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Suffering from erectile dysfunction, premature ejaculation and passing smelly urine. Any cure?

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Psychiatrist
Practicing since : 2003
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I am 26 Years old I have following problem

I have masturbation addiction and porn addiction.
Pennies are very soft and suffering from erectile dysfunction and premature ejaculation.
Ejaculation is very short and sperm is very liquid not very thick. No Morning erection.
i am suffering from past one year.

I am having foul smell after the passing the urine.

Kindly let me know whom to contact and how long it will take to cure completely.
Posted Wed, 26 Dec 2012 in Erectile Dysfunction
 
 
Answered by Dr. Jonas Sundarakumar 24 minutes later
Hello and welcome to Healthcare Magic. Thanks for your query.

I will certainly advise you regarding your problems. In order to guide you better, can you please provide the following clarifications...

- How did your sexual problems start (suddenly or gradually)?

- How frequent or how severe is your erectile dysfunction?

- Have there been any problems with your sexual desire / drive (i.e. psychologically)?

- Have you had any sexual relationship before? If so, did you have any problems in your sexual performance?

- How frequently do you practise masturbation? Do you have any guilt associated with it?

- How frequently do you watch porn? Do you feel that you are unable to control this impulse?

- Do you suffer from anxiety, fears, negative thoughts or low mood?

- Do you smoke or consume alcohol or any other drugs?

- Do you have any other medical problems or are you on any medication currently?

Please get back to me with these details and we shall take it forward.

Regards,
- Dr. Jonas Sundarakumar
Consultant Psychiatrist & Sexologist
Above answer was peer-reviewed by
 
Follow-up: Suffering from erectile dysfunction, premature ejaculation and passing smelly urine. Any cure? 17 hours later
- How did your sexual problems start (suddenly or gradually)?
Gradually

- How frequent or how severe is your erectile dysfunction?
It is very severe and frequent. I am having soft erection for few seconds only. No Hard Erection for intercourse

- Have there been any problems with your sexual desire / drive (i.e. psychologically)?
No.

- Have you had any sexual relationship before? If so, did you have any problems in your sexual performance?
No.

- How frequently do you practice masturbation? Do you have any guilt associated with it?
Daily once or twice. Yes I feel very guilt after I finish masturbation. I masturbate by seeing porn.


- How frequently do you watch porn? Do you feel that you are unable to control this impulse?
Three or four time in week. I am unable to control the impulse.

- Do you suffer from anxiety, fears, negative thoughts or low mood?
Yes I suffer from anxiety, fears, negative thoughts and lack of concentration.

- Do you smoke or consume alcohol or any other drugs?
No.

- Do you have any other medical problems or are you on any medication currently?
No.
 
 
Answered by Dr. Jonas Sundarakumar 8 hours later
Hello again and thanks for your clarifications.

Your main and most distressing sexual problem appears to be erectile dysfunction. In fact, this is the most common sexual problem in men. Now, there can be a variety of causes for this problem and often multiple factors are involved. So, the first and most important step in management is a comprehensive evaluation. This will include a detailed medical & sexual history, a thorough physical examination and certain investigations, as per the necessity. This is both informative to the doctor and serves as an opportunity to educate the patient and clarify his doubts.

Firstly, any medical causes (like hormonal disorders, vascular diseases causing poor blood flow, etc.) need to be ruled out. For this, you will need to have a thorough physical examination and certain investigations, as per the necessity. Regarding investigations, you may need to undergo a few blood tests since cetain medical conditions like diabetes, high cholesterol, etc. can lead to sexual dysfunction. Sometimes, hormonal imbalances can also lead to low sexual drive and poor sexual functioning. So, certain additional tests like testosterone level, FSH, LH levels, etc. may be required. Similarly, in order to rule out any blood flow problem to the penis, which could be causing poor erections, a doppler study is sometimes advised to check for the blood flow to the penis.

Having said this, I would also like to let you know that in more than 80% of cases of erectile dysfunction, psychological factors also play a major role in causing or aggravating the problem. Performance anxiety, feelings of sexual inadequacy, self-doubts, guilt, past negative sexual experiences, etc. can all affect sexual functioning and performance. So, removing the person's doubts and fears, and improving his self-confidence levels will also definitely help in improving sexual performance. Sometimes, patients are also advised to have a nocturnal penile tumescence testing done to differentiate between medical and psychological causes.

Secondly, treatment is targeted according to the findings on evaluation. If there are any underlying medical problems resulting in the erectile dysfunction, then those problems have to be first treated. Also, there are certain medication which improve the blood flow to the penis and promote better erection, such as Sildenafil, Vardenafil and Tadalafil.

