Ever since my spinal cord injury in 2000, I have had certain sexual problems/frustrations stemming from the rather-unique set of physiological characteristics the injury left me with. In particular, the tendency to prematurely ejaculate, and I mean extremely prematurely. Just a certain touch could bring it on or a kiss or even a thought (if in the right state of mind). And it wouldn’t be an enjoyable orgasm, it would be a very “short-circuited” feeling. I mean, it still felt ok but nothing like what an orgasm should feel like.
Well I struggled with this for years until I happened to stumble on a miracle treatment completely by accident. For starters, let me just say there is basically no effective medical treatment available today for premature ejaculation-other than standard anti-depressant therapy (which has been shown to have the side effect of delaying orgasm). And even that, even with REGULAR premature ejaculation, has an abysmal success rate. And I say regular p.e. because what ails me is not typical. It is a result of nerve malfunctioning and damage and it is way beyond what would typically respond to SSRIs (Ive been on zoloft for 10yrs).
I deal with chronic rotator cuff damage (supraspinatus tendon tears among others) for which I sometimes need analgesic medication. Well I was prescribed tramadol (Ultram) a few years ago for my shoulder pain and it worked fairly well. But what I discovered, after a couple OUTSTANDING experiences, was that my orgasm was BACK BABY when I had the tramadol in my system. It prevented the p.e. and allowed my orgasm to build and gain tension and then explode in pure exctacy-like I remembered an orgasm to be! I have used the medication ever since, judiciously, for both pain-relieving and orgasm-enabling purposes.
I am troubled, however. Troubled at being dependent on a narcotic (I don’t understand why the makers are allowed to get away with marketing tramadol as a non-narcotic, it IS) for what is (hopefully, at least) a lifelong activity (sex). While I am not technically dependent on it to perform, I am dependent on it to have an enjoyable orgasm. So I really want there to be a safer alternative to what I am currently doing, but as of now I see none. Because it is the combination of the SSRI (zoloft) AND the tramadol (which has mild ssri-like effects) that leads to the successful outcome for me. Anything less is failure. It sucks.
Seeing as Tramadol is essentially half anti-depressant, half opioid pain reliever, you might find that antidepressant therapy would work for you.
Heck, I seem to find in a quick Google search that regular opioids actually cause rather than prevent premature ejaculation. That just increases my belief that it is the serotonergic activity that is working. If so, get an SSRI antidepressant, use it in the same way, and it would work the same.
I’m surprised Tramadol works that way for you (glad to hear it does, though). I’ve had a fairly long-term prescription for it due to some chronic pain. For me, regular use simply took sex out of the picture. I’ve cut waaay back to only using it for the “bad days”, mainly because I fear narcotics. The idea of being hooked on something frightens me more than the pain. Does that danger exist with Tramadol?
He said he is on Zoloft, which is an SSRI. My only suggestion is to consider trying another SSRI. Paxil can help people with P.E., but yours is different, so I am not sure.
There has been some research into using low-dose single-use SSRIs to prevent premature ejaculation. I think I saw a med chemist from Lilly(?) give a talk on this ~5 years ago. No idea if anything has been approved.
Yes, doctors currently do prescribe antidepressants off-label to patients to treat P.E. I mentioned this in my OP. However, this therapy, for one, has a pretty low efficacy rate and it wouldn’t work for me. I have been on a standard dose (100mg/day) of an SSRI (zoloft) for many years and have had my severe P.E. despite this. My dose is a fair degree higher than that that would be used for P.E. treatment.
Another thing to note is that most premature ejaculation has roots in psychological, mental or emotional issues. Mine is a direct result of nerve damage from my spinal cord injury and is many times more pronounced. I can’t stress this enough.
This is slightly different. You’ve been on a daily dose. Now granted, it was more focused on the chemistry than the physiology, but the talk I went to was on single doses before sex, in addition to whatever else one might be taking. While it may not be applicable in your situation due to the different mechanism, it may be for anyone else who comes to this thread looking looking for information.
Wow no shit? As for a new ssri, Paxil for premature ejaculation, forget it. Not only will you not ejaculate prematurely, YOU WILL NOT SHOOT AT ALL!!! Yeah, you’ll be stuck with the engine running and unable to hit 1st gear. And it’s not like you can stop if the dose you’re on is adequate and has therapeutic value. Wow go tramado for you “quick-draw-mcgraw’s”
No two people have the same reaction to SSRIs. The sexual effects are notoriously bad.
I’ve been on Paxil, too, you know. It never caused anything like that in me.
I still think it is the serotonergic effects of the tramodol. You probably aren’t taking the maximum dose of your Zoloft, so I’d check there first. (It’s easier to go up than to switch.)
The sertonergic effects of the tramodol are much weaker in comparison to the SSRIs. While I don’t dispute that it has SOME degree of responsibility for the effect, it can’t be the sole (or even main) factor. And the dosage of Zoloft I am on, 100mg, isn’t a low dosage; it’s significantly higher than the dosages prescribed for P.E. treatment.
It did for me, for what it’s worth. On my highest dose I couldn’t get off at all. I took a number of different SSRIs over a period of years and Paxil had the most pronounced “retardant” effect, shall we say. Zoloft did too, actually, but wasn’t as severe.
And I’ve had the same reaction as the OP to tramadol. Pretty sure the opiate-receptor component plays a big part, as I get the same effect from a (single) dose of hydro- or oxycodone… I can last forever, pretty much. Only seems to work well on a single-dose basis, though; if I take tramadol or a traditional opiate for more than two or three consecutive days, my libido goes into hiding, so stamina is a moot point.
One thing I will say is that the dose of tramadol must be very precise in order for the benefits to be reaped. It took a lot of trial and error before I discovered just the right dose. Any more of it and I will not be able to achieve orgasm; any less of it and the orgasm will be “short-circuited” (p.e.) thus not anywhere nearly as enjoyable.
