Hello there. Thank you for the question. Premature ejaculation is the most common sexual dysfunction among men yet the exact causes are not fully understood. Yes, you seem to be having lifelong premature ejaculation. Defining premature ejaculation (PE) can be a bit difficult as it is varying culturally.

However, most would consider PE as ejaculating sooner than you or your partner wishes. As for infertility, PE may be the cause if ejaculation occurs before vaginal intromission. If this is not the case, we need to identify if you or your partner have reproductive problems. For this, I would suggest to consult a gynaecologist.

Lifelong premature ejaculation can be attributed to physical, psychological or hereditary factors. Ejaculation is controlled by chemical substances called neurotransmitters in the brain. The neurotransmitter that helps in preventing ejaculation is called serotonin. If the levels of serotonin are disrupted, you may experience premature ejaculation. Besides that, it can also be due to oversensitive penis.

In order to treat lack of serotonin, Selective Serotonin Reuptake Inhibitors (SSRIs) are commonly prescribed as it delays the ejaculation although it was originally developed to treat depression. However, it comes with side effects such as feeling sick, excessive fatigue and sweating.

Another medication called Dapoxetine, a type of SSRI was developed specifically for PE and works faster and it can be taken when needed, preferably several hours before having sex. However, it does not suit those who have liver or kidney problems. For oversensitive penis, anaesthetic cream are available to make the penis less sensitive. As for psychological factor, it can be due to a lifelong trauma. If you think this may be a reason, consult a doctor.

All of these treatment available are inexpensive for most. Including consultation charges, I would say the cost will be under RM 1000.