Premature Ejaculation

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Erectile dysfunction (ED), also known as impotence, is the inability to get and maintain an erection that is sufficient for satisfactory sexual intercourse.

ED is a very common condition, particularly in older men. It is estimated that half of all men between the ages of 40 and 70 will have it to some degree.

Why does erectile dysfunction happen?

ED can have a range of causes that can be both physical and mental (psychological).

Physical causes include:

  • narrowing of the blood vessels going to the penis – commonly associated with high blood pressure (hypertension), high cholesterol or diabetes
  • hormonal problems
  • surgery or injury

Psychological causes include:

  • anxiety
  • depression
  • relationship problems
[/vc_column_text][/vc_tab][vc_tab title=”Symptoms” tab_id=”1415894353-2-61″][vc_column_text]The main symptom of erectile dysfunction (ED) is the inability to get and maintain an erection for satisfactory intercourse.

ED should not be confused with ejaculation problems such as premature ejaculation, which is a condition where the process of arousal, orgasm and ejaculation occurs very rapidly.

Inability to get an erection

Sometimes ED only occurs in certain situations. For example, you may be able to get an erection during masturbation, or you may find that you sometimes wake up with an erection but you are unable to get an erection with your sexual partner.

In these circumstances, it is likely that the underlying cause of ED is primarily psychological (stress related). However, if you are unable to get an erection under any circumstances, it is likely that the underlying cause is primarily physical.[/vc_column_text][/vc_tab][vc_tab title=”Causes” tab_id=”1415894677813-2-5″][vc_column_text]Erectile dysfunction (ED) can have many causes, such as other medical conditions, certain medications and stress related (psychological) issues.

To understand more about the possible causes of erectile dysfunction (ED) it is useful to understand how erections occur.

Erections

When a man becomes sexually excited (aroused), his brain sends signals to the nerves in his penis. The nerves increase the blood flow to the penis, causing the tissue to expand and harden. Therefore, anything that interferes with the nervous system or the blood circulation could lead to ED.

Anything that affects libido (level of sexual desire) can also cause ED because a reduced libido makes it more difficult for the brain to trigger an erection. Psychological conditions, such as depression, can reduce libido, as can changes in hormone levels (chemicals that are produced by the body).

Physical causes

There are four main types of health conditions that can cause physical problems resulting in ED. These are:

  • Vasculogenic – conditions that affect the flow of blood to your penis e.g. cardiovascular disease, high blood pressure (hypertension) and diabetes.
  • Neurogenic – conditions that affect your nervous system, which is made up of your brain, nerves and spinal cord e.g. multiple sclerosis, Parkinson’s disease and stroke.
  • Hormonal – conditions that affect your hormone levels e.g. hypogonadism, an overactive thyroid gland and Cushing’s syndrome
  • Anatomical – conditions that affect the physical structure of your penis e.g. Peyronie’s disease.

Medicinal causes

In some men, certain medicines can cause ED, including:

  • diuretics – medicines that increase the production of urine and are often used to treat high blood pressure (hypertension), heart failure and kidney disease
  • antihypertensives – medicines, such as beta-blockers, that are used to treat high blood pressure
  • fibrates – medicines that are used to lower cholesterol levels
  • antipsychotics – medicines that are used to treat some mental health conditions, such as schizophrenia
  • antidepressants – medicines that are used to treat depression and some types of pain
  • corticosteroids – medication that contains steroids, which are a type of hormone
  • H2-antagonists – medicines that are used to treat stomach ulcers
  • anticonvulsants – medicines that are used to treat epilepsy
  • antihistamines – medicines that are used to treat allergic health conditions, such as hay fever
  • anti-androgens – medication that suppresses androgens (male sex hormones)
  • cytotoxics – medication used in chemotherapy to prevent cancer cells from dividing and growing

Psychological causes

  • depression – feelings of extreme sadness that last for a long time
  • anxiety – a feeling of unease, such as worry or fear

ED can often have both physical and psychological causes. For example, if you have diabetes, it may be difficult for you to get an erection, which may cause you to become anxious about the situation. The combination of diabetes and anxiety may lead to an episode of ED.

