What works for premature ejaculation?

[miquelangeles]

The problem is it's embarrasing. Also in real PE cases you cum fast even if you go for a 9999th round, you just cum fast period so that's not even a solution.

In my experience i've tried edging, nofap, kegels... it doesn't work. Drugs wise I tried priligy (dapoxetine) and it may give you like 30 extra seconds before involuntary kegels approach where you must stop to not cum (doesn't work with a girl only practicing)

What had a noticeable improvement for me was a topical spray which contains lidocaine and prilocaine. The problem is this spray gives me red spots on the glans which is a nono because you cannot show up with something that may look like an STD, and it stings and caused me shedding of the skin so I dropped it. Unfortunately because this at least gave me 2 minutes without the insane urge to cum.

I have found a cream that has the same numbing compounds so im going to try this cream, and hope that what was causing the redness was not the lidocaine and prilocaine but something on the spray's vehicle. If this doesn't work then im out of ideas.

You need to apply the lidocaine/prilocaine only on the frenulum, same as with the Chinese ointments.

 

[rayban]

In addition to what has already been said, I would add the following:

Frequent ejaculation is a common cause, because it causes lactic acid and free radicals build up in the pelvic area. If you do it too often these byproducts will not be cleared fast enough and will cause inflammation and muscle fatigue and dysfunction. In young men, frequent ejaculation is associated with high risk of prostatitis.
Once a week is probably a good balance. If you go longer than 2 weeks, you might get PE again from the prostatic fluid build up this time.

Shallow breathing is another cause. Complete exhalation is very helpful because it causes muscle relaxation. Exhaling is linked to the parasympathetic nervous system.

Short frenulum is another possible cause. Some people improve after frenuloplasty.

The Chinese topical ointments seem to be very effective (Suifan Chinese Brush, Pau Yuen Tong Old Chinese Balm). They are typically applied only on the frenulum in tiny amounts and they can delay ejaculation sometimes for hours. The nerve endings in the frenulum seem to be highly involved in triggering the ejaculation process, and it would explain why many people get improvement after frenuloplasty.

My frenulum is a bit tight, however, i haven't gone under the knife because it's very subtle, also, I don't want any scars in there. There is some technique called "trying of the frenulum" where a knot is made and then somehow the frenulum grows a bit and then you remove the know and it heals and it leaves no scars. Of course afaik no one practices this on clinics because it's more cumbersome than cutting it which I will never do.

 

[rayban]

You need to apply the lidocaine/prilocaine only on the frenulum, same as with the Chinese ointments.

Well on the prospect of the spray it says that you must apply 3 spray shows on the glans. Check it out:

Fortacin™ Spray for the Treatment of Premature Ejaculation

Premature ejaculation (PE) is a common complaint of male sexual dysfunction affecting men and their partners and consequently causing significant personal and interpersonal distress. Increased sensitivity of the glans penis and abnormalities of the afferent-efferent ...

www.ncbi.nlm.nih.gov

I tried it only on the frenulum. While it improved, it wasn't numbing enough. I will try with the cream next and see what happens.

 

[miquelangeles]

The frenulum is innervated by a branch of the perineal nerve, it has a foremost role in triggering ejaculation.
Frenuloplasty can go both ways depending on how the nerves are affected after healing. It can either cure it or worsen it.
Neither is great but the cream is better than the spray, and if you use a brand name such as EMLA sold in pharmacies it shouldn't cause any irritation.

 

[youngsinatra]

I have PE and I've tested normal and high prolactin at times:



Whenever I've asked how to lower my prolactin I get unclear convoluted answers so I don't know what to do.

Getting up the vitamin D could be a good thing.
Sublingual 10‘000 IU D3 with 200mcg K2 for 1-2 months, 600-1000mg magnesiumglycinate, relatively low calcium intake would be my go to way.

Other than that I would throw in a real mixed vitamin E supplement with 300mg. It has been shown to lower prolactin by 70% at that dosage.

