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“Premature ejaculation since marriage — need effective on-demand medicine”
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Sexual Health & Wellness
Question #17852
59 days ago
181

“Premature ejaculation since marriage — need effective on-demand medicine” - #17852

Chitra

Hello Doctor, I am a 37-year-old male currently working abroad. I have been married for 10 years, and since the early years of my marriage I have been struggling with premature ejaculation. I usually ejaculate within a very short time, often before my partner is satisfied. This problem has affected our relationship and has caused emotional stress, misunderstandings, and arguments over the years. I will be going on a 40-day vacation soon, and I am worried that the same problem may happen again. During my last vacation, we had a very big argument because of this issue. I want to avoid any negative experience during this upcoming trip and improve my confidence. I have never taken proper medical treatment for premature ejaculation. I have only tried basic things like condoms or slowing techniques, but they have not helped much. As far as I know, I do not have any major medical conditions, and I am not taking any regular medications. I do not have heart disease or serious health issues. (If needed, I can provide more details.) I want your guidance on the following: 1. What is the best and safest treatment for premature ejaculation for someone my age? 2. Is Dapoxetine (Manforce/Priligy) safe and suitable for me to take occasionally during my vacation? 3. What is the correct dose, how often can I take it, and what side effects should I watch for? 4. Do I need any tests (heart check, blood tests, etc.) before starting this medicine? This issue is very important for my marriage and mental well-being. Please guide me with the safest and most effective treatment plan. Thank you, Doctor.

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Doctors' responses

Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
59 days ago
5

Hello dear See it is my personal advice to first go for preventing therapy and then switch to medication as last resort Below are the answers to your question The medication you have asked is ok to take but I recommend to take it after preventive therapy. The dies adjustment is to be done by gynaecologist only Yes after 40 below tests are required Serum troponin ECG Crp X ray chest Cholesterol level Scrotum USG Urine analysis Lft Rft In addition please follow below precautions for improvement for atleast 2 months Avoid heavy meals and alcohol Take ashwagandha or triphala once a day for 2 months Do meditation Do physical exercises atleast for half an hour Especially kegel exercises Take shilajeet for 1 month once a day In case of no improvement in 1 month, kindly consult gynaecologist for further clarification Hopefully you recover soon Regards

1671 answered questions
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Dr. Arsha K Isac
I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.
58 days ago
5

Hello,

PE is common and treatable.

Answers to your questions;

1. On-demand dapoxetine and topical lidocaine spray/cream are the safest and most effective options.

2. Yes, it is safe for a healthy 37-year-old with no heart disease or major medical issues.

3. Take 30 mg dapoxetine 1–3 hours before sex (max 1 dose/24 hours). Increase to 60 mg only if needed. Side effects: mild nausea, headache, dizziness.

4. No routine tests required unless you have chest pain, BP issues, diabetes/thyroid symptoms, or take interacting medicines.

I hope its clear Thank you

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Dr. Nikhil Chauhan
I am currently working as a urologist and kidney transplant surgeon at Graphic Era Medical College & Hospital, Dehradun. It's a role that keeps me on my toes, honestly. I handle a pretty wide range of urology cases—stones, prostate issues, urinary tract obstructions, infections, you name it. Some are straightforward, others way more complex than you expect at first glance. Every patient walks in with a different story and that’s what keeps the work real for me. Kidney transplant surgery, though, that’s a whole different zone. You’re not just working on anatomy—you’re dealing with timelines, matching, medications, family dynamics, emotional pressure... and yeah, very precise coordination. I’m part of a team that manages the entire transplant process—from evaluation to surgery to post-op care. Not gonna lie, it’s intense. But seeing someone who’s been on dialysis for years finally get a new shot at life—there’s nothing really like that feeling. In the OR, I’m detail-focused. Outside of it, I try to stay accessible—patients don’t always need answers right away, sometimes they just need to feel heard. I believe in walking them through what’s going on rather than just giving reports and instructions. Especially in transplant cases, trust matters. And clear, honest conversation helps build that. Urology itself is such a misunderstood field sometimes. People ignore symptoms for years because it feels “awkward” or they think it’s not serious until it becomes unmanageable. I’ve had patients who came in late just because they were embarassed to talk about urine flow or testicular pain. That’s why I also try to make the space judgment-free—like whatever it is, we’ll figure it out. At the end of the day, whether I’m scrubbing in for surgery or doing OPD rounds, I just want to make sure what I do *actually* helps. That the effort’s not wasted. And yeah, some days are frustrating—some procedures don’t go clean, some recoveries take longer than they should—but I keep showing up, cause the work’s worth doing. Always is.
57 days ago
5

Hi Chitra,

Premature ejaculation is very common and usually treatable with proper guidance.

First-line options include behavioural techniques, using condoms, and sometimes using topical sprays or gels to reduce sensitivity.

Dapoxetine can be used on-demand in selected patients, but only after a physical check-up and prescription from a doctor to ensure it is safe for your heart and overall health.

Usual practice is to start with the lowest effective dose, monitor for side effects like nausea, dizziness, or low mood, and avoid alcohol with it.

Dapoxetine is usually started as 30 mg taken once, about 1–3 hours before anticipated sexual activity, not more than once in 24 hours, and the dose is only increased if well tolerated and still insufficient.

Basic tests like blood pressure check, ECG, fasting blood sugar, and general health review are advisable before starting any prescription medicine.

Dr Nikhil Chauhan Urologist

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Dr. Shayeque Reza
I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.
58 days ago
5

Dapoxetine 30 mg 1–3 hours before sex Lidocaine spray (delay spray) 10 minutes before sex, wash excess Use condoms if you want extra control

It is safe if : You do not have heart disease You do not take antidepressants You do not take nitrates for chest pain You are not on major psychiatric medications

In person consultation would be better.

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Dr. Prasannajeet Singh Shekhawat
I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.
58 days ago
5

Hello Chita

By going through your history and evaluation of your health status i am recommending you following medicine - Rx - 1) Tab Autrin 1 tab daily after food for 2 months 2) Tab ashwagandha 500 1 tab twice daily after food for 2 months 3) Tab tadalafil 10mg 2 times a week

Investigation:

CBC, ESR Thyroid Profile (TSH, T3, T4) Fasting Blood Sugar & HbA1c Vitamin B12 & D3 Testosterone (Total & Free) – for stamina/libido concerns

Thank you

535 answered questions
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The best treatment for premature ejaculation varies between individuals, but starting with both behavioral techniques and medications is often advisable. Behavioral methods like the “stop-start” or “squeeze” technique might be worth revisiting with practice. On-demand medications like Dapoxetine can be effective, taken 1-3 hours before sexual activity. In terms of Dapoxetine, it is often considered safe for on-demand use and is designed specifically for premature ejaculation. For you, a typically starting dose is 30 mg, but this can be increased to 60 mg if needed, not to be taken more than once every 24 hours.

Users may experience side effects like nausea, headache, dizziness, or insomnia, so it’s essential to be aware of these before taking it, especially if you’re away from home. Regarding pre-treatment tests, a general health assessment, including checking blood pressure and reviewing any previous health concerns, can help ensure you’re suitable for Dapoxetine. Considering a heart check is wise if you have undiagnosed cardiovascular risks, though it’s primarily for individuals with existing medical conditions.

Your lifestyle factors, like stress and communication within your relationship, also play a significant role, so addressing these alongside medical treatment can be beneficial. If you haven’t done so already, discussing this condition with a healthcare professional can provide additional personalized advice. This approach integrates treating symptoms and addressing contributing factors to improve outcomes for both you and your partner.

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