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Erection Problem,premature Ejaculation
Question: Regarding erection problem and premature ejaculation,should we consult endocrinologist? I am male aged 41...I am not married...but had sex with my previous girl friend 2 years back...even relationship failed..now i am planning to get married
I am thin and weigh 59kg,my height is 6 feet..i am active in work..i do not have diabetics
I am thin and weigh 59kg,my height is 6 feet..i am active in work..i do not have diabetics
Hello Mr XXXXXXX
It seems you are concerned about any possible sexual problems once you get married. And it appears you are worried about not getting a full erection and not lasting long enough for satisfaction.
First of all, it may not be a necessity that you should consult an endocrinologist for this problem per se. But if you think you have certain other issues which could be related to hormonal imbalance, you might do the consultation. There might be a concern about the low levels of male hormones. In such cases, the symptoms involve having a lot of feminine characteristics such as a thin voice. You can certainly consult an endocrinologist to find out any hormonal issues, but as I mentioned earlier, the consultation is not essential for the sexual concerns.
We need to have more information about the erection problem such as masturbation, early morning erection on waking up, etc. Also, it would be important to know if you could have the sexual intercourse without many problems two years back.
A lot of people find it easy to achieve erection while masturbating, but some of them find it difficult to achieve or maintain erection when having sexual intercourse. Please let us know your experience about this. It might help us find a way out.
For a complete resolution of the problem, you can consider consulting a Psychiatrist. You will be able to learn some techniques about how to improve the condition. If you cannot consult a Psychiatrist, let us know. We will discuss some of those techniques in the next reply.
Hope this helps your queries.
Take care.
Dr Abhijeet Deshmukh
MBBS, MD, DPM
Consultant Psychiatrist and Psychotherapist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Doctor for an overview.
When I masturbate, i have erection sometimes not Hard.earlier,when i was young ,erection during nasturbating was hard....when I had sex with my partner earlier erection was not hard and found difficult to penetrate and even could not last 2 strokes..say less than 30-40 seconds and ejaculation happens.she use to hold the penis and say not hard..and she could not feel inside...moreover my tip of the penis is dry and cause very sensitive when we tried oral.....But,whether mastrubating or intercourse...i coulkd not hold on ..it's quick ejaculation and duration is very less.
Yes and one more thing.I tried taking Multi-vitamin tablets and tried sex with her.That time there was a minute difference, as i could hold for few more seconds.But,during intercourse there was no hard erection and duration was minimal..the moment she touches some parts,i get excited and all ends abruptly..although i enjoyed my first experience at 38 years..I realised partner,never felt any..she was 33.
Now a days,when I masturbate,there is only minimal erection and ejaculation is fast.
During my younger days,i dream and use to wet.there was such problems.now it's rare.especially after I had an affair with her and intercourse.
I do not have any feminine bent..my voice is hard with good bass.nothing like female orientation.
Thanks you
When I masturbate, i have erection sometimes not Hard.earlier,when i was young ,erection during nasturbating was hard....when I had sex with my partner earlier erection was not hard and found difficult to penetrate and even could not last 2 strokes..say less than 30-40 seconds and ejaculation happens.she use to hold the penis and say not hard..and she could not feel inside...moreover my tip of the penis is dry and cause very sensitive when we tried oral.....But,whether mastrubating or intercourse...i coulkd not hold on ..it's quick ejaculation and duration is very less.
Yes and one more thing.I tried taking Multi-vitamin tablets and tried sex with her.That time there was a minute difference, as i could hold for few more seconds.But,during intercourse there was no hard erection and duration was minimal..the moment she touches some parts,i get excited and all ends abruptly..although i enjoyed my first experience at 38 years..I realised partner,never felt any..she was 33.
Now a days,when I masturbate,there is only minimal erection and ejaculation is fast.
During my younger days,i dream and use to wet.there was such problems.now it's rare.especially after I had an affair with her and intercourse.
I do not have any feminine bent..my voice is hard with good bass.nothing like female orientation.
Thanks you
Mr XXXXXXX
Thank you for replying with more details. It clarifies to me that you initially wanted to consult an endocrinologist to check if there is any hormonal problem that is causing the reduced hardness of erection and premature ejaculation.