 

[Jerkboy]

For me PE became a problem when I started using finasteride. Finasteride lowers 5AR, lowers GABA, it pretty much stimulates stress/fast metabolism. Before finasteride never had PE. I could last forever. So I think trying to fix that angle is the best. You might have high stress hormones and low GABA.

Things that lower stress hormones: milk (calcium), fats, sugar, etc. AKA eat enough food. A lot of people run on a way from stress hormones than they think. Esp. if you also drink coffee and not eat more with it.

 

[redsun]

I have PE and I've tested normal and high prolactin at times:



Whenever I've asked how to lower my prolactin I get unclear convoluted answers so I don't know what to do.

You have high noradrenaline which is what is causing your PE.

Dopamine is the hormone that inhibits prolactin. Its also called the prolactin inhibiting hormone. Calcium is vital for dopamine function thats why vitamin D plus calcium is recommended to lower prolactin. The vitamin D increases calcium absorption which is what you need. You have low vitamin D (both 25-OH and 1,25 D). 1,25 D is what increases calcium absorption. You probably need to take vitamin D in large doses for a little while.

The typical doses for raising vitamin D is D3 50,000 IU once a week for at least 8 weeks. Beyond this you need to consume 1g or more of calcium from bioavailable sources (dairy) while doing this which is the whole point of the vitamin D. High doses of vitamin D are also serotonergic so this may also help PE.

The other thing is if you don't have enough iron you will end up with low dopamine. Vitamin D also reduces hepcidin, increasing iron absorption. So it works in two ways to potentially lower prolactin.

Besides this, cholinergic supplements help counteract excess sympathetic activity (high NE). Some examples are B-complex vitamins (especially B1, B5), vitamin A, choline, zinc, manganese.

Considering cortisol is also high you are probably under some form of chronic stress. Maybe a diet related issue or lifestyle or both. Problem with excess cortisol is it reduces calcium absorption and increases calcium resorption (bone loss).

 

[rayban]

The frenulum is innervated by a branch of the perineal nerve, it has a foremost role in triggering ejaculation.
Frenuloplasty can go both ways depending on how the nerves are affected after healing. It can either cure it or worsen it.
Neither is great but the cream is better than the spray, and if you use a brand name such as EMLA sold in pharmacies it shouldn't cause any irritation.

Yeah, i've heard about EMLA, I will give this one a try. Im just hoping it does not cause irritation because EMLA has the same 2 numbing ingredients as the spray that caused the irritation (lidocaine and prilocaine) so im worried im allergic to one of these two, but hopefully it was the spray vehicle.

 

[rayban]

Getting up the vitamin D could be a good thing.
Sublingual 10‘000 IU D3 with 200mcg K2 for 1-2 months, 600-1000mg magnesiumglycinate, relatively low calcium intake would be my go to way.

Other than that I would throw in a real mixed vitamin E supplement with 300mg. It has been shown to lower prolactin by 70% at that dosage.

Im taking a small dose daily, I don't believe in these insanely high supplementations making much sense. What's the point if you just can take the daily UI? isn't there some study that says the vitamin D receptor may become "stuck" if you collapse it with too much vitamin D?

 

[rayban]

For me PE became a problem when I started using finasteride. Finasteride lowers 5AR, lowers GABA, it pretty much stimulates stress/fast metabolism. Before finasteride never had PE. I could last forever. So I think trying to fix that angle is the best. You might have high stress hormones and low GABA.

Things that lower stress hormones: milk (calcium), fats, sugar, etc. AKA eat enough food. A lot of people run on a way from stress hormones than they think. Esp. if you also drink coffee and not eat more with it.

I have had premature ejaculation all my life, before and after fin (I use it topically).
I drink milk every day, I love milk with some cookies or cereal. I drink a decent amount. At night again a yogurt or some icecream after dinner. So I think I get decent amount of calcium. I dont drink coffee. My diet I think it's varied, mediterranean diet.

 

[rayban]

You have high noradrenaline which is what is causing your PE.

