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Dr. Shyam Mithiya  - Sexologist, Mumbai

Dr. Shyam Mithiya

94 (710 ratings)
MD - Psychiatry, Diploma in Psychological Medicine, MBBS

Sexologist, Mumbai

11 Years Experience  ·  1200 - 2000 at clinic  ·  ₹500 online
Dr. Shyam Mithiya 94% (710 ratings) MD - Psychiatry, Diploma in Psychological Medicine, MBBS Sexologist, Mumbai
11 Years Experience  ·  1200 - 2000 at clinic  ·  ₹500 online
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Personal Statement

To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies....more
To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies.
More about Dr. Shyam Mithiya
Dr. Shyam Mithiya is a renowned Sexologist in Nulife Hospital, Mumbai. He has been a successful Sexologist for the last 10 years. He is a qualified MD - Psychiatry, Diploma in Psychological Medicine, MBBS. You can consult Dr. Shyam Mithiya at Dr.Shyam Mithiya's Psychiatry & Sex Clinic in Nulife Hospital, Mumbai. He has been reviewed by 13 patients. Book an appointment online with Dr. Shyam Mithiya and consult privately on Lybrate.com.

Lybrate.com has a nexus of the most experienced Sexologists in India. You will find Sexologists with more than 39 years of experience on Lybrate.com. Find the best Sexologists online in Mumbai. View the profile of medical specialists and their reviews from other patients to make an informed decision.

Info

Education
MD - Psychiatry - Nair Hospital - 2012
Diploma in Psychological Medicine - Nair Hospital - 2011
MBBS - Terna Medical College - 2007
Past Experience
Consultant at Seven Hills Hospital
Languages spoken
English
Hindi
Professional Memberships
Indian Psychiatric Society
Bombay Psychiatric Society

Location

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Dr.Shyam Mithiya's Psychiatry & Sex Clinic

A / 308, 3rd Floor, Harekrishna Building, Near Telephone Exchange, IBS Road, Ghatkoar West. ( Above Nulife Hospital )Mumbai Get Directions
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Cozy Clinic

Ground Floor, Sea Shell, Seven Bunglow Road, Opp Nana Nani Park, Seven Bungalows, Andheri WestMumbai Get Directions
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Aasharya Development Aid Center

Water Field Road, Opposite A Kreation Salon, Diagonally Opposite Caravan Sarai, Bandra WestMumbai Get Directions
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"Well-reasoned" 5 reviews "Very helpful" 25 reviews "knowledgeable" 16 reviews "Professional" 3 reviews "Caring" 3 reviews "Prompt" 1 review "Inspiring" 1 review "Sensible" 1 review "Practical" 2 reviews "Helped me impr..." 3 reviews "Thorough" 2 reviews "Saved my life" 2 reviews

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7 Problems That Can Make Sex Painful for Men

MD - Psychiatry, Diploma in Psychological Medicine, MBBS
Sexologist, Mumbai
7 Problems That Can Make Sex Painful for Men

Sex is meant to be a pleasurable activity, but sometimes it can be painful for the man involved. Pain can be a symptom of a number of health conditions like an illness or infection or a physical or psychological problem.

Some of these conditions are:

