Hi,When I start sex My sperm gets out Why is it that I am very much tense cause of that Please tell me what should I do for that.
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Thanks a lot for your query. I am really sorry to learn about your� problem. Its very difficult to diagnose with such a brief history. In order to help you, I will suggest you to try Sertraline 25 mg. After breakfast� (one tablet daily) for at least 4-6 weeks in order to treat premature ejaculation. However, longer assessment is needed for formulatingthe correct diagnosis and management plan. You can also search on google for sensate focus techniques suggesred by masters and Johnson for treatment without medications. All the best and happy New year. N.B.--Above mentioned advise has been given in good faith on the Lybrate platform. There is no conflict of interest. I haven't charged anything for this professional advise and it's not subjected to any Medicolegal purposes. Considering the limitation of inadequate history and examination�,please consider all the suggestions with this background. Premature ejaculation (PE) refers to the persistent or recurrent discharge of semen with minimal sexual stimulation before, on, or shortly after penetration, before the person wishes it, and earlier than he expects it. In making the diagnosis of PE, the clinician must take into account factors that affect the length of time that the man feels sexually excited. These factors include the age of the patient and his partner, the newness of the sexual partner, and the location and recent frequency of sexual activity. Causes Premature ejaculation (PE) is a common complaint. The available evidence supports the notion that control and modulation of sexual excitement is learned behavior. If someone has learned it incorrectly or inadequately, they can relearn it. PE is only rarely caused by a physical or structural problem; in these cases it is usually associated with other physical symptoms, usually pain. In rare cases, PE may be associated with a neurological condition; infection of the prostate gland; or urethritis (inflammation of the duct that carries urine and semen to the outside of the body). With the rising prevalence of substance abuse, an increasing number of cases of PE are being diagnosed in patients withdrawing from drugs, especially opioids. PE may be of lifelong duration or develop in later life, especially if a difficult interpersonal relationship is one of its causes. Although PE is commonly associated with psychological symptoms, especially performance anxiety and guilt, these symptoms are its consequences rather than its causes. Once PE is firmly established, however, the accompanying psychological factors, especially in combination with sexual overstimulation, may form a self-perpetuating cycle that makes the disorder worse. Premature ejaculation is common in adolescents where it may be made worse by feelings of sinfulness concerning sexual activity, fear of discovery, fear of making the partner pregnant, or fear of contracting a sexually transmitted disease (STD). All of these may be made worse by performance anxiety. Adults may have similar concerns as well as interpersonal factors related to the sexual partner. Symptoms In PE, ejaculation occurs earlier than the patient and/or the couple would like, thus preventing full satisfaction from intercourse, especially on the part of the sexual partner, who frequently fails to attain orgasm. PE is almost invariably accompanied by marked emotional upset and interpersonal difficulties that may add frustration to an already tense situation, which makes the loss of sexual fulfillment even worse. It is also important to differentiate male orgasm from ejaculation. Some men are able to distinguish between the two events and enjoy the pleasurable sensations associated with orgasm apart from the emission of semen, which usually ends the moment of orgasm. In these cases, the partner is capable of achieving orgasm and sexual satisfaction.
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