Last week you addressed a very important issue afflicting many men in Nigeria. Please I would like you to address the issue of premature ejaculation as it is my problem and that of many other men.

Jonny Q

Thanks Jonny for sending the above question and equally 3 others have sent similar question based on last week’s publication. Pre-Mature Ejaculation (PME) can be defined as the  inability for a man to sustain erection up to the time when his partner gets satisfaction or the inability to sustain erection up to 60 seconds or before penetration . In essence PME means lack of satisfaction for both parties.

Causes of PME

The commonest cause of PME is Anxiety. It is the bed rock of PME. Others are; presence of Sexually Transmitted Infections, which weaken erection and worsen PME. PME is a health as well as social problem, as such its treatment may not be even taking any drug or concoction, but one needs to try and improve his relationship with his partner. If anyone out there really believes he has a problem or his  partner  is convinced that it is a problem, the couple is not expected to start lamenting but one of them needs to take the initiative to open  a discussion about the PME.

The man can open a discussion and admit that he has a problem and if he is the shy type, let his partner table the issue while they are alone. I believe that is the first step in solving PME. The next step is for the couple to thoroughly discuss the problem and try to identify the cause of his anxiety and in which way can they collectively address the issue. They can resort to going together to see a medical doctor, or the man can go alone and on return give his partner a feed back on the outcome his visit and what is recommended of them.

Simple management of PME

Let me mention some simple measures that one can adopt and practice with the hope that the problem could improve. Anxiety as explained earlier is the bedrock of PME, to alleviate anxiety is to make sure that on return home, take a rest for some time after retiring to bed before any action commences.

To ensure relieving of anxiety, couple can prolong foreplay and forget about actual intercourse, let the suspension be at least for 20 to 30 minutes. By that time, one is relaxed, anxiety will remarkably improve. During sexual intercourse, the couple   could be intermittently disengaging to allow self-rest for like five minutes. Adopting these measures on a regular basis will ensure alleviation of anxiety, building self-confidence and charisma and with time the PME will improve.

Another mechanism of action that partners can adopt is the use of condom. Its usage will reduce friction, sensation and body contact; as such one tends to stay longer than one minute. Couple can be alternating having intercourse with condom and without condom until PME improves. It needs active collaboration of the couples.

I have itchy sensations  

For over one year, I have been having vaginal itch and some discharge. Please what are the likely causes and remedy?

K W

Severe Vaginal Itching is also called Pruritis Vulvae which is defined as unpleasant sensation which provokes the desire to scratch. Severe itching can equally lead to rashes.

Local causes

Sexually Transmitted Infections such as Candida, Trichomonas vaginalis, Gonorrhea  or viral warts

Infestation with scabies

Contact Dermatitis, this could be due to allergic reaction, irritation due to using of certain cream or soap, use of vaginal douches, spermicidal  creams and deodorants, also use of Nylon Panties.

General causes

1. Metabolic Problems such as Obstructed Jaundice,

2. Lack of certain vitamins like Vitamin A and B.

Idiopathic (some women may experience itching, without any known cause).

The approach to your problem is to be physically examined and properly investigated.

Some of the investigations to do are as follows:

1. High Vaginal Swab for Microscopy, culture and sensitivity.

2. Urinalysis.

3. Skin snip for Microscopy.

4. Also to improve personal hygiene and if any of the irritants mentioned above are provoking the problem, one needs to stop using them.