  • Peyronie's Disease: This is commonly known as erectile dysfunction and is characterized by the inability to achieve and maintain an erection. It can be a genetic problem or triggered by a traumatic accident. This makes the scar tissue in the penis bend thus making any sort of sexual activity painful and difficult.
  • Prostatitis: This condition is characterized by the inflammation of the prostate gland. This causes pain, swelling and painful ejaculation. Prostatitis can affect men at any age and can also contribute towards erectile dysfunction and a lowered libido.
  • Urinary Tract Infections: Urinary tract infections affect both men and women. When it comes to men, it can cause pain during ejaculation and a burning sensation while urinating. It can also make the penis emit a foul smell. A yeast infection can also lead to an itching or burning sensation around the tip of the penis.
  • Dermatitis: The skin around the penis is thinner than skin in other parts of the body. Sometimes, the skin in a man's genital area can be allergic to soaps, creams, fragrances etc. This can trigger inflammation and itchiness making sex uncomfortable. Such allergies are noted more commonly in men who have been circumcised.
  • Herpes: Genital herpes can cause painful sores to erupt on the penis. This may be accompanied by an itching or tingling sensation. Herpes is also a sexually communicable disease and sex should be abstained from if you suffer from herpes.
  • Psoriasis: Genital psoriasis can make the skin on the penis and scrotum dry and scaly. This can affect men of all ages. With friction, these scales can fall off leaving raw skin that is prone to bleeding. While non scaly plaque is more common in uncircumcised men, circumcised men are prone to scaly plaque. This condition can also be very itchy.
  • Phimosis or Paraphimosis: Phimosis is a congenital condition where the foreskin of the penis is too tight to completely retract over the head of the penis. Paraphimosis is a condition where the foreskin cannot be pulled over the head as it is stuck behind it. In both cases, it can make having an erection very painful and can make intercourse uncomfortable.

So, it is always recommended to consult a sexologist regarding any of the condition of pain and uneasiness in sex before it gets worse as penis is a very delicate organ of a man. In case you have a concern or query you can always consult an expert & get answers to your questions!

6186 people found this helpful

Things You Didn't Know About Birth Control Pills

MD - Psychiatry, Diploma in Psychological Medicine, MBBS
Sexologist, Mumbai
Things You Didn't Know About Birth Control Pills

The birth control pill is one of the best inventions in the medical field. At the same time, it has been misused and abused also. Whether it is to avoid pregnancy or to fight other hormonal issues like ovarian cysts or even severe acne, birth control pills are used extensively for purposes beyond what they were originally meant for. There are a lot of hidden facts about the oral contraceptive pills (OCP) or the birth control pills (BCP). Read on to know more!

  1. Plays with your mood: So, if you have experienced PMS, this is not new to you. Remember that chemically speaking, the BCP or OCP is just a dose of hormones. Therefore, it is very natural for a woman to have mood changes when taking the pills. You may experience anxiety and the irritability which sometimes can be hard to deal with.
  2. Affects sex life: It affects your sex life in multiple ways – reduces libido, shrinks the clitoris, and causes vaginal dryness due to the excessive hormones. All this, in effects, spells less sex, at least less enjoyable sex.
  3. Intestinal damage: The pill alters the normal bacteria present in the stomach. These bacteria are essential for the proper digestion and absorption of foods including vitamin B12, B6, B2, and C. Minerals like selenium, zinc, magnesium are also not properly absorbed. Therefore, the woman taking these over a long term can have these nutritional deficiencies. They are also more prone to develop stomach infections.
  4. Increased blood pressure: The pill causes increased blood pressure by constriction of the blood vessels. This in turn can lead to various other conditions like migraines, visual disturbances, increased risk of stroke, etc. Studies have suggested that the risk of BP increase is higher when the woman is also a smoker.
  5. Cancer connection: The OCP when regularly used can also cause cancer of the lungs, liver, ovaries, uterus, and endometrium. The estrogen level is constantly on the higher side, which in some cases can lead to cervical cancer. A woman taking OCP for 5 years or more should get evaluated for cervical cancer regularly.
  6. Beneficial too: For women in their early 40s who are not yet into menopause, taking the BCP under supervision can help in controlling symptoms like hot flashes and irregular bleeding.
  7. Other medicines interactions: If you are taking other medications, then talk to your doctor before popping that pill repeatedly. Antibiotics, antidepressants, and medical supplements should be discussed with your doctor before taking the pill.
5 people found this helpful

5 Reasons Sex Can Be Beneficial To Your Health!

MD - Psychiatry, Diploma in Psychological Medicine, MBBS
Sexologist, Mumbai
5 Reasons Sex Can Be Beneficial To Your Health!