Dopamine is the hormone that inhibits prolactin. Its also called the prolactin inhibiting hormone. Calcium is vital for dopamine function thats why vitamin D plus calcium is recommended to lower prolactin. The vitamin D increases calcium absorption which is what you need. You have low vitamin D (both 25-OH and 1,25 D). 1,25 D is what increases calcium absorption. You probably need to take vitamin D in large doses for a little while.

The typical doses for raising vitamin D is D3 50,000 IU once a week for at least 8 weeks. Beyond this you need to consume 1g or more of calcium from bioavailable sources (dairy) while doing this which is the whole point of the vitamin D. High doses of vitamin D are also serotonergic so this may also help PE.

The other thing is if you don't have enough iron you will end up with low dopamine. Vitamin D also reduces hepcidin, increasing iron absorption. So it works in two ways to potentially lower prolactin.

Besides this, cholinergic supplements help counteract excess sympathetic activity (high NE). Some examples are B-complex vitamins (especially B1, B5), vitamin A, choline, zinc, manganese.

Considering cortisol is also high you are probably under some form of chronic stress. Maybe a diet related issue or lifestyle or both. Problem with excess cortisol is it reduces calcium absorption and increases calcium resorption (bone loss).

I have the question you see above about high vitmain D dosaging. Im taking a supplement that has 200 UI, and another one has 200UI and included vit K mk7 at 75 μg. 200 UI and 75μg are the recommended daily dose according to the supplement details. Im just paranoid that if I take massive amounts the vitamin D receptor become blocked and cause problem long term. I dont see the benefit in risking this when you can just take what you need and not have some huge amount at once. I don't even take it daily, just EOD. Btw that bloodwork was before I started supplementing, I have to do another bloodwork to see if the supplements improved the levels. Hopefully soon I can make the test. But im researching about which viruses should I get checked. Please visit this:

Which is the best way to guarantee you have no viruses or bacteria?

Im trying to find out the trigger of my thyroid antibodies and I would like to clear out the possibility of a virus or any other pathogen. I also have itchy, white tongue, not sure if related. And I get dental plaque on 4 of my lower teeth for some reason. Could you please tell me which viruses...

raypeatforum.com

Because while im at it, I might as well test for as many viruses as I can to discard any presence of pathogens. And I also need to learn a way to find out if I have allergy to something im eating, but I don't know any tests, so I don't know how to go about this. Because if I remove something from my diet im not sure what to sustitute it with

About iron, I did a hair mineralogram, but I don't know how to read this test. I was told that this is mega complex, that there is endless ratios, it's not just as simple as loong at the mineralogram bars and seeing if it's or not on range, so dunno about that. I was going to do a new mineralogram, because it also says if you got heavy metal accumulation, the problem is I cut the hair and put it on the sealed plastic bar for a month, I forgot to send it to the lab. So my question is, is the sample now not fit for the test, or the hair stays the same? it's pubic hair btw, cause with head hair the sample can be corrupted due using shampoos and stuff. Problem is, I cut my pubic hair for the summer so I wouldn't be able to do the test until the winter, because you need to leet it grow too much and temp is too high now for that.

My sleeping schelude is screwed because I feel better at night so I stay up very late. Also, now with covid, I don't know what to do. Any plans I can think of, I can't do, so I stay at home most of the time. Im saving to buy a house with a pool so at least I can get that space and proper space for sun etc. Im considering renting a place for the summer but at the same time I want to save as much capital as possible to reinvest it and achieve the required money to buy the house faster, but at the same time it would be healthy investment to get fresh air in the summer during this covid insanity.

What can be done about noradrenaline and cortisol and dopamine? I mean, like I said before, unless I invest 2k a month on moving to a nice house with a pool at least for the summer, im not sure how can I improve lifestyle.

Cheers

 

[youngsinatra]

Im taking a small dose daily, I don't believe in these insanely high supplementations making much sense. What's the point if you just can take the daily UI? isn't there some study that says the vitamin D receptor may become "stuck" if you collapse it with too much vitamin D?