There are many emotional issues that may also affect your physical ability to get or maintain an erection. These include:

  • relationship problems, such as being unable to talk openly about any problems that you have
  • lack of sexual knowledge
  • past sexual problems
  • past sexual abuse
  • being in a new relationship

Other causes can include:

  • excessive alcohol intake
  • tiredness
  • using illegal drugs, such as cannabis, heroin or cocaine
[/vc_column_text][/vc_tab][vc_tab title=”Treatment” tab_id=”1415894678677-3-1″][vc_column_text]

We offer a variety of prescription only medicine (POM) to treat ED at different dosages:

  1. Viagra 25mg (Sildenafil)(Branded Viagra)
  2. Viagra 50mg
  3. Viagra 100mg
  4. Sildenafil 25mg (Generic Viagra)
  5. Sildenafil 50mg
  6. Sildenafil 100mg
  7. Cialis 2.5mg (Taldafil)
  8. Cialis 5mg
  9. Cialis 10mg
  10. Cialis 20mg
  11. Levitra 5mg (Vardenafil)
  12. Levitra 10mg
  13. Levitra 20mg
  14. Spedra 50mg
  15. Spedra 100mg
  16. Spedra 200mg
  17. ED Trial Pack 4 x (Sildenafil 50mg, Cialis 10mg and Levitra 10mg)

Viagra lost its exclusive patent in the UK in June 2103. Viagra is now available legally in the UK under the name sildenafil. Sildenafil is sometimes also known generic Viagra or generic sildenafil. Viagra and sildenafil are both supplied by Dr Felix, they are medically the same but Sildenafil is much cheaper. See comparison table.

Phosphodiesterase-5 (PDE-5) inhibitors

Phosphodiesterase-5 (PDE-5) inhibitors are one of the most widely used and effective types of medication for treating ED. They work by temporarily increasing the blood flow to your penis.

In UK, three PDE-5 inhibitors are available for treating ED. They are:

  • Sildenafil – sold under the brand name Viagra
  • Tadalafil – sold under the brand name Cialis
  • Vardenafil – sold under the brand name Levitra

Sildenafil, Tadalafil and Vardenafil

Sildenafil and Vardenafil work for about eight hours and they are designed to work ‘on demand’. Tadalafil lasts for up to 36 hours and is more suitable if you require treatment for a longer period of time, for example, over a weekend.

Depending on the type of PDE-5 inhibitor you are taking and the dose, it should take about 30-60 minutes before it starts to work. With sildenafil and vardenafil, you should be able to have sex from one to 10 hours after taking the medicine. After taking tadalafil, the effects will last for up to 36 hours.

It may take longer to notice the effects of the tablet if it is taken with food, so you should take your PDE-5 inhibitor on an empty stomach. You can then eat after an hour without affecting the medicine.

Only take one tablet within a 24-hour period.

You may have the choice of which PDE-5 inhibitor to take as sildenafil; tadalafil and vardenafil are likely to be equally effective. Your GP should explain the benefits of each medication and how it works. The choice may depend on:

  • how often you are sexually active
  • whether you have tried any of the medications before

There have been many studies to test the effectiveness of sildenafil, tadalafil and vardenafil. In general, at least two-thirds of men report having improved erections after taking one of these medicines.

If you do not find that PDE-5 inhibitors are effective it may be because:

  • you have not waited long enough after taking the dose
  • you have waited too long after taking the dose
  • the dose is not high enough
  • you have not had enough sexual stimulation

These medications are triggered by sexual stimulation, so you also need to be aroused for the medication to work.[/vc_column_text][/vc_tab][vc_tab title=”Side Effects” tab_id=”1415894679430-4-8″][vc_column_text]Most men do not experience significant side effects. On rare occasions a sustained, painful erection called a priapism can occur, which needs medical attention. Possible side effects are:

Cialis Levitra Viagra (Sildenafil)
headache headache headache
flushing muscle pain palpitation
indigestion indigestion indigestion
congestion congestion dizziness
nausea flushing congestion
dizziness dizziness flushing
blurred vision
[/vc_column_text][/vc_tab][vc_tab title=”Which Treatment?” tab_id=”1415894681131-5-2″][vc_column_text]
Drug name Viagra Cialis Levitra
Active Ingredient Sildenafil Tadalafil<“2>dizziness flushing
blurred vision    
[/vc_column_text][/vc_tab][vc_tab title=”Comparison Table” tab_id=”1415977538436-5-6″][vc_column_text]

rvous system or the blood circulation could lead to ED.Anything that affects libido (level of sexual desire) can also cause ED because a reduced libido makes it more difficult for the brain to trigger an erection. Psychological conditions, such as depression, can reduce libido, as can changes in hormone levels (chemicals that are produced by the body).Physical causesThere are four main types of health conditions that can cause physical problems resulting in ED. These are:

  • Vasculogenic – conditions that affect the flow of blood to your penis e.g. cardiovascular disease, high blood pressure (hypertension) and diabetes.
  • Neurogenic – conditions that affect your nervous system, which is made up of your brain, nerves and spinal cord e.g. multiple sclerosis, Parkinson’s disease and stroke.
  • Hormonal – conditions that affect your hormone levels e.g. hypogonadism, an overactive thyroid gland and Cushing’s syndrome
  • Anatomical – conditions that affect the physical structure of your penis e.g. Peyronie’s disease.

Medicinal causesIn some men, certain medicines can cause ED, including:

  • diuretics – medicines that increase the production of urine and are often used to treat high blood pressure (hypertension), heart failure and kidney disease
  • antihypertensives – medicines, such as beta-blockers, that are used to treat high blood pressure
  • fibrates – medicines that are used to lower cholesterol levels
  • antipsychotics – medicines that are used to treat some mental health conditions, such as schizophrenia
  • antidepressants – medicines that are used to treat depression and some types of pain
  • corticosteroids – medication that contains steroids, which are a type of hormone
  • H2-antagonists – medicines that are used to treat stomach ulcers
  • anticonvulsants – medicines that are used to treat epilepsy
  • antihistamines – medicines that are used to treat allergic health conditions, such as hay fever
  • anti-androgens – medication that suppresses androgens (male sex hormones)
  • cytotoxics – medication used in chemotherapy to prevent cancer cells from dividing and growing

Psychological causes

  • depression – feelings of extreme sadness that last for a long time
  • anxiety – a feeling of unease, such as worry or fear

ED can often have both physical and psychological causes. For example, if you have diabetes, it may be difficult for you to get an erection, which may cause you to become anxious about the situation. The combination of diabetes and anxiety may lead to an episode of ED.There are many emotional issues that may also affect your physical ability to get or maintain an erection. These include:

  • relationship problems, such as being unable to talk openly about any problems that you have
  • lack of sexual knowledge
  • past sexual problems
  • past sexual abuse
  • being in a new relationship

Other causes can include:

  • excessive alcohol intake
  • tiredness
  • using illegal drugs, such as cannabis, heroin or cocaine
[/vc_column_text][/vc_tab][vc_tab title=”Treatment” tab_id=”1415890519550-3-6″][vc_column_text]We offer a variety of prescription only medicine (POM) to treat ED at different dosages:

  • Viagra 25mg (Sildenafil)(Branded Viagra)
  • Viagra 50mg
  • Viagra 100mg
  • Sildenafil 25mg (Generic Viagra)
  • Sildenafil 50mg
  • Sildenafil 100mg
  • Cialis 2.5mg (Taldafil)
  • Cialis 5mg
  • Cialis 10mg
  • Cialis 20mg
  • Levitra 5mg (Vardenafil)
  • Levitra 10mg
  • Levitra 20mg
  • Spedra 50mg
  • Spedra 100mg
  • Spedra 200mg
  • ED Trial Pack 4 x (Sildenafil 50mg, Cialis 10mg and Levitra 10mg)

