Things that help PE

[Kael]

My research and treatments that work so far.
Update: I am placing this update at the top because it is the most important. So far the most effective and most tolerable treatment out of all of my research is LM Kanna extract combined with a PDE5i. I have taken it on a few occasions between 25mg-50mg and measured an IELT of 2 minutes and 30 seconds, where usually I am at 1 minute. I increased the dosage to 80mg sublingual and measured an IELT for 4 minutes and 15 seconds (after 10 minutes of dosing). Also, after the first ejaculation, it becomes extremely difficult to cum, yet it is possible with hard work. I must note that it should be combined with a PDE5i, because it seems to lessen erection quality along with its delaying effect. In combination with a PDE5i though it works very well. Its nice because it kicks in really fast. It can make you a little dizzy with a head rush, but once you know to expect it, it can be kind of enjoyable especially when combined with pleasure. I will post another article with the specific times and dosages that I recorded and everything else in more detail, and cnce I trial it a few more times to dial it in.

One of the greatest things about Kanna, is you can use it mid foreplay, and all of a sudden you will feel it kick in and you know its time for sex. Its almost perfect because its effect on delay works so quickly. You could literally be on the edge, and then boom, it kicks in and extends that edge even further.

Here is a more in depth article I posted on it here:

https://www.reddit.com/r/PrematureEjacu ... _far_part/

Original article:

Research for more encouraging treatments

I have been diving deep into this issue of Premature Ejaculation for the past few months, and trying to find more suitable, tolerable, and encouraging treatments aside from numbing creams and SSRI's. This is an ongoing research process and I will continually report what has been working. I would really love for people to comment on this post and state whether they have tried any of these treatments or not. If you haven't tried them yet and it feels safe and reasonable for you to do so, it would be greatly appreciated if you experimented with some of the treatments and report back. I am not a Doctor, but I absolutely love researching medicine, so this list will be continually updated as it is a passion of mine.

A neurophysiological level

One thing I will state, is this is not a post for physical or emotional techniques. Training yourself to delay ejaculation with slower and more conscious masturbation, start stop techniques, deep breathing, and pelvic floor relaxion exercises might be helpful, but anecdotally doesn't always work for everyone even after consistent effort over a long period of time. This will be purely from a neurophysiological influence through supplements, medicines, or herbs.

Sex frequency can help but...

One thing I experienced that helped with premature ejaculation was being in a relationship with someone I was comfortable with, talking openly about the issue, and then working together towards solving the problem while having a high frequency of sex. This is not always feasible during certain circumstances, as some people live with their spouse for a long period of time, and their frequency of sex eventually decreases. Other people have been single for some time and they may have a lot of performance anxiety entering into a new relationship. Some people even have a hard time controlling their ejaculation even when they are engaging in a high frequency of sex.

What we know might work

Before we get in to this, it will be beneficial for us to understand that much of the medical research involving premature ejaculation seems to involve the serotonergic pathway via agonists of 5ht2c and antagonists of 5ht1a, opioid receptors agonists, and pde5 inhibitors which may relax the smooth muscle tissues involved in ejaculation, decrease central sympathetic output, and act as a peripheral analgesic.


The two most effective and tolerable treatments so far:


L-Tryptophan

This works, it is what I would recommend above most else, and I would recommend trying it first before anything else. After a few days of lower dosages, I took 4 capsules of 500mg and that evening had a hard time ejaculating. A friend of mine was experiencing PE in his relationship, and I told him to take Tryptophan gradually and slowly, starting at one 500mg capsule in the evening, then after 2 weeks two capsules. After about 3 weeks he noticed he could finally last long enough to make his wife have multiple orgasms before he did. What I like about this treatment method is its something you can slowly build up in your system, and should have a cumulative effect. So if you take it slow and steady, even if you have not taken the capsules yet that day, you should notice an ejaculatory delay. If you end up taking L-tryptophan long term, you might want to consider taking L-tyrosine to counteract a potential dopamine depletion in order to maintain balance. If you start to feel a lack of drive, motivation, or excitement after very long term use of tryptophan, that would be a signal to balance and supplement with the right amount of Tyrosine to put you in balance.

The reason this may work is simply increasing the amount of serotonin available.

