Hello,
Thanks for your query at DoctorSpring.com.
I have gone through both the mails that you have posted in detail and I can understand what you are going through.
You have two different problems, premature ejaculation (PE)and erectile dysfunction (ED). Both of them affect the penis but the cause for both of them is different.
Lets start with the erectile dysfunction. You have stated that there is reduced blood flow and probably that seems to be confirned by a doppler test. Now that's a significant reason for your erectile dysfunction. Both sildenafil and Megalis are temporary cosmetic solutions and the basic requirement is to increase the blood flow in your penis.
There are certain invasive radiology procedures but the success rate is very low and can be risky as well. So they are not routinely advised. There is no permanent cure for this. basically you should try quiting smoking as well as even tobacco causes erectile dysfunction and in my clinic i have seen patients improving just by quiting smoking/tobacco cehwing/"Kharra" use. You should go ahead with quiting it.
The vacurect that you were referring is a new product and it will help you in your condition. But then it is difficult to predict will it be a permanent cure or not.
Regarding the other aspect of premature ejaculation, it is not due to any bodily cause and the most common reason for this is anxiety. This can be controlled by sensate focus theraoy exercise and Cognitive behavioural therapy sessions. These are 20 min sessions which have to be taken weekly for 6-8 weeks and are very useful. A medication called paroxetine is also very useful for pemature ejaculation if given in the night time dose of 12.5 mg. May be you can try a consultation from a Psychiatrst who can start you with these therapies as well as give you a prescription of this drug.
Hope that helps
Regards
Dr. Srikanth Reddy
Neuropsychiatrist and Sexologist
Patient replied :
My PP is right now 157, smoking - 15-20 cigs daily, alchohol - once in a week, 2-3 pegs, minor operation earlier 3 times
Sir, Thanks for your advice. But you have mentioned theraoy exercise for solving premature ejaculation. You have also advised to use medicine paroxetine 12.5 mg. Can i use this one tablet daily at night before going to psychiatrst. Is it any problem to use this medicine from today? Please guide me.
Patient replied :
Hello,
Thanks for the follow-up query.
I am sorry for my typographical error at a crucial spot. What i suggested was "sensate focus therapy" and "cognitive behavioural therapy". Both these therapies are taken up by psychiatrists/psychologists who have training in sex therapies.
Secondly coming to the drugs, in my clinic I prescribe my patients Paroxetine CR 12.5mg once at night and they do quiet well with premature ejaculation. Some people experience problem with erection after taking the med and those people i stop using it. They are back to normal ones they are off medications and ED doesn't stay.
But this being a online forum, I wont be authorized to prescribe you medicines. moreover these are psychiatry medications and they mostly wont be available without a proper doctor medication. I apologize for the discomfort.
Regards
Dr. Srikanth Reddy
Psychiatrist and Sexologist