Dear Doctor, I experience pain when I am about to ejaculate. My partner enjoys performing orally, but the experience is ruined when I am about to climax because the pain is too much. The pain is associated with the tip of my penis which is perhaps oversensitive? I have asked a local sex clinic doctor who has carried out relevant tests but found nothing. I am wondering if there is an ointment I could use to numb the pain.

Dear Friend, you present an interesting situation. I sense from your letter that there is no pain until the climax and that this is a new occurrence.

There are two different nervous systems involved in erection and ejaculation. The cholinergic works the valves and creates the erection but the sympathetic, the fight or flight system, leads to the shoot.

I wonder about how you could affect one system and not the other. This could occur as a scarring from trauma, vascular problems as in diabetes,or post herpetic neuralgia. You mentioned a clear medical check though but herpes can be asymptomatic. After herpes as zoster or genital herpes there can be localized nerve pain since this virus affects sensory nerves.

There is a prescription cream called EMLA, which can numb an area enough to suture. the drawback is that it takes 30-45 minutes to take effect. It also might diminish pleasure if applied too liberally. Possibly something like aspirin or ibuprofen before activity could reduce the pain as well. Ellar, M.D.