Studies indicate that patients with lifelong and secondary premature ejaculation (PE) are likely to benefit from a combination of medical psychosexual behavioural therapy and psychological therapy. The medical treatment involves a prescription pill of Selective Serotonin Re-uptake Inhibitor dapoxetine, which needs to be taken one to three hours before the planned sexual encounter, and no more than one pill in 24 hours.
"This is an on-demand pill," explains Felister Mwangangi, the Country Lead for Menarini Kenya, which distributes this treatment for PE. "One should watch out for headaches, nausea, fatigue, reduced sleep and in rare occasions, syncope," she says of the side effects, advising that men should take it with a full glass of water.
The medicine, however, is contraindicated in people with heart failure, liver impairment, history of fainting, hypomania, bipolar disorder and it should not be taken with grape juice. "It prolongs time to ejaculate by three to four-fold," says Evelyne Makena, Franchise Head for Acute Care at Menarini.
Dr Grace Kanyi, an obstetrician and gynaecologist in Tharaka Nithi, says PE is a common problem that leads to frustration around intimacy, saying "couples should have realistic sex goals to manage performance anxiety and other issues that may psychologically affect their sex lives."
Catherine Holden, a specialist in addiction, sexuality and relationships, says a majority of people learnt about sexuality through watching pornography, "which is not a real way to understand pleasure, sex or the enjoyment of it."
She works with couples to learn what works for them, including some techniques to manage anxiety and stress in healthier ways; focusing on understanding their own inner fears and the psychological conflict that can arise from this.
"As a therapist, I provide a safe and non-judgemental space for men struggling with premature ejaculation to share their experiences," she says. "With their partners, I encourage them to support the men in their life by being understanding and moving away from putting pressure on them to 'perform'."
The experts advise men suffering in silence to reach out to certified sex therapists since PE is "also easy to treat with sex therapy treatment protocols, in most cases."
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