PREMATURE EJACULATION

R.W., Federal Employee, 30

R.W. is a 30-year-old federal employee who developed severe premature ejaculation, ejaculating within one minute of vaginal penetration. Lacking a primary-care physician, he made an appointment with a urologist, who spent five minutes with R.W. and conducted no tests. Premature ejaculation is common, he told R.W., and recommended that he have sex more often and wear thick condoms to desensitize his penis.

The urologist was out the door before R.W. could tell him he was already having frequent sex, as he and his new wife were trying to start a family — which of course negated the possibility of condoms, whatever their thickness. Unhappy with this visit, R.W. made an appointment with Obsidian.

We took the time to understand R.W.’s problem and the stress it was creating in his new marriage. Having sex more often, we told him, was not the solution he was looking for, and we weren’t going to recommend condom use. A complete physical exam plus simple lab tests revealed that R.W. had a prostate infection. Antibiotics cured the infection and increased his time to ejaculation from one to three minutes.

Still, R.W. and his wife weren’t totally pleased, because they wanted more time to enjoy each other sexually. We therefore employed a combination of topical anesthetic and an oral drug to delay ejaculation, enabling R.W. to last 15 to 20 minutes before ejaculating. This dramatically improved his sexual relationship with his wife — and the reduced anxiety led them to have sex more often. R.W.’s wife got pregnant with their first child two months later.