The most common sexual complaint in men, and one of the most treatable. Control is a trainable skill, and most men improve substantially with the right combination of technique and medication.
Premature ejaculation means reaching climax sooner than you and your partner would like, with a sense that you cannot delay it, and enough distress about it to matter. The stopwatch is far less important than those last two points. Plenty of men with a two minute average are perfectly content, and plenty with five minutes are not.
There are two distinct patterns. Lifelong premature ejaculation has been present since the first sexual experiences and usually reflects how sensitive the ejaculatory reflex is. Acquired premature ejaculation appears later in a man who previously had normal control, and that pattern almost always has a cause worth hunting for, commonly an erection problem, prostate inflammation, an overactive thyroid or a sharp rise in anxiety.
At Elegance Clinic we separate the two before treating either, because the plans are genuinely different. What both share is that results come from combining a trainable skill with medical support, rather than relying on a spray or a tablet alone.
The measure that matters is not the clock. It is whether you feel you have a choice in the moment, and whether the lack of choice is causing distress.
Lifelong and acquired forms have different drivers, and the history usually makes clear which one you have.
A calm, detailed history covering how long this has been present, how it behaves in different situations, erection quality, medication and relationship context. Nobody is rushed and nothing is judged.
Genital examination, and where indicated thyroid function, blood sugar and a prostate assessment. Acquired cases are investigated more thoroughly than lifelong ones, because a treatable cause is far more likely.
You are told which type you have, what drives it, and what realistic improvement looks like. For many men this conversation alone removes a great deal of unnecessary worry.
Behavioural technique taught in detail with a written practice schedule, alongside medication or a topical agent where that will help. Partners are welcome to attend this session.
Progress reviewed honestly, technique corrected where practice has drifted, and doses adjusted. Most men have measurable improvement by this point, and the plan is refined rather than replaced.
A fuller reassessment. Where control has become reliable, medication is reduced with a clear plan, and you are shown how to manage the occasional setback without losing ground.
On demand medication works from the first dose, so many men see a clear difference within a week. Daily medication takes longer, with the useful effect building over two to four weeks. Topical agents work immediately but need correct application and timing, otherwise they simply numb both partners.
Behavioural training is slower and more valuable. Most men who practise consistently notice real change by week four and solid control by week eight to twelve. That is the part that keeps working after the medication stops, which is the whole point of doing it.
Where an erection problem or prostate inflammation is driving the pattern, treating that often resolves the ejaculation issue on its own, sometimes within a few weeks and without any specific ejaculation treatment at all.
The consultation covers assessment, an explanation of which pattern you have, and the behavioural programme itself. Beyond that, cost depends on the route chosen. On demand tablets, daily medication and topical agents each carry a different monthly outlay, and none of them is expensive by comparison with surgical treatment. Where a thyroid problem, prostate inflammation or an erection problem is found, treating that carries its own cost and is quoted separately after examination. You are told the full monthly figure before starting, and there is no package you must commit to in advance.
Nearly every good result comes from a combination. Medication buys time, and behavioural training turns that time into lasting control that does not depend on a prescription.
The stop start and squeeze techniques, taught in detail with a structured practice schedule. This is the part that produces control which lasts after medication stops, and it is why we do not treat this condition with a prescription alone.
Ask about thisA supervised programme to strengthen the muscles that control ejaculation. Most men contract the wrong muscles when left to work it out alone, so the technique is checked in person before the schedule is set.
Ask about thisA short acting tablet taken one to three hours before sex, useful for men who have sex occasionally or who want a quick, reversible option while behavioural training builds. Side effects are usually mild and settle with use.
Ask about thisA low dose taken every day, reaching full effect over two to four weeks. It gives more consistent control than on demand dosing for men in regular relationships, and it is tapered once training has taken hold.
Ask about thisA measured spray or cream applied before sex to reduce sensitivity. Correct dose, timing and wiping off excess are essential, otherwise your partner's sensation drops too. Taught precisely rather than left to the packet instructions.
Ask about thisCorrecting an erection problem, treating prostate inflammation or an overactive thyroid, or releasing a tight frenulum. Where one of these is driving the pattern, treating it frequently resolves the ejaculation problem without any further intervention.
Ask about thisHonest answers about this procedure in Surat.
Ask a QuestionThree things together, rather than a number on a clock. Climax happens sooner than you would like, usually within a minute or two of penetration. You feel unable to delay it. And it causes you or your partner real distress. Without that third element, a short duration on its own does not need treatment.
Usually both, in varying proportions. Lifelong cases are largely biological and relate to how sensitive the ejaculatory reflex is. Cases that appear later in life often start with a physical trigger such as an erection problem or prostate inflammation, then anxiety builds on top. Effective treatment addresses both sides rather than arguing about which came first.
They work well when used correctly, which means applying a measured amount to the right area, waiting the recommended time, then wiping off any excess. Applied carelessly they reduce your partner's sensation too, or dull the erection. Used properly they are a reasonable option, particularly for men who prefer not to take tablets.
That is not the goal. Medication is used to create enough delay for behavioural training to become possible, and once control is established the dose is usually reduced and then stopped. Some men choose to keep an on demand tablet for occasional use. Others need nothing after a few months of consistent practice.
Very often, and the order matters. Some men rush deliberately because they fear losing firmness, which looks like premature ejaculation but is really an erection problem in disguise. Treating the ejaculation alone in that situation fails. Erection function is therefore assessed in every case before a treatment plan is written.
Most men who practise consistently notice a genuine difference by about four weeks, and reliable control between eight and twelve weeks. Progress is not linear, and a poor week after a good one is normal rather than a sign of failure. Practice frequency predicts the result far more than any medication does.
Yes, and they are underused. Strengthening the pelvic floor gives some men a physical means of holding back at the point of no return, and studies of structured programmes have shown meaningful improvement in latency. The exercises must be taught properly, because most men squeeze the wrong muscle group when left to guess.
It helps but it is not essential. Several behavioural techniques are easier to practise when your partner understands what you are doing and why, and it removes the pressure of secrecy. That said, plenty of men attend alone throughout and do very well. The choice is entirely yours and nobody will press you on it.
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View detailsSpeak with Dr. Ashutosh Shah at Elegance Clinic, Surat.
