Premature Ejaculation Causes, Ayurvedic Treatment, Tips

Article by Dr Raghuram Y.S. MD (Ay)
There is a saying,
‘Jumping to conclusions is like Premature Ejaculation, only satisfying to the guy doing it and eventually he stops getting chances to do it’ 

Sexual drive and sexual intercourse are the basic instincts of the mankind which has made possible his journey from the primitive stone-age to the modern-era of technological sophistication
For man or woman, Sex is the basic need and an essential part of life
Healthy sex on the other hand is the secret of physical and mental well-being

The sexual union culminates with orgasm and ejaculation of pleasure fluids. But if these fluids rush out in a hurry and if you are not able to control its output, you may end up with unsatisfied sexual experience. You may at the same time be the cause for discontent of your partner and self embarrassment if this continues for a longer period.
Have you ever experienced this bitter part of sex?
If yes, you are suffering from Pre-Mature Ejaculation

premature ejaculation

What is Pre-Mature Ejaculation (PME or PE)?
Premature Ejaculation (PE) is –

  • Uncontrolled ejaculation either before or shortly after sexual penetration (quick orgasm and quick ejaculation)
  • It happens with minimal sexual stimulation and before the person (or his partner) wishes
  • It results in unsatisfactory sex for both partners
  • This can increase the anxiety and further worsens the problem (the person may wish to keep away from sex rather than getting embarrassed)
  • It is one of the most common forms of male sexual dysfunction
  • It has probably affected every man at some point of his life

Tips for prevention and cure of PE:
Sex related –

  • Masturbate an hour or 2 before intercourse
  • Divert – Stop when there is ejaculatory response and repeat foreplay techniques or divert your mind from intercourse and focus on other types of sexual play
  • Pause-squeeze technique
  • Use condoms – This will help lessen the stimulation on penis
  • Communicate with your partner
  • Try different sexual positions rather than missionary positions
  • Penis massage before intercourse with 1 ounce of sesame oil added with 5-10 drops of mustard oil

Exclusions –
Stop alcohol, tobacco, drugs, smoking
Avoid junks, fried foods, canned foods, processed foods, denatured foods
Avoid white sugar, white flour

Inclusions –

  • Deep breathing exercises
  • Take eggs – They provide cholesterol which assists production of sex hormones
  • Include cereals and blueberries – they prevent blockage of arteries, improves blood circulation to genital area, helps to get and maintain erection
  • Take fresh fruits (especially banana) and fruit juices in plenty
  • Include nuts, cereals, vegetables (especially fennel, celery and onions), fruits, honey, milk in diet
  • Take ginger, lettuce, fish, shellfish,
  • Yoga
  • Whole body massage

Best ways to prevent PE –
Follow the below said religiously:

  • Dinacharya / Ratricharya – Following a systematic daily protocol of life including wake-up and sleep patterns, proper quality and quantity of food, sleep, sex, brushing teeth, having bath, exercise, do’s and don’ts to be followed at evening and night times etc
  • Rutucharya – Following a systematic seasonal protocol
  • Sadvritta and Sadachara – Having a circle of goodness and getting into a practise of doing good deeds
  • Achara Rasayana – Conducts and behaviours which will provide all benefits of taking Rasayana (immune modulators / anti-ageing medicines / rejuvenators)
  • Avoid Vega Dharana and Vega udeerana – Do not forcibly control the natural impending urges / reflexes as those for defecation, urination, emotional discharge (crying), sneeze, thirst, hunger, sex, sleep etc. Also avoid forcible expulsion of the above said. Also control or avoid exhibiting the mental vegas like anger, anxiety, stress, grief, possessiveness, hatred, greed etc.

Click to Consult Dr Raghuram Y.S. MD (Ayu) 

Technique for longer erection:
Pause-squeeze technique –

Begin stimulation of penis until you feel almost ready to ejaculate
Ask your partner squeeze the end of your penis and maintain it for several seconds, until the urge to ejaculate passes
Later ask your partner to release the squeeze. Wait for 30 seconds and go back to foreplay. The squeezing will make the penis less erect but when stimulation is resumed it will soon gain full erection
If you again feel that you are about to ejaculate, ask your partner to repeat the squeeze process
Benefit – After repeating this for many times you will reach a point of entering your partner without ejaculating. After a few practice sessions, you will learn how to delay ejaculation.

Topics covered in this article:

Yoga for PE

Various Yoga postures when practised daily will help you to get rid of PE. Some important Asana’s are as below said Related reading –
http://www.thehealthsite.com/sexual-health/control-premature-ejaculation-with-yoga-p114/

Sarvangasana – The shoulder stand

Paschimottasana– Seated forward bend

Gomukhasana – Cow head pose

Bhujangasana – The Cobra pose

Dhanurasana – The Bow pose

https://www.youtube.com/watch?v=MqLqE8yd_uo

Garudasana – The Eagle pose

Halasana – The plough

Matsyasana – The fish

Ushtrasana – Camel

Vajrasana

Utthita Padmasana – Elevated lotus

Anulom Vilom Pranayam

Home remedies for PE:

  • Shatavari Churna (powder of Asparagus racemosus) – 1 ½ – 2 spoons added to 1 cup of milk, boil for 10-15 minutes, drink twice daily
  • Almonds – Take 10 almonds, soak them in water and leave them overnight. Peel off their skin and crush them the next morning. Add the crushed almonds, pinch of cardamom powder, pinch of saffron and a pinch of ginger powder to 1 cup hot cow’s milk. Mix the contents thoroughly. Drink this every morning.
  • Ashwagandha Churna (powder of Withania somnifera) mixed in honey or warm milk twice daily.
  • 1 spoon of onion seed powder mixed in a glass of water before each meal
  • Powder of Ashwagandha (Withania somnifera), Bala (Sida cordifolia) and Vidari (Pueraria tuberose) – ½ spoon in warm goat’s milk
  • Chew 2-3 cloves of raw garlic
  • Green onion seeds – Add one tsp of green onion seeds into a glass of water and stir thoroughly. Drink before every meal.
  • Ginseng – take ½ spoons after food with warm goat’s milk every day
  • Kumkuma (saffron) should be consumed with milk
  • Jatiphala (Myristica fragrans) powder 3-5 grams quantity mixed in milk and made into paste and taken as internal consumption
  • Take 1 spoon Jambu seeds (Syzygium cumini) powder with milk
  • Powder of Almonds, pepper, sugar-candy and ginger (equal portions) with milk
  • Black gram powder and Almonds powder with warm milk
  • Dates with milk
  • Massage pubic bone and glans penis before intercourse with Brahmi Ghrita, Shatavari Ghrita and Ashwagandha ghrita (ghrita=medicated ghee)

PE – Modern disease review –
Premature Ejaculation (PME or PE) occurs when a man
Experiences orgasm and ejaculates (expels semen) sooner during sexual intercourse than he or his partner would like
Ejaculates within a small duration (may be a few seconds) after starting sexual activity or with minimal stimulation of penis

PE is defined as –
Ejaculation which always or nearly always occurs prior to or within about one minute (International Society for Sexual Medicine)
Ejaculation occurring within 15 seconds from the beginning of sexual intercourse (International Classification of Diseases – ICD-10)

Synonyms:

  • Early ejaculation, quick ejaculation,
  • Rapid ejaculation
  • Rapid climax
  • Premature climax
  • Ejaculatio praecox

Causes for premature ejaculation:

Exact cause of PE is not known. It occurs due to a complex interaction of psychological and biological factors.
Psychological Causes:
You may have some early sexual experiences. These experiences tend to establish a pattern which becomes difficult to change in later part of life. These include:

To avoid being caught in the act – Hurry to reach climax (masturbating quickly during adolescence) and finish off with oomph factor (ejaculating) while trying to avoid being discovered in the act

Guilty feelings that make you to rush through sexual encounters

Unresolved Oedipal conflict / complex – Emotions and ideas that the mind keeps in the unconscious via dynamic repression that concentrates upon a child’s desire to have sexual relations with the parent of the opposite sex (i.e. males attracted to their mothers and females attracted to their fathers)

  • Erectile dysfunction – Some men may be anxious or develop a fear of getting an erection and also to maintain it during intercourse. Such men may develop a pattern of ejaculating in a hurry. Over a period of time it becomes difficult to change the pattern.
  • Anxiety – either about sexual performance (performance anxiety) or related to any other issues
  • Relationship problems between you and your partner
  • Passive aggression (indirect expression of hostility)
  • Depression

Biological causes:

  • Abnormal hormone levels
  • Abnormal levels of neurotransmitters (brain chemicals)
  • Abnormal reflex activity of the ejaculatory system
  • Thyroid problems
  • Prostatitis
  • Inflammation and infection of the prostate gland and / or urethra
  • Inherited traits
  • Nerve damage from surgery or trauma (rare)
  • Having too little sex

Physiological mechanisms:
Serotonin receptors
Genetic predisposition
Elevated penile sensitivity
Nerve conduction atypicalities

Others:
Side effects of some drugs and medications
New partner
Long time since last ejaculation

Symptoms –

  • Uncontrolled ejaculation either before or shortly after intercourse begins
  • Ejaculation occurs before the person wishes it (inability to delay or control ejaculation for more than 1 minute after penetration, can occur even during masturbation and other sexual situations also)
  • Ejaculation occurs with minimum stimulation
  • Lifelong (primary)PE occurs all or nearly all of the times beginning with your first sexual encounters
  • Acquired PE has the same symptoms but develops after you have had previous sexual experiences without ejaculatory problems
  • Natural variable PE – characterized by periods of rapid ejaculation as well as periods of normal ejaculation

Diagnosis:
Diagnosis is usually made on the basis of clinical symptoms.
PE is caused due to different causes. Your doctor may order some lab tests to rule out any other medical problems. Your doctor will conduct a thorough medical examination and discuss sexual history with you. He or she may also want to talk to your partner.

