Hello doctor,Since I was 16, I have been suffering from delayed ejaculation whenever having sex with a woman. I have not usually had trouble maintaining an erection, but I have never been able to ejaculate during sex, despite going for over 30 minutes at a time. Since I was 14, I have been on Zoloft, and recently switched to Paxil last fall. I believe the issue may have something to do with the fact that I masturbated frequently as a teenager, sometimes as frequently as once per day, and I feel this may have desensitized me to the feeling of sex. I masturbate by rubbing my penis against a bed or other surface and do not usually have trouble reaching ejaculation this way but do not find much pleasure from handjobs or blowjobs. I want to know if there is anything I can do to fix this.
Hi. I have gone through your query, I would like to know a few more details to answer your question better. How old are you presently? How long have you been on medication? Do you have a steady partner with whom you have this problem? Do you have any problems with arousal before or during sexual contact? Are you able to maintain the erection for the duration of the encounter? Based on your history, I feel that your problems are due to a combination of your vigorous masturbation style coupled with your anti-depressant medication which is known to cause delayed ejaculation. The amount of stimulation by vigorous masturbation cannot be provided by either oral or vaginal intercourse. In addition, it is also important to rule out if there are any reversible hormonal disorders that may cause this like hypothyroidism. Therapy for this will involve psychosexual therapy integrated with changes in your lifestyle, medication. Medications are under investigation but mostly are used off-label and are not approved for use in this condition as their effectiveness is limited. With combination therapy, there will be a definite improvement, but the magnitude will depend.  For more information consult an urologist online -->