There are some facts you may know about human sexuality. These facts are not usually discussed in a conservative society, and may not be advertised via the internet that often.
1) The strength of erection reduces with age. According to one study, the strength can reduce to as much as 1/4th by the age of 30 years. What it means is not the actual angle of erection, but the hardness. This is normal. However, the hardness should be enough to be able to penetrate during intercourse. And if you are not able to penetrate, you may consider the hardness ineffective.
2) Physical stimulation of the body can bring on ejaculation early.
3) The nervous system is gets habituated to achieving pleasure of orgasm from masturbation. Masturbation provides the stimulation of the palm of the hand, which is a constant stimulation. And during masturbation, there is minimal movement of the hip. But during sexual intercourse, hip movements are there, which send signals to the sexual orgasm for orgasm early.
4) Anxiety can prevent hard erections and a long enough intercourse.
Having read these four facts, let us see how you can start improving your situation now.
First of all, you need to choose which are you want to work on first - erection strength or ejaculation time. Let us discuss the strength issue first.
As you are 41 yrs as of now, the natural erectile strength is expected to be lesser than what you used to have at the age of 20 or 25 yrs. And you should not feel too sad about this. The good news is that you can have erections strong enough for a successful intercourse. You may need to take some extra efforts for this. While masturbating, you may need to include 'deep and regular breathing' as a new feature. What this will do is ensure a regular and full blood supply to the penis. Also, do not hurry up while masturbating. Try to prolong it as much as you can. You can use lubrication if you want, to prolong the sensation. This method will train your nerves to hold on ejaculation for a longer time as well as have a harder erection.
Sexual intercourse is a complete phenomenon. It is not a mechanical act. So, while masturbating, try to visualize each and every step of the intercourse, including foreplay. You brain needs to be trained for holding on ejaculation during actual intercourse. But masturbation is not actual intercourse, so you need to fool the brain for this training.
During masturbation, when the point comes when you feel you are going to ejaculate, try to stop. Take a pause for half a minute. After the wave of feeling has passed, continue. This can train the tissue to sustain the erection for a longer time and also hold on ejaculation for a longer time.
Now, about efforts to prolong the act, there are some techniques you will be able to use when you actually have intercourse.
1. Regular and XXXXXXX breathing. - As is true with masturbation, this technique will give you more time before ejaculation. But more importantly, this will prevent anxiety being produced. Most people never breathe normally during intercourse.
2. Passive position - Take a more passive position to reduce the hip movements at minimum. This means you may have to lie on your back while your partner is on top. The idea is that your hip will not be moving that much, and your ejaculation will be delayed that much.
3. Foreplay - This is important. Do not attempt to enter sooner than is needed. You can do foreplay for as long as you want. This will not only train your system to be used to touch and other stimulation, it will also bring on satisfaction for your partner.
4. Sensate Focus - This is a technique advised by Sex Therapists for couples who have problems of loss of erection, premature ejaculation, etc. You may search on Google for more information. It involves starting with being friends all over again. And slowly making progress towards hugging, kissing, etc. This can really transform your sexual life.
If you are planning to get married soon, and feel that you do not have enough time for trying thee techniques, you can do the following -
1) First of all, talk with your wife about your problems. Do not keep her in dark. Otherwise she might start drawing wrong inferences and might get a negative view of your relationship. If you are going to marry someone you know, you may talk with her even before the marriage. Talking will increase the cooperation from her side, and it will also drastically reduce your anxiety about being able to perform. Performance anxiety is #1 reason for premature ejaculation and loss of erection.
2) You might take help of Sildenafil Citrate (Viagra) for a few days to get accustomed to the new relationship. You can actually prefer Tadalafil, as it has a quicker onset of action and lesser side effects, if at all.
3) You can also consider an anti-anxiety pill for a few days around the time of marriage. You may try it even one of these days. The effect will be best seen during sexual intercourse, however.
I hope this piece of information helps you. Please let me know if you want some clarification or some more information.
Best Regards
Dr Abhijeet Deshmukh
MBBS, MD, DPM
Consultant Psychiatrist and Psychotherapist
Thank you for replying with more details. It clarifies to me that you initially wanted to consult an endocrinologist to check if there is any hormonal problem that is causing the reduced hardness of erection and premature ejaculation.
