Thanks for using DoctorSpring.com for posting your query.
I have gone through your question in detail and I can understand what you are going through.
The condition that you are suffering is called premature ejaculation. Now its a type of anxiety disorder and the person normally suffers from performance anxiety where in he is anxious if he can perform or not.
First you can try the start stop technique. Your partner is supposed to start stimulating you and the moment you are about to ejaculated she is supposed to stop all the stimulaton and and hold your penis head hard. Now this should be repeated.
Perineal exercises also help. These are the muscle exercises that occur when you contract the perineal muscles like when you are trying to stop the urine or feces. You have to do this contrations repeatedly daily to tone up the perineal muscles.
One solution is medications. Some patients are not willing to wait for these acts to produce results and instead demand medicines. I prescribe them 12.5 mg paroxetine at night and they are doing good. Normally one should try until 25mg of Paroxetine. If paroxetine is not effective then Dapoxetine is an option. It has to be given 1 hour before having sex and will prolong the sexual interval.
Your loss of erection seems mostly due to the loss of confidence due to premature ejaculation. Ones the problem of premature ejaculation settles down, the problem of erectile dysfunction may also settle down.
Still you may get the serum testosterone levels checked. Occasionally deficiency of the same may also cause faulty erection.
Hope this helps,
In case if you have any further query, do let me know.
Dr. Srikanth Reddy
Patient replied :
Yes I think it could be a anxiety disorder. I am calm and can chat to the person with ease but do feel a nerves sensation at the same time and on a rare occasion start feeling very hot. Would paroxetine effect me while i'm working at my job? I work in Contruction.
When in 2012 I decided to have no sexual contact, masterbation included ( 1 year without) and cycled (raced) mountainous terrain trails every day. When I meet a woman and got a full erection but the second I did my penis started pumping and I ejaculated. (first time I ever prematurelly ejaculated) Was that to do with my testosterone level? I'v stopped mountain biking but I have had the problem ever since.
I had a masterbation problem but stopped in mid 2011 for over 2 years. That didn't fix the problem.
Due to excessive masterbation problems since my teenage years old patientI believe this was the cause of my erectile dysfunction and due to not getting it sorted it evolved into premature ejaculation aswell. Is this the cause of it?
The Amitamin M Forte I am taking since July 8th is for men with vasular erectile dysfunction. Do you think this is the right medication for me and is there something in it that I should not be taken or is it all okay?. I ask because I did suffer from premature ejaculation before taking it but now since taking it my penis only needs to be touched for it to ejaculate. Was it just on a downward spiral anyway and had nothing to do with the medication or do you think it did?
I'm going to show you what amitamin M Forte website says it is given me to help you with your answer.
3.000 mg L-Arginine
amitamin® M forte’s central ingredient is 3,000mg pharmaceutical grade L-arginine. The natural amino acid L-arginine is the the only precursor for the synthesis of Nitric Oxide (NO) in the human body. NO is a critical neurotransmitter in the regulation of arterial diameter and therefore rate of blood flow.
Zinc is one of the most important trace elements in the human body. Amongst many other things it is a critical ingredient in the production of healthy sperm and maintenance of the male sex hormone testosterone, which body produces from zinc and amino acids. Healthy testosterone levels are important for male libido, fertility as well as general drive and motivation.
Pine Bark Extract 80mg
Bark extracts have been used for medicinal purposes for thousands of years. Pine Bark Extract is especially effective and has been extensively researched and applied in modern nutritional techniques. The extract of the French maritime pine contains many polyphenols, which have vascular protective properties. We use only high-grade extract of the French maritime pine (Pinus pinaster).
Betaine 500mg, folic acid 300pg, vitamin B6 4.2mg and vitamin B12 7.5pg
Homocysteine ??is a harmful by-product of regular human metabolism. There are many causes of elevated homocysteine ??levels. An increased homocysteine ??level is responsible for damaging arteries and vessels in particular. The fine vessels of the male penis are particularly susceptible to vascular damage.
Homocysteine ??therefore is a cell poison and must be permanently degraded in the body to be rendered harmless. It can only be metabolised if enough folic acid, vitamin B6 and vitamin B12 are present in the system. Furthermore, Betaine is centrally involved in the degradation of harmful homocysteine??. The combination of these nutrients is therefore very important for healthy homocysteine ??levels and healthy blood vessels - and good erectile function.
Vitamin D 10pg
Vitamin D contributes to the maintenance of normal muscle function and plays an important role in cell division - not only in the blood vessels. Vitamin D can be formed only in strong sunlight and the associated UV radiation on the skin. Food generally contains very low levels of vitamin D.
Vitamin E 36mg
Vitamin E and zinc help protect cells against the destructive oxidative stress caused by free radicals.
Paroxetine is safe even if you are working in a construction business.
Masturbation is a safe way of expressing ones own sexual desires. It leads to no physical or mental problems. The sperms and semen which are formed in the body are meant to come out of the body. They cannot be accumulated in the body and like urine they are formed in the body and are thrown out. They may come out on having sex or during masturbation. If you are indulging in none of these then the sperms and semen will come out at night by self (night fall) or routinely during any sexual stimulation. This is a normal phenomenon and will not cause any harm to you. Masturbation is safe and will cause no harm. It is harmful only when indulged in excessively leading to avoidance of normal work and schedule. Masturbation cannot lead to erectile dysfunction/premature ejaculation. It is also not related to testosterone as well.
The suppliment that you are taking is good for erectile dysfunction but not very effective for premature ejaculation. You may continue to take it.
Patient replied :
Is it okay to take paroxetine and the medication I am taking at the moment for erectile dysfunction (Amitamin M Forte) at the same time? Amitamin M Forte is for treating Vascular problems.
Yes, it can be taken together safely.