The bonus with tryptophan is that most people could experience relief from depression, insomnia, and anxiety. Some people on the other hand can experience an adverse reaction; myself included, as I have noticed an increase in anxiety and or insomnia from L-tryptophan. Part of this could be starting at too high of a dose, so its recommended to start very slowly and build up gradually. Another part could be the conversion of tryptophan to quinolinic acid via the kynurenine pathway in the presence of inflammation markers such as indoleamine 2,3 dioxygenase-1 (IDO1) or tryptophan-2,3-dioxygenase (TDO), and or potential deficiencies of serotonergic metabolic cofactors such as b6, niacin, magnesium, folic acid, zinc, and vitamin C. If you have an adverse reaction to Tryptophan you can try priming the body with cofactors (b6,zinc,mg,niacin) for a week or two and then try again, if you can't tolerate it yet, you might need more time, or it may not be for you. You might also experience better effects with 5-htp or a slow release 5-htp supplement. 5-htp bypasses the kynurenine pathway (as far as research has told us) but 5-htp may cause a rise in HPA axis which in theory maybe later be downregulated with lower dosages over a longer period of time. You have to find what works for you.


Dextromethorphan (dm)

Yes, this is essentially what is in Robitussin, and it works extremely well. You literally have to try very hard to cum when you get the dosage right and time it properly. You can get pure dm in Robitussin coughgels liqui-gels. Its a small container of 20 gels that contain 15mg each, and they have no additional cough or cold ingredients. You can experiment with the dosage but around 60mg can be taken about 3 hours before sex, or even the day before having sex. Personal experience was that it helped the first round, and then the second round I found it extremely difficult to cum. I have noticed and also have read other reports that you can actually notice a beneficial effect on ejaculatory latency the 1st or 2nd day afterwards, even when you are no longer on the medication. You might even be better off taking it the day before going on a date or having sex, as you can feel quite strange or weird on it and that might be a little bit uncomfortable unless you are in a very transparent long term relationship and you are totally comfortable and open with the person as to what you just took and why. Dm has binding affinity with both 5-ht2c and 5-ht1a, and I can only assume that it antagonizes/agonizes the right ones albeit inconclusively. It also has been suggested as an off label anti-depressant treatment because it has treatment properties similar to Ketamine. This I would say is an "instant" treatment, its a quick fix, the only problem with it is that it can make me feel slightly anxious, a little strange, and exacerbate insomnia, which can be counteracted by taking a Benadryl (diphenhydramine). Benadryl is not something that you want to be taking consistently over a long period of time as it can cause rebound and dph dependent insomnia, but it does act as a CYP2D6 inhibitor. DM is rapidly metabolized by CYP2D6 into dx, decreasing its bioavailability and potential anti-depressant activity. Taking dph at the time of taking dm could help potentiate its therapeutic effects and reduce the more drug like dx psychotomimetic effects in higher dosages. You might even notice that taking it just once a week prior to the weekend works just right for you.

Here is some very interesting research on it as a rapid acting anti-depressant.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044468/

https://researchrepository.wvu.edu/cgi/ ... ontext=etd

Its also an agonist of the mu, delta, and kappa-opioid receptors.

https://go.drugbank.com/drugs/DB00514

What's interesting is that:

"Mu opioid receptors in PVN centrally mediate ejaculation by regulating the sympathetic outflow. Neurons in PVN projected directly to lumbar spinothalamic cells in Lumbar 3-4 spinal cord. Mu opioid receptors in PVN could inhibit the ejaculation but have no effects on sexual motivation."


Others treatments that are being tested:

Kanna

I have heard reports of this being useful for PE and I have just started taking it in the form of Zembrin 25mg for about 5 days so far. I have not noticed any effect in regards to PE, but it does have an SRI type of action and it has been reported from others to help them with PE. I can only assume that was reported in higher doses, but I suspect that taking lower dosages overtime would have a beneficial and cumulative effect, not necessarily on the amount of medicine that is in the body, but rather its continual effect on serotonergic transmission and neuroplasticity. If it does work I should notice a difference in about 3 weeks, if not I will try higher doses. This I will continue to update.


Update: Lower dosages of Zembrin 25mg did not work, but Lift Mode Kanna extract on demand did.


