Hello XXXXXXX

Thanks for posting your query. Basically what you are having is erectile dysfunction and premature ejaculation. Both of these are causing sexual dissatisfaction for you and in turn for your partner.

An erection problem is the inability to get or maintain an erection that is firm enough for a man to have intercourse. If the condition persists, the medical term is erectile dysfunction.

Causes may be psychological, smoking, alcohol, illicit drugs and medical conditions like diabetes, high blood pressure, heart or thyroid conditions, poor circulation, low testosterone, depression, spinal cord and neurological causes. To exactly pinpoint a diagnosis you need to get a complete examination done from a urologist.

I will describe some simple measures which you can incorporate and these should help you. First of all, quit smoking and alcohol (if you are taking any), indulge in physical exercise and eat a healthy diet. Have faith in yourself and do not take any stress. You can talk to your partner openly and indulge in plenty of foreplay before sex. Exercise, particularly aerobic exercise is very effective.

If however the symptoms persist then we need to rule out the medical conditions mentioned above. The commonly prescribed drug by the doctors is sildenafil, which causes erections to be stronger and long lasting. However it is not safe to take this drug without a doctor’s advice and moreover it is important to rule out these medical conditions as well.

Regarding the premature ejaculation, it depends on multiple factors , the most common being psychological factors. The psychological factors may include stress and anxiety in daily life and depression due to personal, professional , financial and other social issues. Medical causes of premature ejaculation include abnormal hormone level, reflex activity of ejaculatory system, thyroid problems, diabetes, hypertension and neurological causes.

Try distracting yourself when you feel you are about to ejaculate. Take a XXXXXXX breath and stay relaxed during intercourse. Also do not worry about performance and talk to your partner openly about any apprehensions if you have. Other treatment methods which can be followed are stop-start or squeeze-pause technique.

In stop start technique, near ejaculation withdraw from your partner and relax and think about something else. In squeeze- pause technique, squeeze the end or the tip of the penis for 10 to 20 seconds when you are close to ejaculation and then resume stimulation after withholding for half a minute. If the symptoms persist then desensitizing creams and SRRI (selective serotonin reuptake inhibitors) may need to be prescribed for which you have to consult a urologist. You may need to undergo certain medical tests like for diabetes, thyroid profile and hormonal assay.

Any good urologist in one of the good hospitals in Jaipur can be consulted. Dr XXXXXXX Mehta is a good urologist and you can consult him at XXXXXXX hridyalaya. You can also click on the following link to have a look at his profile: WWW.WWWW.WW
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

---

Hello XXXXXXX

Thanks for writing back. I can understand your concern. It is good that most of the medical causes have been ruled out in your case. Stress can be there due to the erectile dysfunction or premature ejaculation.

What happens is that with these conditions, you start having negative feelings about non performance which gives performance linked anxiety. This makes sex a task rather than a pleasure and then a vicious cycle of stress- erectile dysfunction and premature ejaculation- non performance- stress starts.

Relax, you will be able to lead a normal sex life after appropriate treatment and examination from a urologist. Apart from exercises you may need psychotherapy and medicines as well. For this you should consult a urologist.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

---