Diagnostic criteria –
You are sure to be suffering from PE if you:
Always or nearly always ejaculate within one minute of penetration
Are unable to delay ejaculation during sexual intercourse all or nearly all of the time
Feel distressed and frustrated, and tend to avoid sexual intimacy as a result

Risk Factors:
The below said factors may increase your risk of PE –
Erectile dysfunction – ED is trouble getting or maintaining an erection (occasional or consistent). Fear of losing erection may cause you to consciously or unconsciously hurry through sexual encounters.
Health problems – If you have a serious or chronic medical condition, such as a heart disease, you may feel anxious during sex and may unknowingly rush to ejaculate
Stress – emotional or mental strain limits your ability to relax and focus during sexual encounters

Complications:
PE alone doesn’t increase your risk of health problems. It can on the other hand cause many problems in your personal life –
Stress and relationship problems
Fertility problems

Concept and Ayurvedic treatment for premature ejaculation

I have tried to compare a few conditions explained in Ayurveda with early ejaculation. They are as below explained –
Shukragata Vata –
क्षिप्रं मुञ्चति बध्नाति शुक्रं गर्भमथापि वा।
विकृतिं जनयेञ्चापि शुक्रस्थः कुपितोऽनिलः॥{च.चि}

Shukragata Vata is one close condition which resembles PE. It is one of the forms of Gatavata condition wherein the morbid Vata gets illegal entry into any tissue or organ of a body producing some disturbances in the normal functioning therein. In due course of time, if Vata is not eliminated from those target tissues or victimised organs, serious diseases can set in. In this condition, the morbid Vata enters Shukra (semen) and causes the below said deformities –
Kshipram munchati – Semen gets ejaculated very quickly
Shukram badhnati – Semen doesn’t get ejaculated at all

These 2 contrasting presentations are due to the unpredictable nature of Vata. But while discussing PE we are more interested in knowing that Shukra gets expelled quickly than desired due to the mechanism brought about by the morbid Vata. Both presentations of Shukragata Vata puts man in an awkward and embarrassing position during sexual intercourse. This further leads to mental derangements and lack of interest or forcible withdrawal from sexual encounters. This also shows us that PE is one of the features of Shukragata Vata and doesn’t constitute the whole disease. When both these are occasionally encountered we need not bother too much because they may be just casual presentations in an otherwise healthy sex life. When the first condition i.e. the semen getting discharged too early happens on a regular basis owing to excessive motivation and stimulation of sex organs and loss of mind control over ejaculation as caused by chala guna (nature of mobilising or causing hyper-motivation) of morbid Vata, it needs to be addressed as a disease. Thus in established PE, the chala guna of Vata is severely disturbed and out of control. The Vayu, in normal condition helps in accomplishment of normal ejaculation and sexual pleasure, but the same Vayu when gets aggravated, will cause PE.

Treatment of Shukragata Vata:
Shukragata Vata is treated on the basis of 2 principles –
Controlling the Vayu and
Strengthening the Shukra and genital system

Acharya Charaka advices to administer the below said in Shukragata Vata –
Harshana – Exhilarating treatment and counselling to the patient
Balakara chikitsa – The medicaments enhancing bala (strength and immunity of the body) should be given. Balya group of drugs can thus be considered in tackling PE.

The below said are the best strength promoting drugs (Balya) –

  • Aindri – Bacopa monnieri
  • Rushabhi – Mucuna pruriens / Fagonia cretica / Mucuna monosperma
  • Atirasa (Shatavari) – Asparagus racemosa
  • Rushyaprokta – Argyreia petaloides
  • Payasya – Roscoea procera
  • Ashwagandha – Withania somnifera
  • Sthiraa – Uraria picta
  • Rohini – Picrorrhiza kurroa
  • Bala – Sida cordifolia
  • Atibala – Abutilon indicum

Shukrakaram – Medicines and treatments which could enhance the quality and quantity of Shukra (semen) should be administered. This indicates that Vajikara dravyas (aphrodisiacs can be used in tackling PE. The concept of Vajikarana in treating PE will be explained in the coming passiges.

The best Shukrakara dravyas are –

  • Ksheera – Milk
  • Sarpi – Ghee
  • Madhura dravya – Drugs which have sweet taste
  • Snigdha Dravya – Drugs which are unctuous (which cause oleation)
  • Jeevaka – Crepidium acuminatum / Malaxis acuminate
  • Rishabhaka – Manilkara hexandra / Malaxis muscifera
  • Meda – Polygonatum verticillatum
  • Mahameda – Polygonatum cirhifolium
  • Kakoli – Roscoea purpurea
  • Ksheerakakoli – Lilium polyphyllum
  • Mudgaparni – Phaseolus trilobus / Vigna trilobata
  • Mashaparni – Teramnus labialis
  • Jivanti – Leptadenia reticulate
  • Madhuka – Glycyrrhiza glabra
  • Kapikachchu – Mucuna pruriens
  • Masha – Black gram
  • Vidari kanda
  • Svarna bhasma
  • Rasa sindoora etc

Shukravrita Vayu –
शुक्रावेगोऽतिवेगो वा निष्फलत्वं च शुक्रगे।{च.चि}
This is a condition in which the Shukra (semen) causes pathological obstruction to the normal functioning of Vayu, especially Apana Vayu (the vayu which governs the functions of the lower portion of the body and the organs located therein including sexual organs).
Ativega of Shukra (quick ejaculation or premature ejaculation of semen) has been mentioned as one of the symptoms of Shukravrita Vayu

Treatment of Shukravrita Vayu:
Firstly Virechana (therapeutic purgation) should be given followed by Samsarjana Krama (Dietetic protocol administered after Virechana wherein the diet is gradually graduated from liquid to semisolid to solid to normal food over a period of 1 week to 10 days). When the person starts consuming normal food and gains good strength, the same treatment mentioned in Shukragata Vata should be administered.