It might be surprising for many to know that sex, along with pleasure, can offer several benefits as well. Sleeplessness, stress, weight gain, and heart problems are a few of the many conditions that find relief with regular sex.

Yes, making love can do wonders for your health, in various ways. Sex is a part of life that people usually relate to pleasure and intimacy, both physical and emotional. Here is an account of the health benefits sex can offer you-

1. Boosts the immune system
Studies have shown sex to be extremely effective in increasing the production of immunity-boosting IgA or antibody immunoglobulin A. Increased levels of IgA results in boosting the immunity power of the body as it makes the body stronger against infections and illnesses.

2. Improves the heart health
Regular sex can not only boost the health of your heart but can also prevent risks of heart attacks. In both men and women, engaging in sex can be a great form of cardiovascular exercise that can reduce the risks of hypertension, stroke, and heart-related diseases. Sex is considered to be an effective way of burning calories which is certainly beneficial to not only your heart but to your overall health.

3. Lowers blood pressure and manages stress
From lowering the blood pressure to relieving one from stress and anxiety, sex can be healthy in various different ways. Sex is responsible for increasing certain hormone levels in the body, such as endorphin which helps in creating a good mood and relieving stress. Even when under stress, sex has a significant role to play in preventing the blood pressure from rising up.

4. Ensure better sleep
Sound sleep leads to sound health. And various studies have shown that once orgasm is achieved, certain hormones are released that can make one feel relaxed and sleepy. Therefore, having a satisfying session of sex can help you achieve uninterrupted sleep. And when the sleep you have is an undisturbed and profound one, waking up next will naturally be a refreshing experience with energetic feelings.

5. Improves bladder control
In women, regular sex helps in strengthening the pelvic floor. And a strong pelvic floor is necessary for reducing the risks of incontinence, contractions, etc. So, in a way, sex helps in improving women's control over the bladder. Plus, a strong pelvic floor can also be beneficial in reducing the chance of vaginal prolapse and making the penetration less painful during sex.

In case you experience any sexual issues that prevent you from enjoying the experience with your partner, it is advised to opt for immediate medical attention. Consult with a sexologist if need be, as sex is an integral part of not only the reproduction process but also the overall health.

6058 people found this helpful

Tips To Improve Your Sexual Health!

MD - Psychiatry, Diploma in Psychological Medicine, MBBS
Sexologist, Mumbai
Tips To Improve Your Sexual Health!

A good sex life is essential for overall emotional and physical well-being. No matter how big or small the problem is, there are various ways that a couple can improve their sex life. However, to be able to do that you must understand that the sexual well-being is extremely important for your mental, emotional and physical health. Maintaining a healthy lifestyle, proper diet and most importantly communicating with your partner can go a long way in helping you get through the tough times.

Read on to know some tips that can help bring back the lost spark and boost your sex life:

1. Talk to your partner
You may often find it difficult to discuss the sex-related problem with your partner. This could be due to various reasons such as a feeling of shame, hurt, guilt or resentment. Few things that can help have a frank conversation with your partner are: find a right time, do not criticize, be completely honest and confide in your partner.

Tip: It is important to understand that sexual performance does not equate with love. Having sexual difficulties does not mean that the love between the two of you is lost.

2. Strategize and focus on self-help
Dealing with a sexual problem is much easier now. There are various medications that can enhance the sexual experience. Taking help from professional sex therapists can also be an excellent way to deal with major sexual difficulties. Making changes in your style in bed can also spice up your sex life, here are few things that can help: Getting ready for the act, maintaining physical affection, engaging in foreplay, taking control during the sexual act and trying different positions.

Tip: Experimenting with sex toys or engaging in roleplay can add spice to your sex life and help get rid of sexual problems.

3. Maintaining a good health
Sexual well-being is directly connected with your overall health. Therefore, maintain a healthy lifestyle and keeping good health can do wonders for your sex life. Taking care of few factors such as: eating right, exercising, managing your weight, quitting smoking and drinking can definitely improve sexual health.

