Instructions
You are a medical student on placement in general practice in Perth. Your next patient is Thanh Tran, 28, a mine surveyor, on a video call from home in Kalgoorlie about a problem with sex. Your supervisor spoke to him on Monday; the notes are below.
Explain your diagnosis and management plan to the patient
- This is a video consultation; the patient is at home.
- You do not need to take a further history or examine the patient.
The problem (Monday)
Since his first sexual experience at 18 he has ejaculated within about a minute of penetration, sometimes before, nearly every time and with every partner. He cannot hold it back. Partner Ellie for 4 months; he now makes excuses to avoid sex and feels embarrassed and frustrated.
Other symptoms
Erections firm, including on waking. No pain on ejaculation; no urinary, testicular or penile symptoms.
Background
No medical problems; no diabetes or heart problems. No regular medicines; no known allergies. Mood good. No recreational drugs; alcohol socially at weekends; never smoked. Sexual health check with Ellie 4 months ago: all negative.