Shukraja Udavarta –
Udavarta is a medical condition in which the vitiated Vayu moves retrograde (upwards) from its normal site and causes a set of disorders. This happens when the Vega’s or natural urges (reflexes) of the body are forcibly withheld. In case of Shukraja Udavarta, the retrograde flow of Vayu leading to sex related and fertility related problems is caused by a habit of forcibly controlling the impending reflex of semen discharge (ejaculation) over a long period of time.

मूत्राशये वै गुदमुष्कयोश्च शोफो रुजा मूत्रविनिग्रहश्च।
शुक्राश्मरी तत्स्रवणं भवेच्च ते ते विकाराभिहते च शुक्रे॥{च.चि}
Apart from many symptoms related to urinary bladder, anus, testes etc, the symptom which points towards PE is Tatsravanam which means quick discharge (ejaculation) of semen.

Treatment of Udavarta:
In all types of Udavarta, attempts to control and bring Vayu to normalcy is the primary motive of treatment
Snehana (oleation or administration of medicated ghee / oils in metered doses), Swedana (Fomentation / Sudation / Steaming treatment) and Vasti (Decoction and oil enemas) form the bulk of treatment approach.
The below said line of treatment should be adapted in Shukravarodhajanya Udavarta –

  • Abhyanga – Massage
  • Snana – Refreshing bath
  • Madhyapana – Administration of medicated alcoholic drinks
  • Charanayudha – flesh of cock
  • Shali anna – Rice and rice preparations
  • Paya – Milk
  • Niruha Vasti – Decoction enemas
  • Maithuna – Sexual intercourse

Bala-sidda ksheera – Milk processed with roots of Sida cordifolia
Rice should be taken with juice of Bala (Sida cordifolia) mixed with Vat alleviating drugs (like castor roots etc), meat soup and salt

Dwiruttara Churna –
Powder of Hingu (Asofoetida), Kushta (Saussurea lappa), Vacha (Acorus calamus), Sarja Kshara (Sodium bicarbonate) and Vida Lavana (Sodium sulphate)

Naracha Churna –
Powder of Sharkara (sugar), Trivrit (Operculina turpethum) and Pippali (Piper longum) with honey at morning. Read more about Naracha Churna

Hingvadi Yoga –
Hingu (Asofoetida) mixed with Saindhava Lavana (Rock salt), Eranda taila (castor oil) and Rasona swarasa (juice of garlic)

Madanadi Phalavarti –
Suppositories made from Madanaphala (Randia dumetorum), Pippali (Piper longum), Kushta (Saussurea lappa), Vacha (Acorus calamus), Sarshapa (mustard), Guda (Jaggery) and Dugdha (milk)

Hingvadi Varti –
Suppositories made from Hingu (Asafoetida), Madhu (honey), Saindhava lavana (Rock salt) smeared with ghee

Apana Vata Vaigunya –
Apana Vayu is one of the 5 subtypes of Vayu which basically controls the lower portion of the body (below navel). Defecation, urination, ejaculation, menstruation all are under its control. By eliminating the toxins from the system Apana Vayu rehabilitates the body and mind every day. If it is disturbed (hyper or hypo), Apana Vayu causes various disorders and disturbs the other types of Vayu too. Disturbance of Apana Vayu may lead to loss of control over the reflexes controlling defecation, urination and ejaculation. Thus Apana Vayu dysfunctions can readily cause PE.

Treatment of Apana Vayu Vaigunya –
Apana Vayu should be treated by helping it gain its normal course and direction i.e. we should guide it downwards. When Apana Vayu gets settled and starts functioning normally, PE will be automatically corrected. The below mentioned will achieve the purpose –

Vatanulomana and Nitya Virechana –
Mild herbal laxatives which are prepared with medicinal herbs will mobilize Apana Vayu in a downward direction and regularize it. They will also keep the bowel clean; detoxify the system by throwing out the cellular metabolites (ama), help in correcting the neuromuscular conductivity and blood supply to the organs related to Apana Vayu and curing PE. The below mentioned are best in controlling the Apana Vayu dysfunctions and also helpful in restoring its functions so as to correct the problems occurring in PE –

  • Gandharvahastadi Kashayam
  • Maharasnadi Kashayam
  • Dhanwantaram gulika
  • Vayu Gulika
  • Gandharvahastadi Eranda Tailam
  • Nimbamritadi Eranda Tailam
  • Brihat Vata Chintamani Ras
  • Vatagajankush Ras
  • Mahavata Vidhwamsini Ras etc

Virechana –
Therapeutic Purgation will help not only in controlling Apana Vayu functioning but also will remove any blocks obstructing its normal functioning. It will correct the metabolic and hormonal errors. The pathology of PE is corrected from the roots.