Tip: Seeking help can be a great option when above-mentioned tips don’t work. Proper counselling can help in identifying the problem and finding a solution for the same.

4. Reduce stress
Stress can be one of the major causes of many health issues, one of them being the loss of libido. Excessive stress can also increase blood pressure. Both stress and blood pressure can damage sexual health and performance. Exercise can go a long way in reducing stress, thus improving sexual health. Stress can result in irritation, mood swings and engaging in habits like alcohol consumption and smoking which can hamper sexual performance.

Tip: Meditation and yoga are known to reduce stress levels. Practicing them on a regular basis can help you stay calm and enhance sexual performance.

In case you have a concern or query you can always consult an expert & get answers to your questions!

5557 people found this helpful

Facts You Must Know About Post Coital Tristesse

MD - Psychiatry, Diploma in Psychological Medicine, MBBS
Sexologist, Mumbai
Facts You Must Know About Post Coital Tristesse

The coitus was great, but after everything is over, why do you feel so sad and depressed? If you feel like fleeing or if you need some reassuring physical contact after intercourse, you might be suffering from a psychological condition called 'post-coital tristesse' (PTC)

What does it mean?
Post-coital is a Latin phrase while tristesse is a French word which literally translates to “sadness”. If you suffer from PCT, you might experience intense feelings of uneasiness, anxiety or sorrow immediately after coitus, or even two hours later.

Why does it happen?

  1. There are specific hormonal changes during sex and immediately after it. Two main hormones involved are ‘dopamine’ and ‘prolactin’. Dopamine is a neuro-hormone that precedes the release of adrenaline and is linked with feelings of pleasure and sexual arousal; while prolactin is the hormone responsible for producing milk in women (men secrete it as well). Dopamine is released in copious amounts during sex, so to counter this, prolactin is released. Prolactin drastically reduces dopamine levels, and this can make you sad.
  2. The other cause is psychological. Under the influence of dopamine, you might end up saying things you regret later. This too can result in sadness and depression.

Is it different for men and women?
Yes, men and women handle PCT very differently. Men feel like leaving so that they feel less sad. On the other hand, some men choose to stay, which only worsens their condition. It makes them associate sex with melancholic feelings. Women, on the other hand, crave for reassurance and physical touch from their partners. Nice words or cuddling can ease their discomfort. Suffering from this might result in disaster for them. When the man flees and the woman needs reassurance, it will lead to negative feelings about sex and development of resentment for each other.

Can abstinence and avoidance help?
Abstinence can help if you do not have an active sex life. Time away from sex can actually help you understand your problems better. However, abstinence can trigger depression, low self-esteem and extreme emotions of loneliness.

Are there any other solutions?
Communication and therapy are traditionally the best treatments for PCT. Talking to a therapist, alone or together with your partner, can help you with a solution.

In case you have a concern or query you can always consult an expert & get answers to your questions!

5429 people found this helpful

Having too much sex - Can it make you gain or lose weight?

MD - Psychiatry, Diploma in Psychological Medicine, MBBS
Sexologist, Mumbai
Having too much sex - Can it make you gain or lose weight?

Can sex really lead to weight gain or loss? Well, there are a lot of differences of opinion about the impact of sex on a body. However, there are many researches that suggest that having too much sex leads to weight gain among women. On the other hand, there are also views, which say that sex helps to burn calories. So let us discuss the two aspects separately.

Sex and Weight Gain
There are reports where women say they gain weight on their hips and breasts after making love. The reason behind this weight gain can be the hormone “prolactin”. It stimulates fatherly love and milk production. The level of hormone in the blood levels increases especially when orgasm is reached after sex.

However, it is a common belief that people after marriage often tend to gain weight. Not only women, but men also gain a lot of weight after their marriage. But scientists believe it has nothing to do with sex as there are no physiological reasons to establish that.

After marriage, people get a sense of security and they start living happily with their life partners. This reason is considered to be more predominant behind weight gain in people.

