How can delayed ejaculation during sex be managed?

Hi,

Welcome to icliniq.com.

I have gone through your query, I would like to know a few more details to answer your question better. How old are you presently? How long have you been on medication? Do you have a steady partner with whom you have this problem? Do you have any problems with arousal before or during sexual contact? Are you able to maintain the erection for the duration of the encounter? Based on your history, I feel that your problems are due to a combination of your vigorous masturbation style coupled with your anti-depressant medication which is known to cause delayed ejaculation. The amount of stimulation by vigorous masturbation cannot be provided by either oral or vaginal intercourse. In addition, it is also important to rule out if there are any reversible hormonal disorders that may cause this like hypothyroidism. Therapy for this will involve psychosexual therapy integrated with changes in your lifestyle, medication. Medications are under investigation but mostly are used off-label and are not approved for use in this condition as their effectiveness is limited. With combination therapy, there will be a definite improvement, but the magnitude will depend.

Hi,

Welcome back to icliniq.com.

If your arousal is adequate, it means that your sexual centers in the brain and your testosterone levels and sensitivity are fairly normal. I would certainly advise a period of abstinence, and also to avoid your practice of masturbation as they help get your sensitivity back to normal levels. You can visit your therapist who prescribed you Paxil (Paroxetine) and discuss with them to change to another group of medication that has lesser adverse effects on ejaculation. They will also be able to guide you on psychosexual therapy, if not your local urologist will be able to help you.