Hi XXXXXXX

Thank you for writing to us,

Performance deterioration during sexual intercourse can be of many types. I would like to clarify what your problem is precisely. Is it erectile dysfunction? premature ejaculation? (where ejaculation occurs much before time) Or retarded or reduced ejaculation affecting orgasm? painful ejaculation? It would be useful if you gave details about the duration, since when you are experiencing this problem. How was it before that? Do the problems exist even while masturbation or with partner alone?

Has there been any stressful events in your life lately? Do you regularly use alcohol? Has there been any change in the relationship with your partner?

If there are any other details you think may be related or relevant do add it. How your health has been lately, what medications are you on for hypertension? You have mentioned you are case of sugar addict. Can you please elaborate on that? If you been tested for diabetes mellitus then do mention that.

I would like to emphasize that sexual problems are of many kinds and have numerous reasons for the same. That was the reason for asking you so many details. There may have been an incident that has started the problem. There may have been some childhood experiences that has changed things for you. Or there may be other factors causing or maintaining your current problems.

All these can contribute to the problems you are facing and it is not possible to assess you without these details.

Write back with the details,
Dr. A. Rao. Kavoor

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Hi,

Thanks for writing back,

As I have already mentioned, any sexual dysfunction can have multiple causes. In order to treat a particular problem, the underlying cause needs to be explored and resolved. You have mentioned many causes that are frequent contributors. It is quite clear that your problem is most likely a psychological one as opposed to a purely medical one.

Firstly you mentioned peptic ulcer and its treatment have contributed to some extent. What you can do is to see to it that the condition is under control. Check with your doctor regarding the status if symptoms persist. If your complaints or symptoms of the same have resolved then take meals regularly and in more frequent, small amounts to avoid further problems. Avoid anything that contributes to it like smoking or alcohol intake.

I must emphasize that depressive illness is one of the most common causes of sexual dysfunction. And it is one of the most common disorders that go untreated in many people. If this underlying problem does not resolve completely, it is unlikely that your sexual problem will be resolved. There are a number of treatment options available for this including pharmacological and non-pharmacological. I urge you to seek help from a psychiatrist for this.

There are many factors that may be maintaining your problem, like partner’s expectations, demands, a possible communication gap, and following so many failures in your attempts there may be a performance anxiety and a constant anticipation that it may not go right this time. All these can be addressed by a professional as it may be difficult for you to resolve. Coming to the sexual problem as such, there are various techniques in sex therapy (administered by a qualified clinical psychologist) that are taught to reduce problems like premature ejaculation. You will be given exercises in a graded manner for a few weeks which will be easy to follow. It is advised you avoid rapid masturbation as it may lead to premature ejaculation. It would be encouraged to prolong masturbation for a fixed period for eg. 15 minutes each time before ejaculation. Later, use a lotion so that you can get used to more intense stimulation and higher arousal. It will take some time to recover. So be patient.

The positive part being that you used sex as a stress buster and still have good interest in it, you may hope for a fast recovery.

Wishing you the best of health,
I hope this answers your question,
Write back in case of any doubts,
Dr. A. Rao. Kavoor.

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