Researches show that when compared to people in relationships, single people eat less. After getting married, couples have meals together and calorie intake goes high naturally. Researchers also say that a happy and secure relationship can actually increase the appetite. Nonetheless, men and women may not be aware that they are eating more than usual because of their happy relationship.


Hence, to make sure you are not putting on excess weight after marriage, keep your diet in check. A healthy diet and a little bit of regular exercise go a long way in helping you remain in good shape.

Sex and Weight Loss
The fact is you actually burn some calories after you exhaust yourself in bed. Figures suggest that on an average, 100 calories get burned in 30 minutes of passionate sex. So the more active you are in bed, the more you lose weight.

According to another study, the amount of stress on the heart of young married men during sex is tantamount to walking up to two flights of stairs. During sex, the heart rate goes as high as 130, which is considered similar to moderate physical activity.

Sex also does curb your fat and carbohydrate cravings because of cortisol, the high-anxiety hormone that can be kept in check by having regular sex.

So for that slimmer midsection, stay active in bed. In case you have a concern or query you can always consult an expert & get answers to your questions!

 

3 people found this helpful

5 Easy and Effective Tips To Spice Up Your Sex Life!

MD - Psychiatry, Diploma in Psychological Medicine, MBBS
Sexologist, Mumbai
5 Easy and Effective Tips To Spice Up Your Sex Life!

Sex is enjoyable is the common norm. However, of late, if the sex episodes are not offering you the excitement it ought to give you, it is time you work on spicing up your sex life. Irrespective of the kind of person you are who seeks romantic or passionate or a thrilling lovemaking experience with your partner, it is never too late to make your otherwise boring sex life an interesting one.

Here are the five super-easy and effective tips that can help you boost your sex life and make your intimate moments unforgettable.

1. Take care of your health
Staying healthy is crucial to ensure an interesting sex life. When you suffer from medical conditions, your health problems may end up having a serious impact on your sex life. By taking good care of your health, you get a step closer to a healthy and interesting sex life.

2. Try different new positions
Trying new positions can be a fun way of spicing up your sex life. However, while experimenting with new positions, take care not to indulge in such positions in which you or your partner may end up being injured. With so many easy and satisfying sex positions being out there, finding a few safe ones for your sex life won’t be that difficult at all!

3. Lose the extra calories to stay in shape
Libido has a crucial role to play in making the entire lovemaking experience an exciting one. And the best way to boost your libido is by losing the extra calories and getting your body in shape through regular exercise. Whether it's yoga or any other strenuous physical activities, it will boost the flexibility of your body as well as the mood, which are essential for a spiced-up sex experience.

4. Make love at different timings
If, so far, your sex life is active during nights, try indulging in early morning sex. Spending intimate times with your loved one in the morning, right after waking up from sleep or in the evening when you get back home from work might make your sex life more thrilling.

5. Introduce something exciting and new
To prevent boredom from creeping in your sex life, you can try new exciting ideas, such as having a great talk or spending some fun time together before moving to having sex. Even trying exciting clothing ideas or having dirty little talks with your partner can also help in bringing back the lost charm of your sex life.

A loss of sexual intimacy eventually may lead to relationship issues. Sex is an important aspect of a relationship, and it is best not to ignore your sex life lacking excitement. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

5604 people found this helpful

How to Manage Premature Ejaculation with Non-Medical Methods?

MD - Psychiatry, Diploma in Psychological Medicine, MBBS
Sexologist, Mumbai
How to Manage Premature Ejaculation with Non-Medical Methods?

In my last article, I talked about statistics of premature ejaculation (P.E), its types, diagnosis and reasons.  Now I will discuss about the non-medical methods of managing / treating P.E. Due to PE both partners often end up experiencing highly unsatisfactory sex. In fact, it can increase anxiety, reduce self-confidence and escalate relationship issues. Remember, there is no magical drug or medicine which can solve your problem overnight especially if you have chronic PE.

