Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Your symptoms could be due to psychological problem and medical problem like diabetes, hypertension, prostate enlargement, nerve problem, smoking and alcohol use, venous problem. Psychological issues like - anxiety about the performance failures in the bed in past (history of premature ejacualtion). Anxiety about partner s satisfaction, marital disharmony, ongoing stress at home and at work place (if any) and excessive fatigue. I would like to advice you for health check up and get the following test done to rule out any underlying medical concerns in the first place : Fasting and postprandial blood sugar, serum testosterone level, Ultrasound pelvis and scrotum. If all of those investigation results comes within normal range, then you should go for sexual counselling and psychotherapy by visiting a psychiatrist. Otherwise take proper treatment of any medical cause. Meanwhile , following advises will help you: Do regular exercise like walking, yoga, kegel exercise, breathing exercises. Free communication and mutual understanding with partner will help. During sex, you have to give proper time for foreplay before going for penetration. Foreplay should continue even during the intercourse also. Medications that will help after complete evluation: Tetrafol plus and sildenafil. Hope this may help you. Let me know if I can assist you further. Best regards, Dr. Sagar