Question 1

What is premature ejaculation (PE)?

Dr. G.P. Yadav · Accepted Answer

Premature Ejaculation (PE) is when ejaculation occurs with minimal sexual stimulation, before the person wishes it, and is associated with distress or frustration. It is classified as lifelong (since first sexual experience) or acquired (starting later in life). It affects approximately 30-40% of men at some point.

Question 2

What causes premature ejaculation?

Dr. G.P. Yadav · Accepted Answer

PE can be caused by psychological factors (anxiety, stress, depression, early sexual experiences), biological factors (low serotonin levels, prostatitis, hyperthyroidism, hormone imbalances), or erectile dysfunction. Many men with ED develop PE as a secondary condition.

Question 3

How can I treat premature ejaculation naturally?

Dr. G.P. Yadav · Accepted Answer

Natural approaches include Kegel exercises (pelvic floor strengthening), the stop-start technique, the squeeze technique, regular exercise, stress reduction, and addressing relationship issues. These behavioral methods can be highly effective, especially when combined with professional guidance from a sexologist.

Question 4

What medications treat premature ejaculation?

Dr. G.P. Yadav · Accepted Answer

Dapoxetine (Priligy) is the only medication specifically approved for PE. SSRIs like Paroxetine, Sertraline, and Fluoxetine are used off-label. Topical anesthetics (Lidocaine/Prilocaine creams) reduce penile sensitivity. All medications should be prescribed by a doctor.

Question 5

Is Dapoxetine (Priligy) available in Nepal?

Dr. G.P. Yadav · Accepted Answer

Yes, Dapoxetine (brand name Priligy or generic versions) is available in Nepal with a prescription. A standard 30mg or 60mg tablet taken 1-3 hours before intercourse can significantly increase ejaculation control. Cost: approximately Rs. 300-800 per tablet.

Question 6

Can premature ejaculation be cured permanently?

Dr. G.P. Yadav · Accepted Answer

While PE may not have a permanent "cure" in all cases, it can be effectively managed long-term with the right combination of behavioral techniques, pelvic floor exercises, and on-demand medication. Most men achieve significant improvement with proper treatment.

Question 7

Does premature ejaculation affect fertility?

Dr. G.P. Yadav · Accepted Answer

PE does not directly affect fertility or sperm quality. However, if PE prevents successful vaginal ejaculation, it may indirectly affect conception. Treatments for PE can help improve fertility outcomes by enabling proper deposition of semen.

Question 8

What is the difference between lifelong and acquired PE?

Dr. G.P. Yadav · Accepted Answer

Lifelong PE is present from the first sexual experience and is likely related to biological factors like serotonin receptor sensitivity. Acquired PE develops after a period of normal ejaculation and is often linked to psychological issues, erectile dysfunction, or medical conditions like prostatitis.

Question 9

Can prostatitis cause premature ejaculation?

Dr. G.P. Yadav · Accepted Answer

Yes, chronic prostatitis is a common cause of acquired PE. Prostate inflammation can affect ejaculatory control. Treating the underlying prostatitis with appropriate antibiotics and anti-inflammatory medications often resolves the PE symptoms.

Question 10

How do I explain PE to my partner?

Dr. G.P. Yadav · Accepted Answer

Open communication is essential. Explain that PE is a medical condition, not a personal failure. Reassure your partner that effective treatments exist. Invite them to attend consultations with you. Our counselors can help facilitate these conversations.

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