Premature Ejaculation: Concerns and Treatment Options - Urology

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Premature ejaculation (PE) is a common sexual dysfunction that affects many men, characterized by ejaculation that occurs with minimal sexual stimulation, often within one minute of penetration. The condition can lead to significant distress, anxiety, and relationship issues. Understanding the concerns surrounding PE and exploring treatment options is essential for effective management.

Your current treatment with the medication "Dapoxetine" (often referred to as Priligy) is a selective serotonin reuptake inhibitor (SSRI) specifically designed for the treatment of PE. It works by increasing serotonin levels in the brain, which can help delay ejaculation. This medication is typically taken one to three hours before sexual activity and is not intended for daily use. It’s important to follow your physician's instructions regarding dosage and frequency.

Regarding your self-training method of masturbation, where you stop stimulation before ejaculation and then resume, this technique is often referred to as the "stop-start" method. It is a behavioral technique that can help some men gain better control over their ejaculation. However, it is crucial to approach this method with caution. Engaging in prolonged periods of arousal without ejaculation may lead to discomfort or other issues, but it is unlikely to directly cause prostate enlargement (benign prostatic hyperplasia, BPH). BPH is typically associated with aging and hormonal changes rather than sexual practices.

That said, frequent and prolonged sexual arousal without ejaculation can lead to a condition known as "blue balls" or epididymal hypertension, which can cause discomfort but is not harmful. If you experience significant discomfort or pain, it would be advisable to ejaculate to relieve the pressure.

In addition to pharmacological treatments and behavioral techniques, other options for managing PE include:
1. Topical Anesthetics: Creams or sprays containing numbing agents can be applied to the penis to reduce sensitivity and delay ejaculation.

2. Counseling or Therapy: Psychological factors can contribute to PE. Speaking with a therapist or counselor can help address anxiety, stress, or relationship issues that may be impacting sexual performance.

3. Pelvic Floor Exercises: Strengthening the pelvic floor muscles through exercises (often referred to as Kegel exercises) can improve control over ejaculation.

4. Alternative Medications: If Dapoxetine is not effective or causes side effects, other SSRIs or medications may be considered. Discuss these options with your healthcare provider.

5. Lifestyle Modifications: Reducing anxiety through relaxation techniques, regular exercise, and maintaining a healthy lifestyle can also help improve sexual function.

It is essential to have open communication with your healthcare provider about your concerns and treatment progress. If you feel that the current approach is not effective or if you experience any adverse effects, do not hesitate to reach out for further evaluation and adjustment of your treatment plan.

In conclusion, while your current self-training method is a valid approach, ensure that it does not lead to discomfort or distress. Regular follow-ups with your healthcare provider will help tailor the most effective treatment strategy for your specific situation. Remember, PE is a common issue, and with the right support and treatment, it can be effectively managed.