Vasti –
Vasti or medicated enemas are the best to control and balance all types of Vayu. Pakwashaya or large intestine is said to be the controlling station for all Vayu functions. Therefore whenever there is a Vayu related disorder, the treatment should be targeted towards correction of the morbid Vayu and eliminating it from its place of operation. Vasti is said to be the best treatment in controlling the aggravated Vata / Vayu. It is administered as –

Asthapana / Niruha or Kashaya Vasti (Herbal decoction enemas)
Anuvasana / Matra / Sneha vasti (enemas with medicated ghee/oil/ghee and oil)

Best enemas in PE:
Erandamuladi Niruha Vasti
Mustadi Yapana Vasti
Ashwagandhadi Ghrita Anuvasana Vasti

Snehapana (nitya) –
Daily intake of medicated oils (and ghee) in metered doses is the best remedy for controlling morbid Vayu.

  • Gandharvahastadi tailam
  • Nimbamritadi Eranda Tailam
  • Ksheerabala tailam 101
  • Dhanwantaram 101
  • Tila tailam (sesame oil)
  • Go ghritam (pure cow’s ghee) etc

External Measures:

  • Abhyanga – Sothing massages with medicated oils
  • Padabhyanga – Foot massage with herbal oils.
  • Kaya seka – Stream pouring of medicated oils / milk over the body
  • Shiro dhara – Stream pouring of medicated oils / milk over the head
  • Avagaha – Tub bath / Tub fomentation with herbal decoctions / oils / milk

Avoiding Vata prakopaka ahara vihara –
Avoiding food and life style activities which aggravate Vata include –

Vata Prakopaka Karanani (Causative factors responsible for Vata vitiation): The below mentioned causative factors should be avoided so as to have Apana Vayu under control –

  • Vyayama – Excessive exercises
  • Apatarpana – Fasting in excess
  • Prapatana – Fall, injury
  • Bhanga – Fractures
  • Kshaya – Depletion of tissues
  • Jaagarat – Excessive vigil (awakening all night)
  • Veganam cha vidharanat – Suppression of natural body urges (reflexes)
  • Ati shuchi – Excessive administration of cleansing procedures (Panchakarma)
  • Shaityadi – Excessive consumption of cold foods and activities
  • Traasaat – Fear
  • Ruksha – Excessive consumption of dry foods
  • Kshobha – Irritation
  • Kashaya – Excessive consumption of astringent foods
  • Tikta – Excessive consumption of bitter foods
  • Katu – Excessive consumption of pungent foods
  • Vari-ghanagame – cloudy and rainy season
  • Parinate anne – After the digestion of food
  • Aparahne – Evening

Useful Vataghna drugs (Drugs alleviating Vata) –

  • Eranda – Ricinus communis
  • Bala – Sida cordifolia
  • Atibala – Abutilon indicum
  • Shallaki – Boswellia settata
  • Agnimantha – Clerodendrum phlomidis
  • Guduchi – Tinospora cordifolia
  • Devadaru – Cedrus deodara
  • Kushta – Saussurea lappa
  • Shatavari – Asparagus racemosus
  • Punarnava – Boerhavia diffusa
  • Dashamula – Roots of 10 drugs

Best things to keep Apana Vayu under control –

Treating Vayu:

  • Sneha – Administration of medicated oils / ghee, Massage, oil pouring etc
  • Sweda – Steaming / sudation / sweating therapy
  • Mridu shodanam – Evacuation treatment (mild cleansing treatments like Virechana etc)
  • Svadu bhojana – Consuming sweet foods
  • Amla bhojana – consuming sour foods
  • Lavana bhojana – consuming salt foods
  • Ushna bhojana – Hot and fresh foods
  • Abhyangam – Massage with herbal oils
  • Mardana – Tapping the body with closed fists after application of vata alleviating oils
  • Seka – Pouring of medicated oils over the body in streams
  • Paishtika Madhya – Alcohol or fermented products prepared with flours
  • Goudika Madhya – Alcohol or fermented products prepared with jaggery
  • Snigdhoshna Vasti – Medicated enemas with oils and ghee, given luke warm
  • Deepana pachana sneha – Oils and ghee processed with deepana (appetizer) and pachana (digestant) drugs

Vajikarana – Aphrodisiac therapy:

Vajikarana is the name given for Ayurvedic aphrodisiacs. They not only boost up the sex health, they also tone up the genital system. It provides horsepower with a perspective of sexual performance. Vajikarana is both a Swasthasya urjaskara (restoring health in already healthy individuals) and Artasya Roganut (disease alleviating and modifying type of medicines). They promote physical and mental health. They can be readily used in alleviating PE. The best Vajikara medicines in the business with respect to quick ejacuiaton are:

  • Ashwagandha – Withania somnifera
  • Kapikachchu – Mucuna pruriens
  • Shilajit
  • Vidari – Pueraria tuberose
  • Bhallataka – Semecarpus anacardium
  • Shatavari – Asparagus racemosus
  • Vanga Bhasma
  • Masha – Black gram
  • Tila – Sesame
  • Gokshura churna – Powder of Tribulus terrestris
  • Ksheera – Milk
  • Ghrita – ghee
  • Udumbara churna – Powder of Ficus racemosa
  • Musali – Chlorophytum borivilianum etc

Best Vajikara Ayurvedic medicines for premature ejaculation:

