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Forum Name: Male Sexual Disorders

Question: Small pimple on the front of Penis


 Microman - Tue Dec 19, 2006 7:35 pm

Hi
Im 23 old male, circumsized. I have a small pimple type in front of my penis, where the protective skin is not there. there is no pain at all, just little sensitive when i touch it.
Please tell me what it is, let me know if more detail is needed.

Also when normal the penis is only 1inch and erected is 4- 4.5 inches.

3rd problem is with having unprotective sex im only able to perform max 1-1.5 minutes of constant thrusting in the vagina.

Please answer.. im worried.
 Dr. Tamer Fouad - Wed Dec 20, 2006 1:56 am

User avatar Hello,

Most penile papules do not have a serious cause, but some are infectious and may lead to more serious conditions.

They could be anything from sexually transmitted diseases such as Molluscum contagiousum to warts. Other conditions are not sexually transmitted, eg, an infected sweat gland or hair follicle, pearly penile papules, Fordyce spots, psoriasis or an early penile cancer.

Regarding your second question about penile size, a flaccid penis is normally at least 1.6 inches long, or 2.7 inches when stretched.[1] Erect penis size normally varies between 4 to 8 inches.

The third question is about a condition known as premature ejaculation. Premature ejaculation is best defined as persistent or recurrent ejaculation with minimal stimulation before, on or shortly after penetration, and before the sexual partner wishes it.

Premature ejaculation is thought to be the most common form of male sexual dysfunction, with an estimated prevalence of up to 40 percent.[2]

It is believed to be a psychological problem and does not represent any known organic disease involving the male reproductive tract or any known lesions in the brain or nervous system. Anxiety may play an important role especially in secondary premature ejaculation.

Treatment of ejaculatory dysfunction centers on relationship counseling, behavioral therapy and pharmacologic interventions.

Relationship counseling is of paramount importance because premature ejaculation can create discord and increase the tension surrounding sexual intercourse. An important objective is to relieve any form of performance anxiety on the male.

Behavioral therapy has been considered the gold standard of treatment, with reported success rates ranging from 60 to 95 percent.[2] Techniques include the Seman's pause maneuver, the Masters and Johnson pause-squeeze technique and the Kaplan stop-start method.

The methods can be self-applied, although with suboptimal outcomes; hence, involvement of the sexual partner is essential. Short-term gains can be substantial, but long-term outcomes are less favorable and depend on continued partner involvement.[2]

Because of the limitations of behavioral therapy, pharmacologic interventions are often used to treat premature ejaculation. Anorgasmia and delayed ejaculatory response are well-known side effects of tricyclic antidepressants and selective serotonin reuptake inhibitors (including drugs such as Zoloft).

Studies have shown that these drugs modify the ejaculatory response in men with premature ejaculation.[2,3] In one of these studies,[3] clomipramine (in a dosage of 50 mg per day) and sertraline (in a dosage of 100 mg per day) were found to increase ejaculatory latency from 46 seconds to 5.7 and 4.2 minutes, respectively. Sexual satisfaction was higher with clomipramine, but sertraline was better tolerated and had a better safety profile.

Given the limitations of the internet as a diagnostic tool, you are advised to seek a direct clinical examination to reach the proper diagnosis.

Consultation with a sex therapist, psychologist, or psychiatrist may prove helpful in order to explore psychological issues and to implement behavioral techniques (eg, squeeze-pause).

References:
==========
1. Shamloul, R. Urology, June 2005; vol 65: pp 1183-1185.
2. Balon R. Antidepressants in the treatment of premature ejaculation. J Sex Marital Ther 1996;22:85-96.
3. Kim SC, Seo KK. Efficacy and safety of fluoxetine, sertraline and clomipramine in patients with premature ejaculation: a double-blind, placebo controlled study. J Urol 1998;159:425-7.

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