So, before seeking any medical treatment for PE, it is appropriate to consider the varied options available for solving this issue. These include counselling with a sexual therapist, medical treatment including both modern & alternative medicine, and non-medical methods like exercises/techniques of controlling early ejaculation as discussed below:

  1. Counselling by an expert sexual therapist or sexologist: It is commonly understood that sex is in the mind. Mind controls your sexual behaviour.  However, repeated premature ejaculation episodes can lead to lot of stress and disappointment. Anxiety due to inability to satisfy your partner itself is a big issue and can lead to reoccurrence of PE. So, the stress /anxiety that is linked to your problem needs foremost attention. Many a times, if your family physician is not able to help you overcome the stress that you are facing with your problem of premature ejaculation, then you must seek advice from an expert. Reassurance, from a sexual therapist/counsellor, that PE is not a disease and can be easily treated is very soothing and relaxing for the men who are facing this problem. So, you may please share your detailed history and sexual habits with the expert that will help him to guide you well.
  2. Behavioural changes: Some basic behavioural changes may also help you to deal with the problem of early ejaculation.  For example, some men attempt to treat themselves for premature ejaculation by distracting themselves by thinking nonsexual thoughts (such as naming cricket players and records!) to avoid getting excited too fast and reaching climax too soon while making love to their partners. This helps them to focus their attention away from the sexual stimulation. Another technique suggested to men is that they should relieve themselves of the sexual tension by ejaculating with self-masturbation 1-2 hours before attempting sexual intercourse with their partner. Condom decreases sensation.  So, using condoms is also useful in preventing ejaculation for some time. For some, “women-on-top” position also helps in delaying orgasm in men.
  3. Exercises & techniques: There are several Exercise and techniques that one can try sitting in his home.  Let’s have a look at some of them.
    • The "stop and start" method: In this technique, the person sexually stimulates himself till the point he feels like he is about to reach orgasm. Then he needs to stop the stimulation for about 20-30 seconds and then start the stimulation again, repeating this pattern until the man finally wants to ejaculate. This can be continued for 10-15 minutes. At the end of, say 10th or 15th minute, one can continue stimulation until he reaches orgasm and ejaculates.
    • The "squeeze" method: This technique requires the man to sexually stimulate himself or be stimulated by his partner until the point he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans penis meets the shaft) for at least 15 seconds. Stop sexual stimulation for about 60 seconds, and then start it again. The person or couple may repeat this pattern for at least 10-15 minutes.  At the end of, say 10th or 15th minute, both can continue stimulation until the man finally reaches orgasm and ejaculates.
    • Deep breathing method: Deep breathing can greatly help in controlling the arousal and tension that cause early ejaculation. Men must avoid taking shallow breaths as it can trigger premature ejaculation. Instead, what one should do is spend 5 seconds inhaling a long deep breath; then hold it for three seconds and then exhale for the next 5 seconds. If you can do this for 5 minutes in the bedroom, without pause, then you can control premature ejaculation. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

6649 people found this helpful

Premature Ejaculation: What You Need To Know?

MD - Psychiatry, Diploma in Psychological Medicine, MBBS
Sexologist, Mumbai
Premature Ejaculation: What You Need To Know?

In my previous health tip, featured here last time, I talked about what actually is Premature Ejaculation (PE) or early ejaculation, what is its actual condition and how is it defined.  Today I will share some statistics, diagnosis, variants and causes of PE.

Statistics of PE:

  1. You are not alone!  PE is a common sexual complaint.
  2. Estimates vary, but as many as 30-40% men across the world experience PE at some point in their lives. 
  3. In US alone, about 60%-70% of people experience premature ejaculation. The National Health and Social Life Survey (NHSLS) indicate a prevalence of 30%, which is fairly spread across all adult age groups. 

Diagnosis of PE:

As per DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), the specific criteria for PE are as follows:

  1. In almost 75-100% sexual activities, the experience of ejaculation occurs within one minute of vaginal penetration.
  2. The problem of PE has persisted for at least six months
  3. The symptoms cause significant mental stress to the person
  4. It occurred due to a nonsexual mental disorder, a medical disease, effects of a drug or medication, etc.

