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Urology/Premature Ejaculation?

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Question
Hi,

I am 23 yrs old.
I've following few issues:

1) Almost everytime i have sex, i happen to ejaculate even before i insert my penis. Its very annoying n disturbing coz the ejaculation happens without any action as such. Please suggest any remedies to control it.

2) Also when i ejaculate (during having sex or on masturbation), there is no force in ejaculation and the fluid just drops down. Can this cause fertility problem? I am also concerned about lower quantity of fluid that comes out.

3) I've noticed that after sex or masturbation I get constipated for a day or two and also have a slight headache.

Please kindly provide solutions for the above mentioned issues.

Thanks n Regards,
Harshit.

Answer
Harshit:

Please understand that the purpose of this forum is general questions only; we don't actually treat patients here and you should have these problems treated by a local physician. However, we can give you some information about these problems.

You have premature ejaculation.  This is a very common male sexual disorder.  Typically, it's related to stress, anxiety and nervousness and is not actually a physical problem.  The most accepted treatments include behavioral modification from a certified sex therapist or medications.  The type of medication is usually an SSRI drug which was originally designed for other problems but has the side effect of delaying ejaculation.  While this hands the problem, it's not a cure which is why we prefer the sex therapy approach when possible.

Decreased force of ejaculation usually means that there is retrograde ejaculation where the semen goes backwards into the bladder.  This is usually treated with medication that tightens the internal sphincter to force the semen out the penis.

I can't explain the constipation or headaches.

Now please make an appointment with your regular local physician to help deal with these issues.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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