„A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L.“

— The Big Vitamin D Mistake (Pubmed)

 

[redsun]

I have the question you see above about high vitmain D dosaging. Im taking a supplement that has 200 UI, and another one has 200UI and included vit K mk7 at 75 μg. 200 UI and 75μg are the recommended daily dose according to the supplement details. Im just paranoid that if I take massive amounts the vitamin D receptor become blocked and cause problem long term. I dont see the benefit in risking this when you can just take what you need and not have some huge amount at once. I don't even take it daily, just EOD. Btw that bloodwork was before I started supplementing, I have to do another bloodwork to see if the supplements improved the levels. Hopefully soon I can make the test. But im researching about which viruses should I get checked. Please visit this:

Which is the best way to guarantee you have no viruses or bacteria?

Im trying to find out the trigger of my thyroid antibodies and I would like to clear out the possibility of a virus or any other pathogen. I also have itchy, white tongue, not sure if related. And I get dental plaque on 4 of my lower teeth for some reason. Could you please tell me which viruses...

raypeatforum.com

Because while im at it, I might as well test for as many viruses as I can to discard any presence of pathogens. And I also need to learn a way to find out if I have allergy to something im eating, but I don't know any tests, so I don't know how to go about this. Because if I remove something from my diet im not sure what to sustitute it with

About iron, I did a hair mineralogram, but I don't know how to read this test. I was told that this is mega complex, that there is endless ratios, it's not just as simple as loong at the mineralogram bars and seeing if it's or not on range, so dunno about that. I was going to do a new mineralogram, because it also says if you got heavy metal accumulation, the problem is I cut the hair and put it on the sealed plastic bar for a month, I forgot to send it to the lab. So my question is, is the sample now not fit for the test, or the hair stays the same? it's pubic hair btw, cause with head hair the sample can be corrupted due using shampoos and stuff. Problem is, I cut my pubic hair for the summer so I wouldn't be able to do the test until the winter, because you need to leet it grow too much and temp is too high now for that.

My sleeping schelude is screwed because I feel better at night so I stay up very late. Also, now with covid, I don't know what to do. Any plans I can think of, I can't do, so I stay at home most of the time. Im saving to buy a house with a pool so at least I can get that space and proper space for sun etc. Im considering renting a place for the summer but at the same time I want to save as much capital as possible to reinvest it and achieve the required money to buy the house faster, but at the same time it would be healthy investment to get fresh air in the summer during this covid insanity.

What can be done about noradrenaline and cortisol and dopamine? I mean, like I said before, unless I invest 2k a month on moving to a nice house with a pool at least for the summer, im not sure how can I improve lifestyle.

Cheers

You basically have borderline vitamin D deficiency and even your active vitamin D (1,25 aka calcitriol) which is needed to absorb calcium is low. You need to take much larger doses to get levels up but not permanently. Then you can maintain with lower doses. Dopamine is going to not function well if you have become low on calcium due to chronic low vitamin D (low calcium absorption) and increased calcium loss due to high cortisol. This is why prolactin is high. It signals parathyroid hormone which is what triggers production of active vitamin D.
High prolactin also reduces testosterone production by inhibiting GnRH in men which is vital for optimal dopaminergic function. There is a connection between dopamine, prolactin, and testosterone. Prolactin is high, means testosterone and dopamine are low. If you lower prolactin, testosterone and dopamine will increase. According to your test here your free testosterone is on the low end of the range.

You need to sleep minimum 8 hours a day and eat enough protein and carbohydrates from whole foods. This minimizes the stress response and should lower cortisol.

As I said before more choline from food cholinergic vitamins/supplements help counteract noradrenaline and should help PE.

 

[youngsinatra]

You basically have borderline vitamin D deficiency and even your active vitamin D (1,25 aka calcitriol) which is needed to absorb calcium is low. You need to take much larger doses to get levels up but not permanently. Then you can maintain with lower doses. Dopamine is going to not function well if you have become low on calcium due to chronic low vitamin D (low calcium absorption) and increased calcium loss due to high cortisol. This is why prolactin is high. It signals parathyroid hormone which is what triggers production of active vitamin D.
High prolactin also reduces testosterone production by inhibiting GnRH in men which is vital for optimal dopaminergic function. There is a connection between dopamine, prolactin, and testosterone. Prolactin is high, means testosterone and dopamine are low. If you lower prolactin, testosterone and dopamine will increase. According to your test here your free testosterone is on the low end of the range.