  • Pugapaka
  • Kameshwara modaka
  • Shatavari ghritam
  • Ashwagandha ghrita
  • Chandrodaya ras
  • Pushpadhanwa ras
  • Madanakamadeva ras
  • Kameshwara ras
  • Vangeshwar ras
  • Vanari Gutika
  • Musalyadi churna
  • Siddha makaradhwaj
  • Vasantakusumakara ras
  • Atirasadi Churna – Powder made with Tribulus terrestris, Indian Ginseng, Saffron, Asparagus, etc

Read related: Aphrodisiacs – Ayurvedic Understanding, Useful Herbs

Rasayana –
Rasayana is a name given to those medicines / drugs which rejuvenate the tissues in the body (including reproductive tissue), maintain their proper formation, qualitative and quantitative maintenance and delay the process of ageing. Like Vajikarana, these Rasayana’s too act as Swasthasya Urjaskara and Artasya Roganut medicine and tone up the physical and mental health to optimum. They also relieve the stress, anxiety and depression associated with sexual performance; relax the nerves and helps alleviate PE.

The best Rasayanas for PE are:

Best Rasayana formulations for PE –

Shukra sthambana –
These are the medicaments which delay the ejaculation and at the same time help in controlling excessive sexual drive and anxiety related to it.

Below mentioned are the best medicines which delay ejaculation and ejaculatory responses:

  • Haritaki – Terminalia chebula
  • Jatiphala – Myristica fragrans
  • Puga / Kramuka – Areca catechu
  • Kokilaksha beeja – Seeds of Asteracantha longifolia
  • Lodhra – Symplocos racemosa
  • Samudrashosha – Argyreia nervosa
  • Bala – Sida cordifolia
  • Chandana – Santalum album
  • Yashtimadhu – Glycyrrhiza glabra
  • Mocharasa – Resin of Salmalia malabarica / Bombax malabaricum
  • Kutaja – Holarrhena antidysentrica

Best formulations which act as Sthambana in PE –

  • Vanari Gutika
  • Puga Pak
  • Musalyadi Churna
  • Shalmali Ghrita
  • Vidaryadi Kashayam
  • Vidaryadi Ghritam
  • Shatavaryadi Ghritam
  • Musali Pak
  • Kutajarishtam
  • Lodhrasavam
  • Jatiphaladi churnam
  • Chandanasavam
  • Nagakeshara vati
  • Kutaja Ghana vati
  • Bolabaddha rasa
  • Bola parpati etc

Akarakarabhadi Churna –

  • Powder of Akarakarabha (Anacyclus pyrethrum), Shunti (Zingiber officinale), Kankol (Piper cubeba), Kumkum (Crocus sativus – Saffron), Pippali (Piper longum), Jaiphal (Myristica fragrans), Lavang (clove – Syzygium aromaticum), Chandana (Santalum album) and Ahiphen (opium – Papaver somniferum) should be taken with honey

External application in PE: The below said can be applied over penis, groin and hips as a remedy in PE:

Useful treatments in PE –
Bahya Chikitsa (External treatments):

  • Abhyanga – Massage with medicated oils
  • Taila dhara (Pizhichil) – Stream pouring of medicated oils over the body
  • Taila Shiro dhara – Stream pouring of medicated oils over the head
  • Shiro vasti – Pooling of medicated oil / ghee within a compartment constructed over the head
  • Shiro Abhyanga – Head massage
  • Shiro pichu – Keeping a cotton pad or cloth dipped in medicated oils over the crown of the head and tying it with a cloth or bandage so as to keep it in position for a couple of hours
  • Shiro lepa – Applications of pastes of medicinal drugs on the scalp of the head

The above said treatments will control the functions of Prana Vayu which governs the other Vayu’s. thus the Apana Vayu functions are controlled. Stress, anxiety and depression are said to be the causative or triggering factors for PE. These treatments control the variations happening at the mind level and enable one to have a control over ejaculation and have a satisfying sexual experience.

Best oils for Abhyanga, Dhara and Shiro vasti in PE –

  • Mahamasha Tailam
  • Ksheerabala Taila
  • Tila Tailam
  • Balashwagandhadi Tailam
  • Ashwagandha ghritam
  • Mahanarayana Tailam etc

Ksheera dhara  – Stream pouring of milk processed with medicinal drugs over the head and body
Ksheera Dhara controls the agitated Vayu (Apana Vayu) and Pitta. The excitation and anxiety of mind is brought under control. It provides soothing of nerves and corrects neuromuscular conductivity. Thus it is useful in PE.

Shashtika Shali Pinda Sweda (Navarakizhi)
Shashtika Shali (rice which is grown in 60 days time) processed in milk processed with decoction of Bala mula and Dashamula is tied in clothes and boluses are prepared. They are dipped in the same herbal milk and rubbed over the body following Abhyanga.

This strengthens the muscles and soft tissues, alleviates Vata, and removes pain, numbness, tingling pain and weakness of muscles and body. This is highly effective in PE.

