Premature Ejaculation and Phimosis: Solutions for Young Men

Premature ejaculation and phimosis?

Hello doctor, I am currently 18 years old.
My penis measures 5 cm when flaccid and 12 cm when erect.
Is there still a chance or method to increase its size? When flaccid, I have a complete foreskin, and when erect, the glans is partially visible but not fully exposed.
When I pull back the foreskin to expose the glans before an erection, it feels very tight and painful when I do get an erection.
However, I have no issues urinating.
After getting an erection, I can pull the foreskin back a little to expose the tip, but I cannot fully retract it without discomfort.
Do I need a circumcision? Additionally, I have issues with premature ejaculation.
I had sexual experiences at 16 and now often experience premature ejaculation during masturbation, ejaculating within 2 minutes of stimulation.
During intercourse, I often feel tightness in my back and buttocks, and I ejaculate quickly.
What methods can the doctor recommend to improve this? Should I consider exercise, diet, or medication? If medication is suggested, are there any side effects?

Si Mi Da, 10~19 year old female. Ask Date: 2016/08/17

Dr. Sun Hongshun reply Urology

Hello, the size is within the normal range, but you have an issue with phimosis.
It is recommended that you visit a urology clinic to evaluate the possibility of circumcision.
As for premature ejaculation, it is advised that you exercise more and maintain a diet low in fats and sugars, and for now, you do not need to use medication.
If you still have questions, it is recommended to discuss them further with a urologist.

Reply Date: 2016/08/17

More Info

Premature ejaculation (PE) and phimosis are two conditions that can significantly affect the sexual health and overall well-being of young men. At 18 years old, experiencing these issues can be concerning, but it’s important to understand that they are not uncommon and can often be managed effectively.

Understanding Phimosis:
Phimosis is a condition where the foreskin cannot be easily retracted over the glans (the head of the penis). In your case, it seems that you are experiencing tightness in the foreskin, which can lead to discomfort during erections. While some degree of phimosis is common in younger males, especially before puberty, it can persist into adulthood. If you find that the tightness is causing pain or discomfort, particularly during erections, it may be worth consulting a urologist. They can assess the severity of your phimosis and discuss potential treatments, which may include:
1. Topical Steroid Creams: These can help soften the foreskin and make it easier to retract over time.

2. Stretching Exercises: Gentle manual stretching of the foreskin can sometimes alleviate the tightness.

3. Circumcision: In cases where phimosis is severe and other treatments have failed, circumcision may be recommended. This surgical procedure involves the removal of the foreskin and can provide a permanent solution.

Understanding Premature Ejaculation:
Premature ejaculation is characterized by ejaculation that occurs with minimal sexual stimulation, often before the individual wishes it to happen. This can lead to distress and affect sexual relationships. The fact that you have experienced this since a young age and during sexual experiences is not uncommon. There are several strategies you can consider to manage PE:
1. Behavioral Techniques: Techniques such as the "stop-start" method or the "squeeze" technique can help you gain better control over ejaculation. These methods involve pausing or applying pressure to the penis to delay ejaculation.

2. Pelvic Floor Exercises: Strengthening the pelvic floor muscles through Kegel exercises can improve control over ejaculation. These exercises involve repeatedly contracting and relaxing the muscles used to stop urination.

3. Desensitizing Products: Over-the-counter creams or sprays that contain numbing agents can help reduce sensitivity and prolong the time to ejaculation.

4. Therapy: Cognitive-behavioral therapy (CBT) or sex therapy can help address any psychological factors contributing to PE, such as anxiety or performance pressure.

5. Medications: There are prescription medications available that can help delay ejaculation. Selective serotonin reuptake inhibitors (SSRIs) are commonly used for this purpose. However, it’s essential to discuss potential side effects with your healthcare provider.

Lifestyle Modifications:
In addition to the above treatments, lifestyle changes can also play a role in improving sexual health. Regular exercise, a balanced diet, and avoiding excessive alcohol and recreational drugs can enhance overall physical and mental well-being, which may indirectly help with both phimosis and PE.

Conclusion:
It’s crucial to consult a healthcare professional, such as a urologist or a sexual health specialist, to discuss your symptoms in detail. They can provide a thorough evaluation and recommend a tailored treatment plan based on your specific needs. Remember, both phimosis and premature ejaculation are manageable conditions, and seeking help is a positive step towards improving your sexual health and confidence.

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