Viagra lost its exclusive patent in the UK in June 2103. Viagra is now available legally in the UK under the name sildenafil. Sildenafil is sometimes also known generic Viagra or generic sildenafil. Viagra and sildenafil are both supplied by Dr Felix, they are medically the same but Sildenafil is much cheaper. See comparison table.Phosphodiesterase-5 (PDE-5) inhibitorsPhosphodiesterase-5 (PDE-5) inhibitors are one of the most widely used and effective types of medication for treating ED. They work by temporarily increasing the blood flow to your penis.In UK, three PDE-5 inhibitors are available for treating ED. They are:

  • Sildenafil – sold under the brand name Viagra
  • Tadalafil – sold under the brand name Cialis
  • Vardenafil – sold under the brand name Levitra

Sildenafil, Tadalafil and VardenafilSildenafil and Vardenafil work for about eight hours and they are designed to work ‘on demand’. Tadalafil lasts for up to 36 hours and is more suitable if you require treatment for a longer period of time, for example, over a weekend.Depending on the type of PDE-5 inhibitor you are taking and the dose, it should take about 30-60 minutes before it starts to work. With sildenafil and vardenafil, you should be able to have sex from one to 10 hours after taking the medicine. After taking tadalafil, the effects will last for up to 36 hours.It may take longer to notice the effects of the tablet if it is taken with food, so you should take your PDE-5 inhibitor on an empty stomach. You can then eat after an hour without affecting the medicine.Only take one tablet within a 24-hour period.You may have the choice of which PDE-5 inhibitor to take as sildenafil; tadalafil and vardenafil are likely to be equally effective. Your GP should explain the benefits of each medication and how it works. The choice may depend on:

  • how often you are sexually active
  • whether you have tried any of the medications before

There have been many studies to test the effectiveness of sildenafil, tadalafil and vardenafil. In general, at least two-thirds of men report having improved erections after taking one of these medicines.If you do not find that PDE-5 inhibitors are effective it may be because:

  • you have not waited long enough after taking the dose
  • you have waited too long after taking the dose
  • the dose is not high enough
  • you have not had enough sexual stimulation

These medications are triggered by sexual stimulation, so you also need to be aroused for the medication to work.[/vc_column_text][/vc_tab][vc_tab title=”Side Effects” tab_id=”1415890546959-4-1″][vc_column_text]Most men do not experience significant side effects. On rare occasions a sustained, painful erection called a priapism can occur, which needs medical attention. Possible side effects are:[/vc_column_text][/vc_tab][vc_tab title=”Drug Comparison” tab_id=”1415890580553-5-2″][/vc_tab][vc_tabs][vc_tab title=”Overview” tab_id=”1415976515-1-48″][vc_column_text]Premature ejaculation is a common problem. It is where the male ejaculates too quickly during sexual intercourse.Many men are unsure about how long ‘normal’ sex should last before ejaculation. A study looking at 500 couples from five different countries found the average time between a man putting his penis into his partner’s vagina and ejaculation was around five-and-a-half minutes. However, it is up to the individual and his partner to decide whether or not they are happy with the time it takes for him to ejaculate. Regularly ejaculating before or within one minute of entering your partner’s vagina would usually be regarded as a medical problem that requires treatment. If you ejaculate within two minutes of penetration and it’s causing you stress, use our service to obtain expert advice and a range of treatments without seeing a doctor face to face. Our UK based doctors can provide initial and ongoing treatment with the oral medicine, Priligy, and a local anaesthetic cream, EMLA.[/vc_column_text][/vc_tab][vc_tab title=”Symptoms” tab_id=”1415976515-2-82″][vc_column_text]The main symptom of premature ejaculation is the inability to control and delay ejaculation for as long as both partners would like.While there is no definition of how long intercourse should last, in the majority of premature ejaculation cases the man ejaculates before entering his partner’s vagina, or within a minute of entering.Occasional episodes of premature ejaculation are common and are not a cause for concern. However, if you are finding that around half of your attempts to have intercourse result in premature ejaculation then it might help to get treatment.[/vc_column_text][/vc_tab][vc_tab title=”Causes” tab_id=”1415976914938-2-5″][vc_column_text]Causes of ejaculation problems vary depending on the person and the type of problem.An ejaculation problem can often have physical and psychological causes. For example, if a man has previously had a health condition that made it difficult to maintain an erection, it may now cause anxiety, leading to premature ejaculation.[/vc_column_text][/vc_tab][vc_tab title=”Treatment” tab_id=”1415977434833-3-9″][vc_column_text]If you suffer from premature ejaculation, or feel that you ‘come’ too quickly, our doctors will assess your condition online and suggest suitable premature ejaculation treatments. We can prescribe and send you an oral treatment or an anaesthetic gel, which will numb the sensation on your penis and help you last much longer.Priligy can help men suffering from premature ejaculation last up to three times longer. The medicine was licensed for use in the UK in March 2012.We supply the following genuine medicine from a registered UK pharmacy:

  • Priligy 30mg/60mg tablets
  • EMLA cream 25mg

Priligy is an oral medication. It contains the active ingredient dapoxetine and is newly licensed in the UK. Men who normally ejaculate after about 1-2 minutes of sex, find that it helps them to last longer.Priligy works by raising your serotonin levels temporarily. It is a type of anti-depressant (also sometimes known as a selective serotonin reuptake inhibitor or SSRI). You take it 1-3 hours before you have sex and it lasts for a couple of hours afterwards. Studies show that priligy is effective at increasing the length of time from when the penis enters the vagina to ejaculation.EMLA cream is a topical cream that is rubbed onto the penis to numb sensation and, in turn, slow down ejaculation. The cream contains two local anaesthetics: lidocaine and prilocaine. You put it on about a quarter of an hour before having sex. Once your penis feels numb, wash the cream off so that it doesn’t also reduce sensation for your partner.[/vc_column_text][/vc_tab][vc_tab title=”Side Effects” tab_id=”1415977482842-4-0″][vc_column_text]Because numbing condoms and topical creams (either from a sex shop or on prescription e.g. EMLA cream) are designed to reduce sensation to help you control ejaculation, they can also reduce your enjoyment of sex.EMLA cream can cause some short term skin irritation, such as redness, swelling or paleness where the cream was applied.Priligy’s most common side effects are dry mouth, headache, dizziness and nausea.[/vc_column_text][/vc_tab][vc_tab title=”Comparison Table” tab_id=”1416400753723-5-4″][vc_column_text][/vc_column_text][/vc_tab][vc_tab title=”FAQ” tab_id=”1416400850420-6-7″][vc_column_text]1. Are there any mental techniques for PE?There are some mental techniques that you can try. Some self-help techniques include masturbation a couple of hours before sex, taking a break during sex, thinking about something dull, using thick condoms so you can feel less, and taking a big breath in when you feel like you are about to ejaculate – to stop the ejaculatory reflex.2. Can therapy help?Psychological therapy can often cure your PE, but you need to be open to discussing your feelings for it to work. Often therapists also recommend that you stop having sex for a short while and explore other forms of pleasure with your partner, like massage or showing affection.3. What about the “squeeze” technique?In the ‘squeeze’ technique, the woman masturbates the man until he feels that he is almost ready to ejaculate, then stops and squeezes the head of his penis for between 10 and 20 seconds. She lets go, waits for a further half a minute, and then repeat.[/vc_column_text][/vc_tab][/vc_tabs]

Cialis Levitra Viagra (Sildenafil)
headache headache headache
flushing muscle pain palpitation
indigestion indigestion indigestion
congestion congestion dizziness
nausea flushing congestion
dizziness dizziness flushing
blurred vision
Drug Name Priligy tablets EMLA cream
Active Ingredient Dapoxetine Lidocaine and prilocaine
Time taken to activate 1-3 hours 15 minutes
Caution In rare cases, Priligy can result in fits or seizures, low blood pressure causing you to feel faint when you stand up, changes in mood, or suicidal thoughts. Stop taking Priligy straight away if you experience any of these. If you have an allergic reaction to EMLA stop using the cream and see a doctor.
Side effects Dry mouth, headache, dizziness and nausea. Redness, mild swelling, a bit of pale discolouration where the cream was on.