Mamsa Navarakizhi – It is an extension over Shashtika Shali Pinda sweda, but in this meat is used in the preparation. It is more nourishing and rejuvenating.
Patra pinda sweda (Elakizhi) – Leaf bolus / bundle fomentation
Swedana –  Steaming with decoction / milk prepared with Dashamula, Bala mula etc

Abhyantara Chikitsa (Internal treatments):
Snehapana –
Consumption of oils / ghee processed with medicinal drugs is used orally in metered doses on a daily basis.
The below mentioned medicaments are used for Snehapana –

  • Mahamasha Tailam
  • Ksheerabala Tailam
  • Gandharvahastadi Eranda Tailam (for purgation)
  • Nimbamritadi Eranda Tailam (for purgation)
  • Saraswatha Ghritam
  • Panchagavya Ghritam
  • Brahmi Ghritam
  • Kalyanaka Ghritam
  • Guggulutiktakam Ghritam
  • Ashwagandhadi Ghritam

Virechana – Therapeutic purgation
Vasti – Enemas
Kashaya Vasti – Decoction enemas
Dashamula Ksheera vasti
Erandamooladi Kashaya Vasti
Mustadi Yapana Vasti
Raja Yapana Vasti
Sneha Vasti – Enemas with medicated oils / ghee, Mahamasha Tailam, Ksheerabala Tailam, Ashwagandhadi Ghritam, Guggulutiktakam Ghritam etc

Ksheera Vasti – Enemas using milk processed with medicinal drugs
Uttara Vasti – Enemas (decoction or oil) given through urethra

Herbs useful in PE:

  • Shatavari – Asparagus racemosus
  • Ashwagandha – Withania somnifera
  • Rasona – Allium sativum (garlic)
  • Musli – Chlorophytum borivilianum
  • Shilajit – Asphaltum (Mineral pitch)
  • Shigru –Moringa oleifera
  • Jatiphala – Myristica fragrans
  • Haritaki – Terminalia chebula
  • Akarakarabha
  • Kapikachchu

Other herbs useful in PE:

  • Gokshura beeja – seeds of Tribulus terrestris
  • Kokilaksha beeja – Seeds of Asteracantha longifolia
  • Yashtimadhu – Glycyrrhiza glabra
  • Bala – Sida cordifolia
  • Nagabala – Sida veronicaefolia
  • Bhanga – Cannabis sativa
  • Dhattura beeja – Datura metal
  • Sarpagandha – Rauwolfia serpentina
  • Akarakarabha – Anacyclus pyrethrum
  • Samudrashosha – Argyreia nervosa

Modern Treatment options for PE:

PE is a common sexual complaint and also a treatable condition. When it happens infrequently it is not a point of concern. Treatment approach towards PE includes:
Counselling
Medications
Adapting sexual techniques that delay ejaculation
Treatment of PE more or less depends on its nature and classification –

Classification –
About 20 years ago PE was classified as:
Lifelong PE (Primary)
Acquired PE (Secondary)
Recent classification (based on controlled clinical and epidemiological stopwatch studies):
Natural variable PE
Premature-Like Ejaculatory Dysfunction

Other classifications:
Primary PE (lifelong experience of the problem since puberty) and
Secondary PE – problem beginning late in the life
Global PE – occurs with all partners and contexts and
Situational PE – occurs in some situations or with specific partners
Doctor should differentiate PE as a symptom and PE as a syndrome before considering treatment options.
Only individuals with lifelong PE with IELT (Intra-vaginal Ejaculation Latency Time) shorter than 1-1.5 minutes (normal – 6 ½ minutes in 18-30 years old) should require medication as a first option along with or without therapy.
For those in other categories, treatment should consist of:
Patient reassurance (counselling)
Behaviour therapy
Psycho-education to explain that irregular early ejaculation is a Rasnadi Churna, Haridra (Turmeric powder), Methika (fenugreek), Saindhava Lavana (rock salt), Eranda Taila (castor oil) normal variation

Treatments –
Self-help and Behavioural techniques

  • Masturbating and ejaculating an hour or 2 before intercourse (helps delay ejaculation during sex)
  • Distraction methods – Focus attention away from sexual stimulation. Avoiding intercourse for a period of time and focusing on other types of sexual play (extending foreplay or intervening / repeating foreplay techniques again when there is ejaculatory response)
  • Thrust more slowly
  • Withdrawal of penis at the ejaculatory response and re-starting after the response ceases
  • Using more than 1 condom

Topical anaesthetics – Application of numbing creams and sprays such as lidocaine over the penis before sex (Possible side effect – temporary loss of sensitivity and decreased sexual pleasure, allergy)

Oral medications –
Antidepressants – Ex. Sertraline, Paroxetine, Fluoxetine, Clomipramine etc (possible side effects – nausea, dry mouth, drowsiness, decreased libido etc)
Analgesics – like Tramadol delays ejaculation (may have same side-effects like antidepressants)
Phosphodiesterase-5 inhibitors – Sildenafil (Viagra, Revatio), Tadalafil (Cialis, Adcirca) or Vardenafil (Levitra, Staxyn) {possible side-effects – headache, facial flushing, temporary visual changes and nasal congestion}

Counselling –
Talking with mental health provider about your relationships and experiences, details of sex life etc
Helps best when combined with drug therapy

Others:
Cutting down on the use of alcohol, tobacco, illegal drugs
Communication with your partner
Use condom to reduce stimulation of penis
Change positions and bring varieties in sexual intercourse

