Brief Answer:
this is due to increase in refractory period, urine examination is needed

Detailed Answer:
Hello,

Thanks for writing to us. I can understand your concern.
Please understand some facts about male sex.

In males there is called 'refractory period' after ejaculation and orgasm. This is the period during which it is physiologically impossible for a man to have additional orgasms.The penis may be hypersensitive and further sexual stimulation may feel painful during this time frame.While the refractory period varies widely among individuals, ranging from minutes to days, most men cannot achieve or maintain an erection during this time. Many perceive a psychological feeling of satisfaction and are temporarily uninterested in further sexual activity.
There are suggested hormonal,neurotransmitter and muscle fatigue theories to specify refractory period.Average period duration varies from 15 to 45 minutes. But it can be less like 1 minute and more like 1 day also.
As age increases duration of refractory period increases.
This is natural phenomenon,not dysfunction we can say and no specific treatment for the same.

In your case as you mentioned you were highly active sexually.Due to frequent intercourse and age your refractory period has been increased likely.
For confirmation you need following investigations.

- Local ultrasound

- Serum testosterone level
If these investigations are normal no need to worry.

As you mentioned burning at the time of urination chances of urinary tract infection is there.

You should go for urine routine-micro examination and after that appropriate antibiotic course.

To regain capacity for frequent intercourse I would recommend abstinence.
Do not go for any type of sexual activity for at least 3 weeks.

Some other approaches are as follows:

There are some natural lifestyle measures which help to improve blood flow to penis and overall sexual performance.

- The most important factor is healthy heart. Blood is pumped in to body by heart.So regular exercise and avoidance of fatty fast food are important measures to prevent heart disease. Regular walking, swimming or running overall improves blood flow to whole body circulation including penis and keep the mind fresh.

- Good healthy food is also an important aspect. Bananas, Garlic, dry fruits(they contains vitamins), eggs, cow milk, cow butter are good food which help in sexual performance.

- Avoid smoking and alcohol. Low amount of alcohol can help in increasing blood flow but more amount can cause opposite effects. So better to avoid the same.

As you are likely form XXXXXXX I would like to also mention ayurvedic medicine option. Tentax forte is the medicine which is used for erectile dysfunction.No side effects has been reported. Two tablets daily at night with a cup of milk should be taken.This may also help to improve your sexual performance.


Hope I am able to clear your doubts.

Regards,
Dr.Chintan Solanki

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Brief Answer:
no possibiity of nerve damage

Detailed Answer:
Hello XXXXXXX

Thanks for follow up.

1. You have good desire of sex. You are achieving erection also. This means there is no nerve damage. If there is nerve damage erection would not possible at all.
In any case if someone has nerve damage treatment depends on duration and severity of problem. Initial stage medicines may work but if problem is chronic it may be irreversible.

2. Because of sex problem you are in too much stress. This stress may lead to depression if your symptoms of excessive thoughts, lack of concentration and sadness continue. Give yourself time. Follow healthy lifestyle with proper food, sleep and exercise. Yoga or medication would help. If symptoms continue and your occupation and/or social life are too much disturbed , consultation of psychiatrist required to evaluate for depression.

Sometime due to fatigue, lack of mood. situational problem or environmental changes man can fail in sex. It is normal phenomenon. However when this failure makes person apprehensive about erection, sex life is affected. This is called performance anxiety. After such failure when person actively thinks about erection or success of intercourse during sex his mind is likely diverted to such thoughts. For constant erection continuous exciting/romantic/erotic feelings should be there in mind. If mind diverted to concern about erection, erection would not be possible.
Give yourself sometime. Do not involve in sexual activity for 4-5 days. Then attempt sex without any thought of failure and relax mind. You will succeed.

Another reason for erection problem may be urinary tract infection.

Revert back to me with reports for more comments.

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Brief Answer:
testosterone supplement needed

Detailed Answer:
Hello XXXXXXX

Thanks for reports.

Yes urine report is clear. Testosterone level is lower.

Low level of testosterone can possible in following situations:

- Depression/stress
- Obesity
- Type 2 diabetes
- Injury to the testicles
- Hormonal disorders
- Infection
- Testicular cancer or treatment for testicular cancer
- Chronic liver or kidney disease

As age progresses testosterone level is reduced in general but not lower than the normal. Stress can reduce testosterone as well as low testosterone which is responsible for erection problem can cause stress. So we need to check what is first there.In your case your main stress is erection problem which is likely due to low testosterone level. Cause for low testosterone level should be checked in your case.You need supplement of external testosterone in form of either capsule or injection. Being an androgen it is strict prescription drug and you need to consult doctor personally for taking it.

I recommend to visit doctor/urologist/sexologist for prescription as well as to rule out other significant causes for low testosterone through examination and relevant investigations.If no specific cause is there stress is likely responsible factor.

Do not be anxious too much, you do not have significant low level. You can be treated and your level will be normal soon.

All the best.

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Brief Answer:
from history no serious condition, you will be cured

Detailed Answer:
Hi XXXXXXX

Thanks for more information.

From history it seems that there is no serious condition likely. Excess sex and stress are likely responsible for testosterone reduction. Testosterone level is controlled by various factors. Sexual activity is one of them. There is complex relation between sexual activity and testosterone level. Excess sex in long run can inhibit testosterone secretion for some time.
Low testosterone is common condition.

In my opinion avoid sexual activity for a week and relax. Go for retesting of testosterone level again preferably early morning sample. Hopefully it will come normal. By chance it comes low again , supplement of testosterone can be given for 4 weeks and gradually withdrawn under doctor's guidance.

Avoid junk food. Take enough vegetables, fruits and dry-fruits. Garlic and cow milk are good food to improve sex power. I recommend to take tentax forte - an ayurvedic product to take daily at night with milk for 8 weeks. It will improve sex power and may also improve testosterone level.

Continue healthy lifestyle and limit your sex life.

You do not have major problem and you will be cured.

All the best.

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