Hello
Thanks for query Based on your statement you seem t have problem of Erectile dysfunction and Premature Ejaculation .

It is very common to face these problem of secondary Erectile Dysfunction and premature ejaculation after the age of 40 years.

You need to consult qualified Urologist for clinical assessment and get following basic test done to rule out any organic cause for ED .
1) Blood sugar levels to rule out Diabetes
2) Thyroid hormonal assessment
3) Color Doppler Scan of penis to rule out vascular insufficiency as a cause for your ED .

If there is no obvious organic cause for your Ed detected on above tests your ED can be considered to be Psychogenic in nature and can,be managed with counselling by Psychiatrist .

Taking Sildenafil (Viagra)as on demand will help to get good hard sustainable erection and to have enjoyable sex and delay ejaculation .
Dr.Patil

Dear service user,
Thank you for writing to Healthcaremagic.
I can understand your concerns about erectile dysfunction and premature ejaculations.

Cause of erectile dysfunction should be ruled out for proper treatment. Mostly it is due to stress and anxiety. Situational reasons like fatigue tension or own ''pressure to 'perform' rather to enjoy'' is very common. This seems more likely in your case.
When individuals are highly concerned about their performance and 'unfortunately' focus on their penis for performance, it leads to erectile failure or weak erections.

First erectile failure due to any reason leads one to be worried about next sexual encounter. One focuses constantly on ''how do i perform''. This leads to anxiety and difficulty in erection in subsequent sexual activities. One’s anxiety goes on increasing with every ‘failure’.
Discuss in detail about your problems with your treating Doctor.
Following methods, in combination often help to delay the climax.
1. Stop-start technique of behavior therapy.
2. Female on top with active role.
3. Double condom
4. Medicines like Fluoxetine 20 mg day or Paroxetine CR 25 mg per day.
(To be taken under medical supervision only)
5. Pelvic muscle strengthening exercise. (As if try to hold urine intermittently during voiding)
6. Penile squeeze technique applied at the point of ejaculatory inevitability.
7. Applying a local anesthetic ointment to glans penis prior to penetration.

One can lead the partner to orgasm by stimulating other erogenous zones rather than vaginal containment only.
I recommend you to consult psychiatrist trained in psychosexual medicine, who will guide you how to utilize all these techniques effectively best suited for you.
Warm regards.