Dr. Ankush Jairath
Urology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have noticed changes in penis for the past six months as well as sexual function changes. To me the head of my penis seems bigger, swollen and now have noticeable bumps when erected. It was not like this before. I am also being treated for premature ejaculation with Sildenafil, however, I have noticed a very little difference in the ejaculation time. My doctor said to try an anti-depressant as a next step. Why should I try an anti-depressant for premature ejaculation? I also have an increased amount of pre-ejaculate fluid now, enough to soak through my underwear and pants. I also have fluid coming out after ejaculation for about 45 minutes or so after. None of these things happened to me before when I supposibly had a yeast infection. I am really starting to think it was something else at this point. The fact I have so much fluid before and after and cannot last in bed more than a minute now makes me think something is going on down there like inflammation or something. Why would fluid come out well after ejaculation all of a sudden and a increased amount of precum? Either that or fluid is still being made after ejaculation which would not make much sense I do not think.
I asked him if this could be like a hormone thing and he said not likely. I have tried everything other than whatever medicines they give for this, but my doctor told me that still he thinks it is a physiological thing. How can that be when I have all these physical changes? I used to last for like an hour in bed and now I cannot even last two minutes. I am really at a loss and have now excepted my sexual performance will never be the same. My doctor said the changes in fluid is probably because I am a healthy 24-year-old man with a sex drive but I was healthy with a sex drive before and this never happened. Would like to have a second opinion to make sure my penis looks almost swollen and like the glands are out way more than they used to be.
Hello,
Welcome to icliniq.com.
First, your pictures of the penile head are normal, nothing wrong with it (attachment removed to protect patient identity). Antidepressants group of drugs have some side effects, but side effects are used as a therapeutic effect in the premature ejaculation. So, the most common drug used is Dapoxetine 30 mg or 60 mg to be taken two hours before intercourse. They are most useful when the time taken after penetration into the vagina is less than 30 seconds. Next about precum, the increased volume can be there in urethritis, so for that, instead of cystoscopy, you can try a five day course of tablet Doxycycline 100 mg twice a day.
Patient's Query
Thank you doctor,
I am not sure how this happened. I went from lasting however long I wanted to last two minutes on a good day in the bed. It is extremely frustrating and depressing. My next question is, how long is this supposed to make you last in the bed? I do not like the idea of being on an antidepressant, but I would do anything to have this problem resolved.
Hello,
Welcome back to icliniq.com.
I am trying to say that the dose of antidepressant drugs at which therapeutic effects in premature ejaculation are seen has no impact on your mind/cognition. So you do not have to worry about that part. Secondly, it does not make you last hours as you might be doing before. But instead may increase the time by three to five minutes or so (different in different individuals). Alternate methods are, to use condoms, you can apply Xylocaine 2 % jelly locally on the penile head before intercourse. Both decrease the sensation and thus increases the threshold at which ejaculation occurs. Start-Stop method is the best natural method. This method involves stimulating the penis until just before orgasm and then stopping until the urge to ejaculate goes away. This is repeated several times so the man can learn to recognize the phase of sexual arousal that occurs before orgasm. During that phase, the level of arousal can still be controlled, and ejaculation can still be delayed for a certain time.
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Urology
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