty of fluids. Incorporate citrus fruits into your diet.
Stress management: Use antioxidants or other suitable options to manage oxidative stress and improve vascular health. Stress management is crucial for overall well-being.

Please review these recommendations and consult with your healthcare provider for personalized advice.

Thanks and regards.

Answer 5

Hello,

Welcome back to icliniq.com.

Although it is not possible to predict complete recovery in such situations, most individuals require treatment for a minimum of three to twelve months. You should not continue the same treatment indefinitely; regular follow-ups every 15 to 30 days are advisable. Based on your response, the treatment course may be extended or shortened. As an alternative to citrus fruits, you can take vitamin C tablets.

Regarding a cure, it depends on the extent of the damage and the response to various medications in a timely manner. Since the problem is long-standing, the prognosis may be somewhat guarded, though not entirely unfavorable.

I hope this helps you.

Thank you.