Patient's Query
Hello, Doctor,
I am a 57-year-old male. Two years ago, I underwent a frenuloplasty and partial circumcision. Before that, I would ejaculate within 10 minutes during sexual intercourse. However, nowadays, it takes me approximately 30 to 40 minutes to reach ejaculation, and I maintain a strong erection with a good interest in sex until that point. My sexual desire has increased tenfold, leading me to engage in sexual activity twice a day.
Additionally, when I am at home, I experience frequent erections, occurring roughly every 30 minutes, which prompts me to manually masturbate about 15 to 20 times. I typically stop after 10 minutes of masturbating, just as I begin to produce precum, but I refrain from ejaculating to prolong the enjoyment for the next session. My partner has no complaints and actually enjoys the extended duration of our sexual encounters, as she can climax 4 to 5 times during this time. Please tell me,
Could you please advise whether this situation is normal?
Are any investigations or treatments necessary to manage my heightened sexual urge?
Kindly help.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
What you are describing is not considered normal sexual physiology, especially at the age of 57 years of age. Normal vaginal intercourse duration is usually 2 to 3 minutes, and in some men it may extend to 5–10 minutes; beyond this, it is termed delayed ejaculation. Similarly, while sexual frequency varies, two to three times per week is common, and even in very high-libido phases, it rarely exceeds a few times per day.
Masturbating 15–20 times a day, even if ejaculation is avoided, indicates excessive sexual drive and compulsive sexual behavior, which can affect
Physical energy.
Mental focus.
Social life.
Work productivity.
Long-term sexual satisfaction.
Initially, prolonged sex may seem enjoyable for both partners, but over time it often leads to fatigue, reduced pleasure, boredom, or relationship strain. Your surgery itself does not usually cause such a marked increase in sexual urge; therefore, this pattern warrants evaluation. I would advise assessment of hormonal levels (especially testosterone and thyroid profile), review of any medications or supplements, and evaluation for psychological or behavioral factors contributing to hypersexuality.
Treatment is available and focuses on regulating sexual urge, not suppressing healthy sexuality. Early evaluation will help you achieve a balanced, enjoyable, and sustainable sexual life rather than short-term excess.
I hope this information helps you.
Feel free to ask further queries.
Thank you.
Patient's Query
Hello, Doctor,
My last lab report of testosterone level 800 and Thyroid profile within normal limits, Rest everything normal except in lipid profile, HDL & triglycerides at borderline. I am not taking any supplements and am taking normal food. Also, I am not taking any medicines except Telsartan 20mg once a day for mild blood pressure. Most of my activities are quite normal except for a more sexual urge.
Only I marked before circumcision surgery, my glans was not fully bulging and was not coming out due to tight pressure by the foreskin, and at that time, ejaculation was within 5 to 7 minutes. But after circumcision, the glans is fully out and becomes bigger with full erection upon the slightest excitation. Kindly let me know if any treatment is available to limit the urge?
Kindly help.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
What you had earlier appears to be partial phimosis, but that condition and the circumcision itself are not the cause of hypersexuality. Your hormone reports, including testosterone and thyroid, are within normal limits, and you are not taking any supplements or medicines that would explain this excessive sexual urge. When investigations are normal, and the sexual drive is disproportionately high, the most likely contributing factor is a stress- or anxiety-related behavioral pattern, sometimes leading to compulsive sexual behavior.
In such situations, addressing the psychological component is important, and consulting a psychologist for counseling can help regulate sexual thoughts and urges effectively. If you are looking for a temporary medical option to reduce excessive sexual drive and help you regain control, you may use the tablet Clomipramine (an antidepressant) 10 mg once at night for 30 days, after which reassessment can be done. The goal of treatment is not to suppress healthy sexuality, but to restore balance and prevent long-term physical and mental exhaustion.
I hope this information helps you.
Feel free to ask further queries.
Thank you.
Patient's Query
Hello, Doctor,
Thank you very much, sir, for your detailed answer, which I appreciate a lot. At the same time, as per my personal evaluation, I could analyze that I am physically, mentally, and emotionally quite normal, and this excess sexual urge may be due to a lack of timely ejaculation.