You need to sleep minimum 8 hours a day and eat enough protein and carbohydrates from whole foods. This minimizes the stress response and should lower cortisol.

As I said before more choline from food cholinergic vitamins/supplements help counteract noradrenaline and should help PE.

+1

 

[imei3489]

i never had pe and could finish whenever i wanted, but then i got my current gf and she is she hot that i cant last as long as id want. i close my eyes and try not to touch her but i still cant last more than 5 minutes. careful what you wish for.

 

[rayban]

You basically have borderline vitamin D deficiency and even your active vitamin D (1,25 aka calcitriol) which is needed to absorb calcium is low. You need to take much larger doses to get levels up but not permanently. Then you can maintain with lower doses. Dopamine is going to not function well if you have become low on calcium due to chronic low vitamin D (low calcium absorption) and increased calcium loss due to high cortisol. This is why prolactin is high. It signals parathyroid hormone which is what triggers production of active vitamin D.
High prolactin also reduces testosterone production by inhibiting GnRH in men which is vital for optimal dopaminergic function. There is a connection between dopamine, prolactin, and testosterone. Prolactin is high, means testosterone and dopamine are low. If you lower prolactin, testosterone and dopamine will increase. According to your test here your free testosterone is on the low end of the range.

You need to sleep minimum 8 hours a day and eat enough protein and carbohydrates from whole foods. This minimizes the stress response and should lower cortisol.

As I said before more choline from food cholinergic vitamins/supplements help counteract noradrenaline and should help PE.

I will continue use the doses I have for vitamin D but im going to wake up earlier and get some sun. Afaik 15 minutes of sun is enough to get a high UI and I am from a sunny south European country, im just too tired in the morning to bother and also due covid since stuff is closed or with restrictions it's not very motivating otherwise I would have joined a gym with a nice pool and outdoors area already but I dont want to be on places like this while cases are on the rise again, also im not vaccinated yet because im paranoid of the vaccine. I mean im sure it's ok but at the end of the day it's still on experimentation phase afaik, so im going to wait a year and once an huge amount of people has been vaccined we should have the data needed. Personally everyone I know that got vaccined had no problems.

As far as getting sun I get it mostly on my arms and legs because im not shirtless. Is it enough? Im a good phenotype to tan but I have some moles here and there that make me paraoid to be exposed in the sun for too much time.

Also in the winter im not sure how its supposed to be done it's too cold.

Are these narrowband UVB lamps safe to use in the winter as a sustition for sun in the cold months so you don't have to resort to some supplement?

„A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L.“

— The Big Vitamin D Mistake (Pubmed)

Well it says only 20% of your vit D should be from food the rest from the sun, so this means you don't need huge UI doses on supplements since if you go to the sun you already get most of the UI needed there.

Explanation of the Pandemic of Vitamin D Deficiency​

Only 20% of our vitamin D reserve is meant to come from the diet. The remaining 80% is expected to be produced in our skin from the UV-B of the sun. In contrast to the context of the recommendations of the 1960s of 4000 to 5000 IU/d to avoid rickets, our diet today is poor in wild fish (×10 richer in vitamin D), wild eggs, and fresh milk. Children are playing and people are working indoors all day long, and powerful sunprotective cosmetics are used to prevent melanoma. Even sunny countries such as Greece present a high prevalence of vitamin D deficiency, as the angle of the sun rays from autumn to spring do not result in sufficient vitamin D production with usual sun exposure.

 

[rayban]

The typical doses for raising vitamin D is D3 50,000 IU once a week for at least 8 weeks. Beyond this you need to consume 1g or more of calcium from bioavailable sources (dairy) while doing this which is the whole point of the vitamin D.

