Brief Answer:
Requires further evaluation to determine cause

Detailed Answer:
Hello and Welcome

I appreciate your concern

Premature ejaculation and Erectile dysfunction are most commonly due to performance anxiety. Sex therapy is a method of counseling which helps you to get rid of performance anxiety and improve interaction between you and your partner w.r.t Sex and relationship.

There are other options available and certain techniques that you may apply that could be of considerable help.

1). stop-start : You should stop just before you feel for ejaculation and wait for some time by diverting your mind to some other thought. Then you may restart again.

2) squeeze : Your partner can squeeze just below the glans penis just before that time when you feel ejaculation is near upon so that your erection goes. Then start again and continue the intercourse.

In Erectile Dysfunction Diabetes, Hypertension, Neurological problems, hormonal deficiencies or imbalance and vascular problems must be ruled out or screened for. A Doppler Ultrasound of penis can look for any vascular compromise if present.

Smoking and excess alcohol consumption should be avoided. Medications that are currently being used may also be enlisted as some medications especially hypertension meds can cause such side effects

Dapoxetine for Premature ejaculation and tadalafil for erectile dysfunction may be prescribed after consultation and due workup with your doctor.

Let me know if you have any query.

wishing you best of health

thanks

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Brief Answer:
Exhaustion due to hyperventilation could be a possibility

Detailed Answer:
hello again,

Hyperventilation or hard breathing during sexual intercourse / masturbation or activity is a psychophysiological mechanism to deepen states of sexual trance. It is an effect rather than a cause.

" hard breathing from the nose " if excessive and unrelated to the stimulus may exhaust the body and have little energy to carry out the sexual act. Deep breathing exercises , yoga and meditation may help in deepening and controlling your breath rather than accelerating the frequency of it.

Let me know if you have any query.

Thanks

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Brief Answer:
consult a urologist

Detailed Answer:
hello again,

Sir, I have mentioned the treatment options as well as the diagnostic workup in my previous answers.

He needs to consult a urologist regarding the erectile dysfunction and premature ejaculation, although your G.P can do other referrals if he deems appropriate. I don't think an ENT consult for checking any nose abnormality would be necessary in this regard, your G.P will suffice in this case.

Thanks.

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