Hello dear Understand your concern Following are the causes of erectile dysfunction and premature ejaculation. Stress, low testosterone, prostate enlargement, diabetes, smoking, alcohol, obesity. I would suggest to undergo following test: blood sugar, lipid profile, urine and semen analysis, USG pelvis. Take following advice: Avoid stress and be relax while doing sex, spend more time in the foreplay before intercourse, use double condom or lidocaine gel, try women on top position, do pelvic exercise and walking and yoga, Avoid smoking and alcohol, take high protein diet and antioxidant rich almonds, fresh fruits, green leafy vegetable and almonds, drink plenty of water. If problem persists then you can use sildenafil plus paroxentine after consulting the urologist. Testosterone injection can be given for low testosterone. If infection found then antibiotic is the treatment. Hope this may help you Contact HCM for further health query Best regards Dr. Sagar