Like I said before im worried that huge doses block vitamin D receptor. I remember reading something about this, can't find it now tho, but it seemed to make sense. Meanwhile this wouldn't happen with sunlight. I wish I could find the place i've read this.

Also, I have hashimotos as you can see, on the thyroid antibodies they are elevated, so it's annoying because some people tell you to cut gluten and dairy and because it causes inflamation and causes these antibodies and others tell you that you need it in your diet so I don't know what to do. I wish I could find wtf is wrong with me. My thyroid is being attacked for some reason. And my tongue is white and itches sometimes. I wish I could know what the actual trigger for this is but doctor wouldn't help me, only give me eutirox and leave my throid be attacked until it's dead. What can I do?

 

[rayban]

Exactly. It is stress hormones. People with high metabolisms tend to also have higher stress hormones. When I was hypothyroid I could last forever. Hypothyroid people have no stress hormones. That is why they are fatigued. Too much stress hormones will also cause fatigue through serotonin. Your body has no fuel to burn so it has to slow the metabolism. It is a different type of fatigue.

That is where Ray Peat is wrong. High metabolism means more stress hormones. Which yes if they go too high by not eating enough or specific food that helps lower them, you will run into problems. Lowering them to nothing you will also feel like ***t.

This is not true, look at my labs. Im hypothyroid, yet I have high adrenalin, high cortisol, etc. Im very lean, my libido is high, I cum fast. So yeah, I don't get it.

 

[Jerkboy]

This is not true, look at my labs. Im hypothyroid, yet I have high adrenalin, high cortisol, etc. Im very lean, my libido is high, I cum fast. So yeah, I don't get it.

High adrenaline + high cortisol is not hypothyroid. People who are hypothyroid have no adrenaline, no cortisol. And so they have chronic fatigue. Too high cortisol + adrenaline + serotonin can also cause fatigue but it is different. RT3, Serotonin, etc is like a brake to your bodies metabolic rate.

I assume you workout?

You might simply not be eating enough or the right food (not enough copper, calcium, or something else) which keeps your metabolism too high (stress hormones high) and you cum fast because your body thinks you are in a danger zone.

 

[Eberhardt]

High adrenaline + high cortisol is not hypothyroid. People who are hypothyroid have no adrenaline, no cortisol. And so they have chronic fatigue. Too high cortisol + adrenaline + serotonin can also cause fatigue but it is different. RT3, Serotonin, etc is like a brake to your bodies metabolic rate.

I assume you workout?

You might simply not be eating enough or the right food (not enough copper, calcium, or something else) which keeps your metabolism too high (stress hormones high) and you cum fast because your body thinks you are in a danger zone.

This is a bit weird . I have not been contributing to what you have been discussing but hypo does bot have high adrenalin and cortisol?? Thats sime far out ***t man. I just refer to Broda Barnes and Peat here in general. That is very typical hypo though it has the chance of sooner or later exhausting the adtenals and then what you describe would nor ally occur. If what you are saying is true then a year or two of keto would not lower peoples metabolism as they usually have a year or so of feeling great due to the compensatory adrenalinprioduction. Or cancer is not a metabolic disease as the patients usually have high cortusol and adrenalin? I dont know what tonsay man but thats some seruous misunderstanding. I cant list like the main part of Peats work here but remember that most metabolic disorders will include a level of hypo or cause one quickly. To go through all the mechanisms is neverending so just start with some of Peats articles on thyroid, any of Broda Barnes books or the old manuals on thyroid from before 1950 when the blood test startrd to be used and the clinical signs was downplayed. (No the where not less reliant and again the thyroid madness article by Peat might be relevant here.) Not saying training cant be part of it but the problem with overtraining (in addition to lactate itself being a problem) is exactly that it makes you both temporarly and possibly long twrm hypo.

Maybe rather go by pulse, temps and symptoms in general. At the least the no high adrenalin is anti-peat and very misguided. If you find this reply harsh it is noy ent to be rude but to make sure this idea is not percieved as a valid understanding if metabolism on this forum :)