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What are the causes and treatment for premature ejaculation?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I ejaculate prematurely and the volume is about 2.5 ml. Is this normal? What can I do to increase sperm volume?

Please suggest.

Hello,

Welcome to icliniq.com.

How long does it take for you to ejaculate? As for the volume, it is satisfactory.

Patient's Query

Hello doctor,

Thank you for the reply.

It lasts for about a minute. If I continue, I feel like I will ejaculate very quickly. Therefore, I have to stop after three to five strokes.

Hello,

Welcome back to icliniq.com.

It occurs due to excessive sensitivity and psychological issues, but there is nothing to worry about. There are various treatments available. Would you like to start with some medications now? The most effective medications need to be taken continuously, as they may take two to three weeks to take full effect. Alternatively, less effective medications can be used, which should be taken one or two hours before intercourse.

Thanks and regards.

Patient's Query

Hello doctor,

Thank you for the reply.

Tell me about the most effective medications.

Hello,

Welcome back to icliniq.com.

We usually prescribe Paroxetine 10 mg once daily in the morning, and increase the dose to 20 mg after one week, as it has strong evidence of efficacy. Consult your specialist doctor, discuss the treatment with them, and take the medication with their consent.

Thanks and regards.

Patient's Query

Hello doctor,

Thank you for the reply.

Does it have any side effects?

Hello,

Welcome back to icliniq.com.

Every medication has potential side effects. Common ones include drowsiness, gastrointestinal issues, constipation, and restlessness. Serious side effects are rare, especially given the minimal dose. Therefore, serious side effects are not expected. I assume you are not currently taking any other medications or have any other conditions.

Patient's Query

Hello doctor,

Thank you for the reply.

I read that antidepressant medications such as Paroxetine may increase the risk of suicidal thoughts and behaviors, particularly within the first few months of treatment or when the dose is adjusted. This risk is higher in children, teenagers, and young adults, so it is important to monitor any unusual changes in mood, behavior, thoughts, or feelings.

Hello,

Welcome back to icliniq.com.

Paroxetine and other medications like Sertraline, which are used for conditions such as premature ejaculation, also have broader applications, including for depression and obsessive-compulsive disorder (OCD). There is generally no issue with their use. The risk of suicidal tendencies is primarily associated with patients who have major depression or significant psychiatric disorders and who already have some baseline suicidal thoughts. In such cases, some medications may paradoxically increase the risk of suicidal thoughts. This should not be a concern for you.

Another option we suggest is using Lidocaine-Prilocaine spray or cream, applied to the penis five minutes before intercourse, which may also help.

Thanks and regards.

Medically reviewed byDr. K. Shobana

Published At March 12, 2018
Reviewed AtFebruary 6, 2026

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