hello, welcome to healthcaremagic.com difficulty to get erection, lack of desire to have sexual intercourse, difficulty to perform masturbation, and too early cum; it definitely mounts that you are having a poor and unsatisfied sexual life. 1. for premature ejaculation, i would advice you to take tetramethylfolate along with paroxetine 10 mg at night time. it will enhance your sexual performance time. 2. for difficulty to having adequate ercrtopn, would suggest you for phosphodiesterase inhibitors like sildenafil, if will increase the tumescence. 3. maintain a healthy diet, regular exercise, avoid smoking and alcohol consumption. 4. while having sex maintain healthy sexual practices, active participation by both partners, healthy foreplay acts. before taking any of the above mentioned medications do consult a physician, if possible a psychiatrist near by. for any query in future,don t hesitate to consult me. thank you.