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She showed up at my clinic without an appointment and asked if she could see me for a few minute. D had been my patient for the past five years. She was 32 and a disciplined, thoughtful and caring person.

It was rather unusual for her to show up at my clinic unannounced. I thought she might have some serious problem. Instead, she was beaming with joy as she placed an invitation card on my table.

“Doc, I am getting married,” she said. “Can I invite you to solemnise our marriage?”

I met D’s husband, an engineer on the day of their marriage. He was 36 and seemed introverted, shy and soft spoken.

I expected good news from D when she came for a consultation six months later. Instead, she burst into tears when she saw me.

“Our honeymoon was a disaster” she sobbed. “We could not consummate our marriage.”

Apparently, her husband ejaculated before penetration every time.

“Was he tense? Did it happen every time?” I asked.

“Yes. He was very tense. I asked him to take it easy and encouraged him to try the next day.

“But again there was no success. We tried a few more times and failed. For the past few months, our sexual desires have waned. We hardly attempt sex now and quarrel over this occasionally. We have lost confidence completely and need help.”

D’s husband has a condition called premature ejaculation (PE). An occasional instance of PE might not be cause for concern, but if the problem occurs with more than 50 per cent of attempted sexual relations, a dysfunctional pattern usually exists for which treatment maybe appropriate.

PE is a very distressing and common sexual problem when the man is unable to control ejaculation voluntarily. It is estimated that about 10 to 40 per cent of men have this trouble. It is less common in older men when the threshold for orgasm is raised.

As in D’s case, PE is devastating for a man’s self-esteem and makes the couple unhappy and frustrated. It threatens or can even ruin a marriage, simply because it spoils their sex lives.