Struggling with Severe Premature Ejaculation: Seeking Effective Solutions - Urology

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Premature ejaculation (PE) is a common sexual dysfunction that can significantly impact a man's quality of life and intimate relationships. It is characterized by ejaculation that occurs with minimal sexual stimulation, often before or shortly after penetration, and can lead to feelings of frustration and inadequacy. You mentioned that you were prescribed "Dapoxetine" (commonly known as Priligy) for your condition, which is indeed one of the newer medications specifically approved for the treatment of PE.
Dapoxetine is a selective serotonin reuptake inhibitor (SSRI) that is designed to be taken on-demand, approximately 1-3 hours before sexual activity. It works by increasing serotonin levels in the brain, which can help delay ejaculation. While many men report positive results, it is important to note that individual responses can vary significantly. Some may experience improvements, while others may not see the desired effects, as you've experienced.

If Dapoxetine did not provide the results you were hoping for, there are several other options you might consider:
1. Behavioral Techniques: Techniques such as the "stop-start" method or the "squeeze" technique can be effective. The stop-start method involves pausing sexual stimulation before ejaculation to help build control. The squeeze technique involves squeezing the base of the penis to reduce the urge to ejaculate.

2. Topical Anesthetics: As your doctor suggested, using condoms that contain a local anesthetic (like benzocaine or lidocaine) can help reduce sensitivity and prolong the duration of intercourse. These products can be effective in delaying ejaculation.

3. Other Medications: If Dapoxetine is not effective, other medications may be considered. Some doctors may prescribe traditional SSRIs like fluoxetine or sertraline, which are not specifically approved for PE but have been shown to help delay ejaculation in some patients. Additionally, certain medications that affect neurotransmitters might be explored.

4. Counseling or Therapy: Sometimes, psychological factors such as anxiety, stress, or relationship issues can contribute to PE. Speaking with a therapist or counselor who specializes in sexual health can help address these underlying issues.

5. Lifestyle Changes: Regular exercise, a healthy diet, and stress management techniques can improve overall sexual health and may help with PE. Avoiding excessive alcohol and recreational drugs is also advisable, as they can affect sexual performance.

6. Consultation with a Specialist: If you continue to struggle with PE, consider seeking a referral to a urologist or a sexual health specialist. They can provide a more comprehensive evaluation and may offer additional treatment options tailored to your specific needs.

It’s understandable to feel frustrated when treatments don’t work as expected. Open communication with your partner about your experiences and feelings can also be beneficial, as it fosters understanding and support. Remember, you are not alone in this, and many men face similar challenges. Seeking help and exploring different options is a proactive step towards finding a solution that works for you.