There are some facts you may know about human sexuality. These facts are not usually discussed in a conservative society, and may not be advertised via the internet that often.
1) The strength of erection reduces with age. According to one study, the strength can reduce to as much as 1/4th by the age of 30 years. What it means is not the actual angle of erection, but the hardness. This is normal. However, the hardness should be enough to be able to penetrate during intercourse. And if you are not able to penetrate, you may consider the hardness ineffective.
2) Physical stimulation of the body can bring on ejaculation early.
3) The nervous system is gets habituated to achieving pleasure of orgasm from masturbation. Masturbation provides the stimulation of the palm of the hand, which is a constant stimulation. And during masturbation, there is minimal movement of the hip. But during sexual intercourse, hip movements are there, which send signals to the sexual orgasm for orgasm early.
4) Anxiety can prevent hard erections and a long enough intercourse.
Having read these four facts, let us see how you can start improving your situation now.
First of all, you need to choose which are you want to work on first - erection strength or ejaculation time. Let us discuss the strength issue first.
As you are 41 yrs as of now, the natural erectile strength is expected to be lesser than what you used to have at the age of 20 or 25 yrs. And you should not feel too sad about this. The good news is that you can have erections strong enough for a successful intercourse. You may need to take some extra efforts for this. While masturbating, you may need to include 'deep and regular breathing' as a new feature. What this will do is ensure a regular and full blood supply to the penis. Also, do not hurry up while masturbating. Try to prolong it as much as you can. You can use lubrication if you want, to prolong the sensation. This method will train your nerves to hold on ejaculation for a longer time as well as have a harder erection.
Sexual intercourse is a complete phenomenon. It is not a mechanical act. So, while masturbating, try to visualize each and every step of the intercourse, including foreplay. You brain needs to be trained for holding on ejaculation during actual intercourse. But masturbation is not actual intercourse, so you need to fool the brain for this training.
During masturbation, when the point comes when you feel you are going to ejaculate, try to stop. Take a pause for half a minute. After the wave of feeling has passed, continue. This can train the tissue to sustain the erection for a longer time and also hold on ejaculation for a longer time.
Now, about efforts to prolong the act, there are some techniques you will be able to use when you actually have intercourse.
1. Regular and XXXXXXX breathing. - As is true with masturbation, this technique will give you more time before ejaculation. But more importantly, this will prevent anxiety being produced. Most people never breathe normally during intercourse.
2. Passive position - Take a more passive position to reduce the hip movements at minimum. This means you may have to lie on your back while your partner is on top. The idea is that your hip will not be moving that much, and your ejaculation will be delayed that much.
3. Foreplay - This is important. Do not attempt to enter sooner than is needed. You can do foreplay for as long as you want. This will not only train your system to be used to touch and other stimulation, it will also bring on satisfaction for your partner.
4. Sensate Focus - This is a technique advised by Sex Therapists for couples who have problems of loss of erection, premature ejaculation, etc. You may search on Google for more information. It involves starting with being friends all over again. And slowly making progress towards hugging, kissing, etc. This can really transform your sexual life.
If you are planning to get married soon, and feel that you do not have enough time for trying thee techniques, you can do the following -
1) First of all, talk with your wife about your problems. Do not keep her in dark. Otherwise she might start drawing wrong inferences and might get a negative view of your relationship. If you are going to marry someone you know, you may talk with her even before the marriage. Talking will increase the cooperation from her side, and it will also drastically reduce your anxiety about being able to perform. Performance anxiety is #1 reason for premature ejaculation and loss of erection.
2) You might take help of Sildenafil Citrate (Viagra) for a few days to get accustomed to the new relationship. You can actually prefer Tadalafil, as it has a quicker onset of action and lesser side effects, if at all.
3) You can also consider an anti-anxiety pill for a few days around the time of marriage. You may try it even one of these days. The effect will be best seen during sexual intercourse, however.
I hope this piece of information helps you. Please let me know if you want some clarification or some more information.
Best Regards
Dr Abhijeet Deshmukh
MBBS, MD, DPM
Consultant Psychiatrist and Psychotherapist
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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