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Premature Ejaculation

Premature Ejaculation Assessment

Private, clinician-guided care to help you last longer and restore your confidence.

100% confidential assessment
Licensed clinician review
Prescription treatment when appropriate
Discreet delivery to your door

Your answers are kept 100% safe & private.

PREMATURE EJACULATION

Do you usually ejaculate within 1–2 minutes after penetration?

Yes No

Your answers are kept 100% safe & private.

Have you ever tried any treatment for premature ejaculation?

Yes — prescription medication. Yes — delay techniques or exercises. Yes — over the counter products. No, never tried anything.

Your answers are kept 100% safe & private.

Do you feel you have little or no control over when you ejaculate?

Yes No

Your answers are kept 100% safe & private.

How often does this happen?

Almost always Often Sometimes Rarely

Your answers are kept 100% safe & private.

Does this concern you or affect your confidence or relationship?

Yes No

Your answers are kept 100% safe & private.

Do you experience any of the following?

(Select all that apply)

Pain during ejaculation Pain or burning when passing urine Difficulty passing urine None of the above

Your answers are kept 100% safe & private.

Current medications

Are you currently taking any medication (including herbal remedies or over-the-counter drugs)?

Yes No

If yes, please list them.

Your answers are kept 100% safe & private.

Do you have any known allergies or reactions to medications?

Yes No

Your answers are kept 100% safe & private.

Have you ever been diagnosed with any of the following?

(Select all that apply)

High blood pressure Heart disease Chest pain during activity Stroke None

Your answers are kept 100% safe & private.

Have you recently experienced any of the following?

(Select all that apply)

Depression or low mood Anxiety or stress Loss of interest or motivation None

Your answers are kept 100% safe & private.

Do you have any of the following conditions?

(Select all that apply)

Kidney disease Liver disease Diabetes Prostate problems Seizures/epilepsy None

Your answers are kept 100% safe & private.

Have you had any major illness or surgery in the past?

Yes No

If yes, please give details.

Your answers are kept 100% safe & private.

Do you regularly:

(Select all that apply)

Drink alcohol Smoke Use recreational drugs None

Your answers are kept 100% safe & private.

I understand that:

This is an online medical service A licensed clinician will review my answers Medication will only be prescribed if safe and appropriate I agree to continue

Your answers are kept 100% safe & private.

Side effects

I understand that if I experience side effects, I should stop the medication and seek medical care immediately.

Yes No

Your answers are kept 100% safe & private.

Alcohol use with medication

I understand that alcohol may reduce effectiveness or increase side effects of treatment.

Yes No

Almost Done – Consultation Review

Your information will be reviewed by a licensed healthcare professional shortly.

What Happens Next

Your responses are reviewed by a licensed clinician
A confidential consultation will be conducted via phone call or secure chat
Treatment options tailored to you will be discussed

Your Details

Required for medical consultation and follow-up.

Full Name *

Phone Number *

Email Address *

Home Address *

Preferred Consultation Time (Optional)

To respect your privacy, tell us when it is most convenient to contact you.

Morning (8am–12pm) Afternoon (12pm–5pm) Evening (5pm–9pm) Chat only (no phone call)

Consultation Fee

KSh 699 – Mandatory

Covers: Medical consultation (phone or chat), clinical assessment and professional advice, secure medical records.

Payment Method

Select one to proceed.

M-Pesa Debit / Credit Card

Private Assessment

Premature Ejaculation Assessment

Do you usually ejaculate within 1–2 minutes after penetration?

Have you ever tried any treatment for premature ejaculation?

Do you feel you have little or no control over when you ejaculate?

How often does this happen?

Does this concern you or affect your confidence or relationship?

Do you experience any of the following?

Current medications

Do you have any known allergies or reactions to medications?

Have you ever been diagnosed with any of the following?

Have you recently experienced any of the following?

Do you have any of the following conditions?

Have you had any major illness or surgery in the past?

Do you regularly:

I understand that:

Side effects

Alcohol use with medication

Almost Done – Consultation Review

What Happens Next

Your Details

Preferred Consultation Time (Optional)

Consultation Fee

Payment Method