When I have sex with my partner, even after enjoying sex for 30 minutes with a strong erection, I am sometimes unable to ejaculate, or by that time, I get too tired to continue making efforts to ejaculate. Sometimes, I cannot ejaculate at all even after such prolonged intercourse.
This may be tempting me toward self-masturbation, and even after masturbating for 10 minutes with a strong erection, my hand gets tired, and I still cannot ejaculate. Perhaps this is what tempts me to masturbate repeatedly.
So, I think my main problem is very delayed ejaculation. I get tired before reaching climax and cannot achieve that feeling of release and satisfaction. I hope, sir, you can now understand the reality of my situation and advise me on how to take care of it, especially regarding how to reduce ejaculation time and achieve proper sexual satisfaction.
Kindly help.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
I can understand your concern clearly. Based on what you have described, this appears to be delayed ejaculation, where erection and sexual desire are good, but reaching climax takes an unusually long time or does not happen, leading to physical fatigue and lack of satisfaction.
This can commonly be related to issues like,
Psychological stress.
Performance anxiety.
Excessive focus on ejaculation.
Obesity.
Sedentary lifestyle.
Medical causes also need to be ruled out, including
Prostate-related issues.
Hormonal imbalance.
High blood sugar.
Early nerve involvement.
Any past pelvic surgery, long-term medications, or substance use should also be reviewed.
From a management perspective, try to reduce performance pressure and avoid repeatedly pushing yourself to ejaculate, as this often worsens the delay. Focus on relaxation, intimacy, and overall sexual satisfaction rather than duration alone. Regular exercise, yoga, meditation, and adequate sleep are strongly advised.
If the evaluation suggests a stress-induced cause, a short trial of Bupropion 150 mg once daily (morning, after food) for 2 weeks may help. Reassuringly, your strong erections and sexual desire indicate that the sexual system is fundamentally healthy, and with proper evaluation and stress control, ejaculation timing and satisfaction can improve.
I hope this information helps you.
Feel free to ask further queries.
Thank you.
Patient's Query
Hello, Doctor,
Thank you very much, sir, for understanding my real problem. Apart from this, I do not take any medicines except Telsartan 20 mg for mild blood pressure.
My reports are as follows:
Fasting blood sugar (FBS): 83.
Testosterone: 995.
HbA1c: 5.2.
Because of some acid reflux, I also underwent an ultrasound of the whole abdomen, which I have attached for reference.
As such, I do not have any anxiety or depression, and my health is slim without obesity. My height is 5 feet 11 inches, and my weight is 67 kilograms. I have a good interest in sex, and my partner is very satisfied. My penis is also straight, and the size is good upon erection. I get erections with simple foreplay, and the erection remains strong and lasts long with proper hardness. The only key issue is delayed ejaculation.
Even when trying to ejaculate manually with oil massage, it takes a very long time, and my hand gets tired, although the erection continues and seems to require more stimulation. At that time, I feel as if ejaculation is about to happen, but I cannot continue putting in more effort.
If ejaculation could occur within 10 to 15 minutes, it could solve everything. Please review the reports and suggest, sir. I have uploaded all the reports.
Kindly help.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
Your blood sugar, HbA1c (glycosylated haemoglobin), and testosterone levels are excellent, and your erections, libido, penile structure, and partner satisfaction clearly indicate that your sexual function is fundamentally normal.
The ultrasound shows mild fatty liver and mild prostate-related changes, which by themselves are not serious but can sometimes be associated with delayed ejaculation. If you are taking any medication for prostate symptoms (even herbal or over-the-counter), that itself can contribute to a delay in ejaculation, so that needs to be clarified and avoided for now.
Given your lean body, good erections, and no metabolic or hormonal issues, this appears to be functional delayed ejaculation, where the ejaculatory reflex is intact but needs excessive stimulation and effort.
For now, continue with the medication I have already shared and give it adequate time to act. Do not force ejaculation or repeatedly over-stimulate, as that worsens fatigue and delay. Focus on relaxed, pleasure-oriented intimacy rather than trying to finish.
With mild prostate correction, lifestyle balance, and proper medical support, achieving ejaculation within 10–15 minutes is a realistic and achievable goal. We will reassess after the trial period and fine-tune further if needed.
I hope this information helps you.
Feel free to ask further queries.
Thank you.
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Answered byDr. Raveendran S R
Medically reviewed byiCliniq medical review team
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