Psychoanalysis –
According to Freudian theory – rapid ejaculation was a symptom of underlying neurosis. Man suffers unconscious hostility (noe strong evidence) towards women, so he ejaculates rapidly, which satisfies him but on the other hand frustrates his lover who is unlikely to experience orgasm that quickly.
PE could be cured by psychoanalysis
The theory was not successful in curing PE

Sex Therapy –

  • Kegel exercises – to strengthen the muscles of the pelvic floor
  • Masters and Johnson’s ‘stop-start technique’ and ‘squeeze technique’
  • Focus exercises
  • Mind/body coordination exercises
  • Masturbation exercises
  • Deep breathing
  • Whole body massage

Studies and Research:
Nucleus Paragigantocellularis of the brain has been identified as having involvement in ejaculatory control
Study – 91% men who have had PE for their entire lives also had a first-relative with lifelong PE
Study – Men who have PE have a faster neurological response in the pelvic muscles

Epidemiology:

  • PE is a prevalent sexual dysfunction in men
  • About 30% men between adolescence and age 59 reported having experienced PE at least once during previous 12 months, 10% reported erectile dysfunction (Sex in America surveys – 1999 and 2008, University of Chicago)
  • Survey – PE affects 28% men age 65-74 years and 22% men between 75-85 years of age (ED is more common after 60 years in comparison to PE)
  • Overall prevalence – 20-30% (PE very common sexual problem)
  • Estimates vary, but as many as 1 out of 3 men have confessed that they had experienced this problem at some time.
  • Prevalence studies – PE rates are constant across all age groups (misconception-younger men suffer more from PE)

To sum up –
If you have come all the way down reading this material, I think my objective is achieved. It is needless to say that you now know that like any other disorder, Ayurveda expertises in the treatment of quick Ejaculation and related sexual disorders to perfection.

Ahara (food), Nidra (Sleep) and Brahmacharya (Celibacy) are the 3 legs of the tripod of our life. They need to be balanced in terms of quality and quantity throughout our life to make sure that they are coordinating with each other and also helping us live healthily. For this we need to lead a disciplined life. We need all the 3 of them, but there is a time and methodology to consume them.

Sex is not only to reproduce, it is also fun, pleasure and the greatest stress reliever if it is practiced in a right sense. There is neither restriction nor a fixed protocol for doing it. But anything in excess is not good. Sex should be a desire and instinct but not an obsession. To enjoy sex life, our life should be heading in a right way. We should have a relaxed and happy mind to enjoy that part of life. We need to understand Brahmacharya in a broader sense deviating from its traditional meaning ‘abstinence’. Brahmacharya is travelling the journey of life in the pathway drawn by the creation, abiding to its principles. (read more about Brahmacharya – celibacy). Having sex in right proportions and at the right time, with total surrender, involvement and happy mind is a part of Brahmacharya. This is a key to prevent many diseases like PE.
Click to Consult Dr Raghuram Y.S. MD (Ayu)


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Comments

  1. abdulkadar mulla says:

    is there any treatment for sciatica and Parkinson’s I am 64 years

    • Dr Malini Bhat says:

      Dear sir, yes there are treatments for both. I would suggest you to take advise from a Ayurvedic Physician for the same. He or she might lay down the treatment guidelines and the treatment for you seeing your body constitution and other parameters.

  2. the herbal medicines for treament of pe how and from where we can get

    • Dr Malini Bhat says:

      Sir you can find them in any ayurvedic pharmacy. Please do consult a ayurvedic physician before taking the same.

  3. Which treatment in aurved For conceiving problem.

    • Dr J V Hebbar MD(Ayu) says:

      HI, Here are general steps.
      1. Checkup for both husband and wife.
      2. Identify cause of infertility
      3.Treatment for it.
      Please consult a gynecologist for the same.
      Best regards.

  4. Dear Raghuram sir,

    “Having sex in right proportions and at the right time, with total surrender, involvement and happy mind is a part of Brahmacharya”

    1) What do you mean by this? (I could not find the meaning of this in the- “more about Bramacharya – celibacy” article). Is this different from abstinence from sex or masturbation?

    2) Is masturbation not wrong as per Ayurveda / sanathana dharma?

    3) If masturbation is not wrong, then when can one (unmarried male) do it and what is the frequency in a day, week and month to keep oneself sexually healthy?

    4) If masturbation done in a proper way (with only the intention / purpose of keeping sexual system healthy) is it good for sexual health and penis? I feel some where I read “Use it or lose it”. By using it you pump more blood / oxygen and keep it healthy. And also the endocrine system and also the hormonal secretion process right from the pituitary gland to the gonads will remain healthy. If not all these get effected over a long period of time (several years) leading to impotency (just like water gets dried up in an unused borewell for a very long time). How true is this?

    4) if masturbation is wrong, then, does one need to follow celibacy and absitante from any mental or physical masturbation (with no thoughts of sex / fantasies ) until his marriage? If yes, then will it not effect his sexual health if he gets married at the age of 30 (because of following celibacy from 16 years of age till 30 years, i.e. for a very long period) ?

    Please clarify the above genuine doubts as I was not able to find the answers about them any where (including holy scriptures / vatsayana kamasutra ). Appreciate your valuable reply as it will not only help me but also many unmarried males of this country.

    Thank you in advance.

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