Severity of PE:

The severity of PE or early ejaculation is broadly defined as follows:

  1. Mild: Occurring within 30 seconds to one minute
  2. Moderate: Occurring within 15-30 seconds
  3. Severe: Occurring even before sexual activity, at the start of it, or within 15 seconds of vaginal penetration

Even the severe form is not uncommon. Many times men approach the doctors with complaint that they are not able to penetrate the vagina. They ejaculate on minor physical stimulation and it occurs again and again. In such case, pregnancy will not be possible unless artificial insemination is used. 

Types and characteristics of P.E.

PE can be Chronic or Acquired

Chronic (lifelong) PE is when the person has been experiencing it since he became sexually active (i.e., post puberty). Usually it is seen that PE starts occurring from the beginning of sexual activity, probably the first sexual intercourse or even on masturbation, when the discharge occurs early.

Acquired (recent) PE means that the condition began in an individual who previously experienced an acceptable level of ejaculatory control and had successful sexual escapades but only recently (couple of weeks to months) has developed the tendency to ejaculate early. 

What causes P.E?

Not a particular cause is responsible for causing PE.  However, the causes of PE can be divided into two broad sub-heads, which are psychological and biological cause:

Psychological causes:

PE is believed to be a psychological problem and does not represent any known defect in the brain or nervous system. Psychological causes behind PE may include a certain pattern that is hard to change as result 
of your previous sexual experiences. They may arise from following:

  1. Atmosphere at Work or school
  2. Relationships with peer groups
  3. General attitude toward sex
  4. Any bad feelings about sex that relates to one or more bad experiences encountered
  5. Erectile dysfunction  
  6. Performance anxiety, where men want to show a good performance of sexual act with the female partner.

Type of the relationship/sexual engagement (e.g., married/unmarried/live in relationship)

Sexual attitude or interest of the female partner

Early sexual experiences, like development of habit of reaching climax soon for pleasure or ejaculating quickly because of fear of being discovered by others when masturbating as teenagers or during early sexual experiences with female partner.   This pattern of rapid attainment of sexual release is difficult to change in later stage of life during marriage or long-term relationships. 

Last but not least, a situation in which you may have hurried climax/ejaculation in order to hide your problem from your female partner; or feelings of guilt that make you rush through sexual encounters. 

Biological causes of PE:

Many scientists have questioned whether PE is purely psychological. A number of investigators have found differences in nervous stimulations and hormonal differences in men who experience PE as compared 
to individuals who do not.  Some believe that some men have hyper-excitability or oversensitivity in their genitalia, which is again not proven.  So, among the biological causes of PE, the most common are:

  1. Abnormal functioning of the ejaculatory system
  2. Thyroid problems
  3. Infection or inflammation of the urethra or prostate
  4. Nerve damage occurring due to trauma or surgery (a very rare cause)
  5. Abnormal levels of hormones and/or neurotransmitters (which are chemicals present in the brain)
  6. Higher, free and total testosterone levels have been demonstrated in men with PE than in men without premature ejaculation. Recent article in a Chinese andrology journal showed that semen from men  with PE contained significantly less acid phosphatase and alpha-glucosidase than the counterparts 
  7. Another study found that many men with PE have low serum prolactin levels.

Somehow these biochemical markers play only a partial role in contributing to PE. Further research is needed. Abnormal functioning of the ejaculatory system. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

6409 people found this helpful

Premature Ejaculation: What Should You Know About It?

MD - Psychiatry, Diploma in Psychological Medicine, MBBS
Sexologist, Mumbai
Premature Ejaculation: What Should You Know About It?

My last article gave insight on the non-medical methods of controlling premature ejaculation.  Now, as a wrap up on this topic, I will highlight the options of medical treatments available for managing P.E. However, take it as a warning that you must consult your doctor before trying out any of these methods and medicines, because more often than not, such drugs and medicines have their side effects that can adversely bother your health.