Ashwagandha

Use of Ashwagandha for 8+ weeks on rats has displayed reduced activity 5-ht1a and increased activity of 5-ht2, which would be the exact mechanism of action required to achieve an effect similar to SSRIs in the treatment of premature ejaculation. What is interesting is that some people using the extract called KSM-66 have reported PSSD or post ssri sexual disfunction symptoms, yet I have not seen anyone report such symptoms with use of non extract regular root powder. This is something I will be trying as well. If you do go this route, I recommend not using the extract, and only the root powder, and you might not see benefits until after about a month. If you do decide to take KSM-66 and experience undesirable PSSD symptoms, then reversal might be possible with taking St. John's Wort, Inositol, or Yohimbine.

https://www.ncbi.nlm.nih.gov/pmc/articl ... 17-169.pdf

Hmmm... here is some evidence that at extreme doses of extract that although EL increased, PSSD symptoms increased as well.

http://www.asiaandro.com/archive/1008-682X/4/295.htm


Tramadol

Ive tried the extended release formula and it didn't really work. The instant release might work better. On-demand use of 50 mg tramadol, taken 2 hours prior to intercourse, exerted a clinically relevant ejaculation delay in men with PE with a 12.7 fold increase in IELT. I don't know if this is something that you want to take everyday, but some people might find it useful.

https://pubmed.ncbi.nlm.nih.gov/16415702/


PDE5 inhibitors

There have been reports and research that Viagra, Cialis, and Levitra have the potential to help prolong ejaculation, whereat Levitra (Vardenafil) seemed to have the strongest effect even adding up to 4+ mins . Even if it is not able to delay ejaculation, reducing refractory time and increasing the hardness could be really beneficial for longer sessions. Even though generics are out for these medications they still seem kind of expensive, but, I think that these could be very useful. I will also be looking into natural PDE5 inhibitors such as ruetin, querctin, or cnidium monnieri. I also think that a PDE5 inhibitor and tramadol would make an excellent combination together.

https://bjui-journals.onlinelibrary.wil ... 10.09646.x

https://pubmed.ncbi.nlm.nih.gov/19474796/

Vardenfail shows the greatest affect amongst all three of the common pde5 inhibitors

https://bjui-journals.onlinelibrary.wil ... jaculation.

https://www.nature.com/articles/ijir201034


Safed Musli

An aqueous extract of safed musli or chlorophytum borivilianum at 125mg/kg/day has been show to increase ejaculatory latency in from 5 min. to 18min. over the duration of 28 days in male rates.

https://www.researchgate.net/publicatio ... _male_rats

It also has anabolic and powerful aphrodisiacal properties

http://www.royanaward.com/files12/Arch% ... 0Behav.pdf


Mucuna Pruiriens

An ethanol extract of mucuna pruiriens increased the ejaculatory latency from 6.4 min. to 22.04 mins using 250mg/kg/day in male rats.

http://royanaward.com/files12/J.Ethnopharmacology.pdf


Zinc

At 5m per day zinc increased ejaculatory latency from 8.15 min. to 11.86 min. in male rats.

https://www.researchgate.net/publicatio ... _male_rats


Herbs that may be helpful yet to a lesser degree:


Anacyclus pyrethrum

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3764879/

https://www.researchgate.net/publicatio ... jaculation


Phoenix dactylifera

https://core.ac.uk/download/pdf/31036952.pdf


Syzygium aromaticum

https://www.researchgate.net/publicatio ... _male_rats


Herbs to avoid:

Although beneficial for libido research shows that these herbs can shorten the time it takes to ejaculate:

Tribulus terrestris

Eurycoma longifolia

Polygonatum verticillatum






link for reddit source https://www.reddit.com/r/PrematureEjacu ... rk_so_far/

[Leb89]

Hey Kael,

thanks for you write up. I want to try out LM Kanna. Can you tell me which exact preparate you use and where you ordered it?

Cheers
Leb

[Kael]

https://www.reddit.com/r/PrematureEjacu ... rk_so_far/

I am not original writer of it.
It is from reddit. There is subreddit that has protocols on it. Just follow the link. Also there are other links in that article just follow it, you will get to know it.

God bless you and hope you get out of this misery soon.