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paymanz

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Clomiphene Effects on Idiopathic Premature Ejaculation - Nephro-Urology Monthly - - Kowsar
Background: Premature ejaculation (PE) is the inability to delay ejaculation, occurring sooner than they or their partner would like during sexual activities. PE is a challenging problem that can affect sexual enjoyment and may harm relationships of couples and affect their quality of life. In idiopathic PE, several helpful techniques and medicines are recommended, but none of them has yielded satisfactory results.

Objectives: Our objective in this study was to evaluate the efficacy and safety of clomiphene as a selective estrogen receptor modulator on the treatment of idiopathic PE.

Patients and Methods: In a randomized clinical trial, 178 married men with idiopathic PE defined according to the Diagnostic and Statistical Manual of Mental Disorders Third Revised Version (DSM-III-R) who referred to urology clinics over a 10-month period in 2012 were randomized into two groups, namely the study (clomiphene) and control (placebo) groups. They completed self-administered questionnaires that included intravaginal ejaculatory latency time (IELT), erectile dysfunction indexes, quality of life (QOL), sociodemographic characteristics, lifestyle, and medical illness. After 6 months of intervention, all data were compared with the baseline data and between the groups.

Results: Within the 10-month study course, 126 patients (70.8%) completed this study. After intervention and comparison of the results between the two groups, IELT, sexual indexes, and QOL improved in the study group, but significant differences were observed only in the IELT and QOL findings.

Conclusions: Clomiphene seems to be useful in the pharmacological treatment of PE compared to the placebo.

In the presence of all hypogonadisms, psychotic statuses such as anxiety and depression are well known to have high prevalence rates and to cause related sexual disorders such as ED and PE. Treatment of these hypogonadal patients by using hormonal replacement would improve their sexual statuses

premature ejaculation may be associated with hypogonadism, and PE may be the first presentation of hypogonadism. Finally, ED and ejaculatory dysfunctions frequently overlap. In some studies were considered ED as an important risk factor of PE and vice versa. For this reason, clomiphene therapy for such cases is preferred to other medical treatment options such as testosterone replacement therapy or psychotherapy (37-39). Clomiphene appears to be a useful agent in the pharmacological treatment of idiopathic premature ejaculation compared with the patients receiving placebo.
 
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Hyper sexual state is very discomfiting. It is possible through practice to modulate and to extend sexual pleasure to enormous depths without frequent ejaculation.
 

mujuro

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I suffer PE from time to time. The cause is absolutely not chemical or hormonal. Mine is physical.

I do a lot of weightlifting. My right leg tends to shorten if I am inactive between weight sessions because I tend to do a lot of sitting down. My quads are dominant over my glutes, especially my right quad, which tilts my pelvis forward as the rectus femoris tugs on the ilium. Weak glutes force the piriformis to undergo excess strain as it tries to do the glute's job of keeping the femur externally rotated and firmly in the socket. The pudendal nerve, its branching and its pathway can vary from person to person but generally runs adjacent to the piriformis. It isn't just PE, it can also be allodynia and discomfort during sex, where gentle stimulation feels like sandpaper and climaxing can be almost impossible.

The solution for me is walking, lots of hills preferably. And sometimes lunges - just bodyweight, but execution is paramount. It keeps the glutes dominant so that my pudendal nerve remains relatively free from irritation and my penis free from hyperexcitatibility/allodynia.
 

Koveras

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I suffer PE from time to time. The cause is absolutely not chemical or hormonal. Mine is physical.

I do a lot of weightlifting. My right leg tends to shorten if I am inactive between weight sessions because I tend to do a lot of sitting down. My quads are dominant over my glutes, especially my right quad, which tilts my pelvis forward as the rectus femoris tugs on the ilium. Weak glutes force the piriformis to undergo excess strain as it tries to do the glute's job of keeping the femur externally rotated and firmly in the socket. The pudendal nerve, its branching and its pathway can vary from person to person but generally runs adjacent to the piriformis. It isn't just PE, it can also be allodynia and discomfort during sex, where gentle stimulation feels like sandpaper and climaxing can be almost impossible.

The solution for me is walking, lots of hills preferably. And sometimes lunges - just bodyweight, but execution is paramount. It keeps the glutes dominant so that my pudendal nerve remains relatively free from irritation and my penis free from hyperexcitatibility/allodynia.

Don't disagree with the physical/anatomical/postural contributions but would add that various stress-related and neurohormonal factors can influence edema in nerve fibres and make any sort of impingement more or less likely depending on what predominates.
 

Gl;itch.e

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I suffer PE from time to time. The cause is absolutely not chemical or hormonal. Mine is physical.

I do a lot of weightlifting. My right leg tends to shorten if I am inactive between weight sessions because I tend to do a lot of sitting down. My quads are dominant over my glutes, especially my right quad, which tilts my pelvis forward as the rectus femoris tugs on the ilium. Weak glutes force the piriformis to undergo excess strain as it tries to do the glute's job of keeping the femur externally rotated and firmly in the socket. The pudendal nerve, its branching and its pathway can vary from person to person but generally runs adjacent to the piriformis. It isn't just PE, it can also be allodynia and discomfort during sex, where gentle stimulation feels like sandpaper and climaxing can be almost impossible.

