Hello dear,
Understand your concern.
Following are the causes of premature ejaculation:
fatigue, stress, relationship issues, performance anxiety, alcohol consumption,
diabetes, obesity, tobacco use,
enlarged prostate gland.
So please do health check up to exclude above causes.
Do the following test
Blood sugar, CBC, ESR, PSA, Lipid prfile, hypertension
Take following advice
1. Start exercising, losing weight, stopping smoking and alcohol if you are taking
2. Tablet viagra 50 mg taken about 30 minute to one hour before sexual activity. maximum dose of 100 mg daily or reduced to 25 mg daily.
Do not use more than one time daily
3.
Testosterone Replacement Therapy after consult with doctor
4. Alprostadil urethral suppository-into your
penile urethra,
erection starts within 10-20 minutes and lasts for 30 to 70 minutes.
5. Talk with your doctor and do hormonal profile like testosterone, steroids and thyroid hormone analysis
6. Do discussion with your partner that help in gaining psychological trust
Also take advice regarding sex:
1. Distract your mind from sexual stimulation
2. withdrawing the penis altogether,
3. purposefully ejaculating before sexual intercourse
4. using more than one condom
5. use squeez technique to reduce excessive arousal
6. drug :
paroxetine 10 mg 30-40 min before sex if nedded.
Hope this may help you.
Take care