When excitement overwhelms

Loise came to the clinic three months after her wedding. She wanted medicine for her husband, whom she described as fond of taking ‘shortcuts’ during sex.

“I think ejaculating even before penetration is kind of weird,” she explained, “so if you give me medicine that I can secretly put in his food to cause a delay I will appreciate.”

Loise was a 24-year-old accounts clerk and rather sexually naïve. She was married to John, a 30-year-old procurement officer at the same company.

The two met when Loise was an intern and instantly fell in love. Their love deepened after Loise was employed by the company, and they had a wedding a year later.

“As advised by my mum I refused to have sex with him before marriage,” Loise explained, “so we only started after the wedding three months ago. What surprised me is that when he holds me and we start caressing, he immediately ejaculates. Is that normal, doctor?”

Loise was embarrassed to discuss her concerns with her husband. She was also not sure what was and what was not normal sexually.

OPTED TO CALL HER HUSBAND

I asked her to bring John along for the next appointment but she vigorously shook her head. She did not have the guts to bring up the topic with John. I therefore opted to call him myself.

John hesitated to talk after I introduced myself. He was surprised to learn that his wife was at the clinic. He, however, agreed that getting professional help was important for newly married couples with sexual difficulties. He agreed to join us later that day. Loise was elated. She opted to wait in the clinic until John’s arrival.

John arrived two hours later. I did my medical interview with the couple again to be sure what the concerns were. I also examined John and had him undergo a number of tests. John confirmed that he had always ejaculated before penetrative sex.

The problem made him not engage in sex until he met Loise.

He was convinced that Loise loved him so much and would not abandon him due to his sex difficulties. He did not know that he could get medical help.

I made a diagnosis of primary premature ejaculation. There are basically two types of premature ejaculation: primary and secondary.

Primary premature ejaculation is congenital, and manifests as soon as the person becomes sexually active. Secondary premature ejaculation comes later in life.

“So what actually is the normal time for ejaculation during sex?” John asked, visibly disturbed. Consistently ejaculating before penetrative sex is classified as severe premature ejaculation.

Then there are situations where a person ejaculates within one to three minutes after penetration. This constitutes mild to moderate premature ejaculation.

LIFELONG TREATMENT

The treatment for primary premature ejaculation is lifelong. I prescribed medicatin for an initial three months; should one medicine fail, there are other options one can use so a trial period is important. Sometimes the medicine can also prolong the ejaculatory time longer than desired and the dose may need to be adjusted.

Loise was in the clinic two weeks later. She was not happy at all. The medicine had incidentally done wonders and John was able to have penetrative sex for about seven minutes, but Loise was in distress. The fact that John could function normally made him overexcited. He demanded sex three to five times every night.

“I cannot cope. I have decided to leave him for now and please do not ask me to stay on,” Loise lamented.

I called John back to the clinic. I had to literally prescribe an allowable frequency of sex; they were to have no more than three to five encounters every week.

“What? That is what we have been doing in one night, how can you prescribe that for a whole week?” John quipped.

Loise insisted that she had to take a break for at least a week from the marriage. She opted to stay with her mother for that period. This made John realise how bad things were and he immediately accepted my prescription.