What meds will help me last longer in bed?

Q. I am using Anafranil to keep my wife satisfied. However, it is a huge disappointment when she initiates sex because if I have not taken it, it will be a failure.

A. Premature ejaculation is the most common male sexual dysfunction.

Anafranil is the brand name for Clomipramine, which is a tricyclic antidepressant used to treat depression by restoring two natural chemicals; serotonin and norephinephrine. A side effect is that it can significantly increase the time to ejaculation during sexual activity (penetration or masturbation) from approximately two to eight minutes.

However, it does not work on libido or necessarily the erection. Diminished sexual desire and/or weak erections are reported by some patients on Anafranil.

Medication such as phosphodiesterase (PDE5) inhibitors may work for people with erectile dysfunction and secondary premature ejaculation and improve lack of spontaneity.

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Taking the medication daily may be an option as this may promote spontaneity and take away some of the performance pressure. It is important to manage expectations. A consultation with a doctor to discuss the options of combination therapy would be of benefit.

Always consult your doctor before changing your regimen or dose as there are drug interactions and medical conditions that make it unsafe to do so.

• Dr Tlaleng Mofokeng (MBChB), sexual and reproductive health practice, DISA Clinic, 011-886-2286, visit safersex.co.za.

• Do you have a question about sex? E-mail your questions to lifestyle@sundaytimes.co.za with SEX TALK as the subject. Anonymity assured.