<s>[INST] Hello doctor, I am 25 years old, male. I have fast ejaculation. If I am very much sexually excited, ejaculation can happen also at about 1 minute. If I do sex second or third time in a row in this case duration of act can be 4-6 minutes or more, but in this case problem is that I sometimes lose erection during the act and I am much less excited, so I do not get big pleasure. I have some symptoms which, in my opinion, can have some connection with my problem of premature ejaculation: 1. I started regular sexual life very late, at age 24, (one year ago) before it was not regular, but very rare. From the age of 13, I was making regular masturbation, almost every day, until I started regular sexual life (3-4 times a week). (Now masturbation almost does not give me pleasure) . 2. I think that the head of my penis is too much sensitive, because it hurts me when it touches to my underwear, if the head of my penis is not completely covered by foreskin. From my childhood until the age of 14-15 the foreskin of my penis was narrow and I could not to make head of penis to come completely out of it. I noticed high sensitivity only after. Now it has no problem and it is very elastic. I am saying this last fact because maybe the sensitivity of my penis was because of later adaptation of penis head without cover. 3. This period I have sex 3-4 times a week. During last one year the frequency of sexual acts was the same, but I want to have more often, minimum 6 days a week. Anyway, I am not sure this is the reason of my problem because also in the case if I do sex every day and next day I am very excited I will finish fast. 4. With oral stimulation of my penis, it is very difficult for me finish, because it does not excite me very much and I need much more time to have ejaculation. 5. My body temperature normally in the morning is about 36.6 celsius, but at midday till evening it remains 37.0-37.2 celsius. Can it be the symptom of inflammation in my genitourinary system or somewhere else, or it is normal? (My general blood and urine analysis are perfect, everything is normal). What can I do for treatment of my problem? [/INST] Hello. Forget about your past. It has nothing to do with your present problems. Premature ejaculation has nothing to do with timing of sex or masturbation. Some people have inherently sensitive genitalia. Also your body temperature is perfectly normal. There is no inflammation. The solution is to start a medicine called Dapoxetine 30 mg which can be taken as and when you have sex. One tablet to be taken one hour before intercourse. This will delay the ejaculation. As long as your partner is satisfied it does not matter how fast you ejaculate. You can bring your partner closer to point of ejaculation by stimulating her by other means like oral sex. And then penetrate her at the peak of her excitement. You can also use a jelly for local application on genitalia called Lignocaine 5 % jelly to be applied 20 minutes before sex. In some countries a spray of Lignocaine, Prilocaine is available. Take it easy. </s>