The solution for me is walking, lots of hills preferably. And sometimes lunges - just bodyweight, but execution is paramount. It keeps the glutes dominant so that my pudendal nerve remains relatively free from irritation and my penis free from hyperexcitatibility/allodynia.
Interesting. I have noticed a trend where after a heavy squat workout I can often last significantly longer than other times. I always assumed it was a hormonal (stress hormone) response to the training which elicited that effect.
 

paymanz

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Interesting. I have noticed a trend where after a heavy squat workout I can often last significantly longer than other times. I always assumed it was a hormonal (stress hormone) response to the training which elicited that effect.
squat workout helps to shut down sympathetic nervous system.even just squeezing butt muscles can do that.
 

timr

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SSRIs have been used to treat PE for decades.... this info is not new, even if the study is just a repeat
check this SSRIs And Male Fertility Markers
also strongly recommend you do not use this type of product - you might try the right dose of gaba, glycine, niacaminde or one of the other calming products recommended in this forum, taken the right time before ic
the 'physical' muscle theory is interesting
 

Warrior_

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I noticed issues with PE after being on bromocriptine and cyproheptadine for a period of time. Libido was high, and the issue did not diminish with more frequent intercourse. This had never been an issue previously, in fact, delayed ejaculation was more of an issue in the past.

Reducing the dose of both seemed to resolve the issue.

I tend to tie the premature-E and delayed-E to the state of arousal though. Generally when delayed-E was an issue, libido was low, and sex was more forced and for the pleasure of my partner. More recently when premature-E was an issue, libido was very high, and almost intoxicating. "Prematurity" didn't seem so surprising when I was so stimulated. And the partner was still sure to be satisfied

Others mileage may be different, and if there seems to be a mismatch between arousal and ejaculation, maybe that warrants further research or using specific substances to modulate things ideally. An understanding partner helps as well. I guess if you're single and need to have a good experience with a new partner you'd want to shift the balance to a state that favours their pleasure. Enough of a libido to have good erections, but moderate enough that you can control your emissions heh.

While I found the hypersexual state I got myself in very stimulating (as did my partner), it did start to disrupt other aspects of my life.

As far as clomiphene, it definitely wouldn't be my first choice. Clomiphene contains two isomers - enclomiphene and zuclomiphene - and zuclomiphene tends to be quite estrogenic. The enclomiphene isomer is now available as a stand alone drug for men, but even then I would be quite wary.

@Koveras I think I am in the same situation.

My libido is so high, I am easily stimulated, and I really crave the intercourse with the partner. My nervous system seem to be too active. Could be "stress" hormones involved, I don´t know. Fact is I cum way too early, and can´t control it. However, after I cum, I can go on with no problem, and it still feels good.

What is your solution for this situation?

I gonna try the caffeine and gaba, mentioned in other posts for sure.
 

Koveras

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@Koveras I think I am in the same situation.

My libido is so high, I am easily stimulated, and I really crave the intercourse with the partner. My nervous system seem to be too active. Could be "stress" hormones involved, I don´t know. Fact is I cum way too early, and can´t control it. However, after I cum, I can go on with no problem, and it still feels good.

What is your solution for this situation?

I gonna try the caffeine and gaba, mentioned in other posts for sure.

Reducing the dose of both seemed to resolve the issue.

Asides from that - although likely not popular here nor healthy longer term - PDE5inhibitors like sildenafil and tadalafil seem to have the most evidence for treating PE. With acute administration they increase both dopamine and serotonin but longer term they only seem to increase serotonin - and the efficacy probably lies in the serotonergic effect.
 
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Asides from that - although likely not popular here nor healthy longer term - PDE5inhibitors like sildenafil and tadalafil seem to have the most evidence for treating PE. With acute administration they increase both dopamine and serotonin but longer term they only seem to increase serotonin - and the efficacy probably lies in the serotonergic effect.

they lower clearance rates of nitric oxide. They are very, very bad. They don't work for about half of men or stop working. They increase vascular leakiness, hurt the eyes (where PDE is very important in vision), increase cancer and lower immunity. They cause testicular damager.

Other than that they are wonderful.
 

Warrior_

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Caffeine / Coffee works BIG time. And I found out, that being calm/relaxed, and breath is really the solution. It is all about the mind (and so the "stress" hormones probably). B-Vits like B3, B1, and also Aspirin seem to help, as they for sure lower the stress hormones.
Also with more and more experience (with a new partner), you get more and more relaxed and it feels kind of a "normal" or "everyday" situation.
With everything mentioned above, using caffeine/or coffee, breath, and being in a relaxed state of mind ... Oh yes .. what a great experience this last days ... changed my world completely ...
 

paymanz

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Comparing the length of penile mucosa in men with and without premature ejaculation. - PubMed - NCBI

RESULTS:
The mean IELT in premature ejaculation group and control group were 47.58 ± 29.55 and 410.38 ± 190.2 s, respectively (p = 0.001). The mean penis length in premature ejaculation group and control group were 127.25 ± 16.23 and 127.03 ± 17.42 mm, respectively (p = 0.901, with nonsignificant difference); the mean penile mucosa in premature ejaculation group was 33.83 ± 11.54 mm and in control group was 31.40 ± 11.97 mm (p = 0.014, with significant difference).