By now we know that Premature ejaculation (PE) occurs when a man reaches peak of sexual excitement and ejaculates before he actually wants it to happen, thus, leaving his partner deprived of the sexual pleasure that she deserves. Even the most empathetic female partner would not like his man to leave her unsatisfied in bed.  Sooner or later this problem becomes a medical problem, reduces the warmth in their relationship.

Several factors including psychological problems such as anxiety; biological problem like penile hypersensitivity, hormonal imbalance (e.g. thyroid problem); behavioural problem like, habituation of quick sex/masturbation, etc may be held responsible for causing PE.

Medical (Allopathic) therapy for PE treatment:

Drugs used for managing premature ejaculation reduce sensitivity and anxiety, improve blood flow and even affect some chemical mediators present in the brain. These class of drugs include local anaesthetics, antidepressants and phosphodiesterase-5 inhibitors.

Anaesthetic compounds were the first medical treatment proposed for PE management. They were applied topically to the surface of skin. Lidocaine-prilocaine sprays or creams decrease the sensation of the penis and increase the time taken to ejaculate during vaginal penetration. These sprays/ creams are applied 10 to 20 minutes prior to sexual activity. Side effects of topical agents include partial loss of sensation of penis, absorption in vagina resulting in vaginal numbness and irritation.

Earlier agents like Alpha Amino Benzoate and Phenoxybenzamine were used to prolong duration of intercourse, but they were associated with severe side effects.

It has been found that Serotonin (a chemical in brain) levels were deficient in PE patients. Treatment medications include Selective Serotonin Reuptake Inhibitors (SSRIs), which interact with a receptor (5-HT2C) present in brain and increases the production of Serotonin. They also help in reducing anxiety and depression associated with PE. Through this mechanism, they prolong the time to reach ejaculation. Several SSRIs have increasingly become used as 'off-label' for PE.

Among the available SSRIs, Paroxetine-Dapoxetine is more beneficial with lesser side effects as compared to other SSRIs. These medications are associated with sexual side effects including decreased fertility and erectile dysfunction. Dapoxetine is a recent SSRI which acts quickly and cleared rapidly from the body. Adverse effects with SSRIs are usually minor and include fatigue, mild nausea, loose stools and sweating. Other side effects may include decreased sexual urge and increased tendency to suicide, especially with long-term use of Paroxetine.

Another potential medical treatment option for PE are class of medications which increase the blood flow by dilating the blood vessels of penile region and prolong the PE. But headache, dizziness, flushing, body-ache associated with them have limited their use in PE.

At present, clinicians need to consider all treatment modalities when evaluating a man with PE, as each patient may respond differently and experience variable side effects. Additional and more effective therapies need to be developed having least side effects.

Ayurvedic therapy for PE treatment:

Vajikaran in Ayurveda is an important treatment modality which increases sexual capacity and improves health. In Sanskrit, Vaji means horse, the symbol of sexual potency and performance thus Vajikaran means producing a horse's vigour, particularly the animal's great capacity for sexual activity in the individual. Vajikaran therapy reenergizes all the seven dhatus (body elements), and restores equilibrium and health. It also offers a solution to minimize the shukra (sperm and ovum) defects.

There are many formulations which are used in Vajikaran. Some of the commonly used formulations include Vrihani GutikaVrishya Gutika, Vajikaranam Ghritam and Upatyakari Shashtikadi Gutika.

Vrihani Gutika is one of the potent formulations while Vrishya Gutika is highly potent aphrodisiac used in treatment of PE. Vajikaranam Ghritam enhances the strength of penis. Upatyakari Shashtikadi Gutika is useful for the enhancement of the fertility.

Also, Chapdraprabha Vati and Kaunch Pak are known to increase sexual vigour and semen consistency helping in increase in sexual timing.

So, with this concluding article, I wrap up my knowledge and experience in treating patients suffering from premature ejaculation. Take care, and stay healthy!

In case you have a concern or query you can always consult an expert & get answers to your questions!

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