CONCLUSION:
Longer penile mucosa can be one of the factors in causing premature ejaculation.

Relationship Between Use of Videogames and Sexual Health in Adult Males. - PubMed - NCBI

These results support the correlation between videogame use and male sexual health. Compared with non-gamers, men playing videogames for more than 1 hour/day were less likely to have premature ejaculation but more likely to have decreased sexual desire

The relationship between acquired premature ejaculation and metabolic syndrome: a prospective, comparative study. - PubMed - NCBI

In conclusion, MetS is associated with acquired PE
 
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paymanz

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Any idea what may affect Mg level in semen?

Seminal plasma magnesium and premature ejaculation: a case-control study. - PubMed - NCBI

The mean (sd) plasma magnesium level was 94.7 (10.9) mg/L in the cases and 116.7 (11.6) mg/L in the controls. There was a significant relationship between seminal plasma magnesium, but not the plasma level, and PE (P < 0.001 and 0.597 respectively).

CONCLUSION:
PE is significantly related with a lower level of seminal plasma magnesium. The pathological physiology of this relationship requires more investigation

Magnesium in human semen: possible role in premature ejaculation. - PubMed - NCBI
significantly lower seminal plasma magnesium levels in men with premature ejaculation
 

paymanz

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I noticed issues with PE after being on bromocriptine and cyproheptadine for a period of time. Libido was high, and the issue did not diminish with more frequent intercourse. This had never been an issue previously, in fact, delayed ejaculation was more of an issue in the past.

Reducing the dose of both seemed to resolve the issue.

I tend to tie the premature-E and delayed-E to the state of arousal though. Generally when delayed-E was an issue, libido was low, and sex was more forced and for the pleasure of my partner. More recently when premature-E was an issue, libido was very high, and almost intoxicating. "Prematurity" didn't seem so surprising when I was so stimulated. And the partner was still sure to be satisfied

Others mileage may be different, and if there seems to be a mismatch between arousal and ejaculation, maybe that warrants further research or using specific substances to modulate things ideally. An understanding partner helps as well. I guess if you're single and need to have a good experience with a new partner you'd want to shift the balance to a state that favours their pleasure. Enough of a libido to have good erections, but moderate enough that you can control your emissions heh.

While I found the hypersexual state I got myself in very stimulating (as did my partner), it did start to disrupt other aspects of my life.

As far as clomiphene, it definitely wouldn't be my first choice. Clomiphene contains two isomers - enclomiphene and zuclomiphene - and zuclomiphene tends to be quite estrogenic. The enclomiphene isomer is now available as a stand alone drug for men, but even then I would be quite wary.
Usually dopamine is blamed for PE but for me its opposite! Dopamine agonists never caused PE problem for me , I think it even improved my time.
 

paymanz

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Was searching for other stuff but found it,

Effects of zinc supplementation on sexual behavior of male rats
Zinc therapy (5 mg/day) improves sexual competence by increasing penile thrusting and prolonging ejaculatory latency without disturbing arousability and motivation of male rats.

However some of the results they report are strange, with 1mg zinc some parameters become worse than control group and then with 5mg or 10mg it gets improved.why should it be like that?!

Also zinc is known to lower prolactin , but here in this study it increased it!
----------------------------------------------

newer studies

Hyaluronic acid injection in glans penis for treatment of premature ejaculation: a randomized controlled cross-over study. - PubMed - NCBI
 
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xeliex

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Usually dopamine is blamed for PE but for me its opposite! Dopamine agonists never caused PE problem for me , I think it even improved my time.

Has it done so significantly?
If so, is it dose dependent?
 

bdawg

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Asides from that - although likely not popular here nor healthy longer term - PDE5inhibitors like sildenafil and tadalafil seem to have the most evidence for treating PE. With acute administration they increase both dopamine and serotonin but longer term they only seem to increase serotonin - and the efficacy probably lies in the serotonergic effect.

do you know the mechanism behind higher serotonin neurotransmission in chronic cases?
 

Koveras

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do you know the mechanism behind higher serotonin neurotransmission in chronic cases?

Probably nitrosative & oxidative stress from NO/ONOO- damaging dopaminergic neurons which are more sensitive to disruption.

Less dopamine would probably feed forward into a cycle with more serotonin as lower dopamine would result in increased prolactin, and a variety of other things around & downstream of that.

I would add to the original thread that vitamin D deficiency can contribute to PE potentially by lowering brain serotonin "excessively"
 
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