Now, coming to your next problem of premature ejaculation, there are certain specific sexual techniques like "stop-start technique" or "squeeze technique" which have been proven to be successful in increasing the ejaculatory time. Practising these techniques regularly will prevent your penis from being 'hypersensitive' to sensations and thus avoid pre-mature ejaculation.

In the stop-start technique, the penis can be stimulated (by masturbation) till a point when you feel close to orgasm. Then the stimulation is stopped for a while and again the process is repeated a few times.

In the squeeze technique, the penis can be stimulated (by masturbation) till a point when you feel close to orgasm. At this point the lower part of the head of the penis is squeezed tightly with the index finger and thumb around for a few seconds till the erection decreases. Then the stimulation can be restarted and the process is repeated a few times.

Also, there are certain medication like Dapoxetine (Prilyxet), which can help you with this specific problem of premature ejaculation. But I would advise you to keep this only as a last resort and like I mentioned before, you need a detailed evaluation before starting any medication.

Regarding your problem of excessive masturbation and porn addiction, you can try the following suggestions:

- Firstly, keep your mind active and occupied at all times. Stop being idle. Idle time is not good and your mind will eventually wander away to sexual thoughts. So, find a new hobby or learn something new (like a new sport or a musical instrument); this will keep your mind form being idle and prevent developing these frequent sexual thoughts.

- Regular physical exercise is very important. You can join a gym or have your own exercise schedule. This will not only keep your body healthy but also keep your mind fresh.

- Make plans and goals for your future. You have to make short-term and long-term goals for your life and start working to achieve them. This will keep your mind foccussed and prevent your thoughts from getting scattered.

- Improve your social life. XXXXXXX friends and relatives, go for outings or group activities and keep yourself busy. If you keep staying alone in your room, you are more prone to engage in masturbation frequently.

- You can try yoga and meditation. This can help you develop a discipline of your mind and body and help you get a mastery over your thoughts.

- Remove anything which triggers you into a mood to masturbate. For example, clear your room of all pornographic material; if you access internet pornography, you can disconnect your internet connection, etc.

- Stop thinking and feeling guilty about this all the time. The more you think about it, the more compulsive it becomes. So, get rid of the guilt in your mind and keep your mind relaxed.

- If you feel that you need professional help, then please don't hesitate to consult a psychiatrist for further personal counselling.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist & Sexologist
Above answer was peer-reviewed by
 
Follow-up: Suffering from erectile dysfunction, premature ejaculation and passing smelly urine. Any cure? 6 days later
Firstly, any medical causes (like hormonal disorders, vascular diseases causing poor blood flow, etc.) need to be ruled out. For this, you will need to have a thorough physical examination and certain investigations, as per the necessity. Regarding investigations, you may need to undergo a few blood tests since cetain medical conditions like diabetes, high cholesterol, etc. can lead to sexual dysfunction. Sometimes, hormonal imbalances can also lead to low sexual drive and poor sexual functioning. So, certain additional tests like testosterone level, FSH, LH levels, etc. may be required. Similarly, in order to rule out any blood flow problem to the penis, which could be causing poor erections, a doppler study is sometimes advised to check for the blood flow to the penis.


question : what is the name of the test for above query and whom should i contact for the test uroligist or sexologist ? and suggest any hospital name in coimbatore please


Performance anxiety, feelings of sexual inadequacy, self-doubts, guilt, past negative sexual experiences, etc. can all affect sexual functioning and performance.

i have above problem and what is the cure for the above issue ?
 
 
Answered by Dr. Jonas Sundarakumar 12 hours later
Hello XXXXXXX

I would suggest the following medical investigations:
* Urine routine test (to rule out any urinary or reproductive tract infections and since you have foul-smelling urine)
* Hemoglobin
* Blood sugar
* Testosterone, FSH, LH levels
* Thyroid function test
* Ultrasound doppler of the penis

You can consult either a Urologist or a Sexologist for this - First you need to have a thorough physical examination, including blood pressure checking and a neurological examination, and then have the medical tests.

Ii is better to have these evaluations done in a speciality hospital set up, so that all facilities will be available in one place. You can consider PSG Institute of Medical Sciences in Coimbatore.

Regarding your psychological problems like performance anxiety, masturbatory guilt, porn addiction, etc. you need counselling. There are good and effective psychological techniques which can target all these issues and help you handle your anxiety and gulit. I would also suggest that you join yoga, take up some sports or join a gym, so that all these will help you improve you physical condition as well as relax or distract your mind from the anxiety and negative thoughts.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist & Sexologist
Above answer was peer-reviewed by
 
Follow-up: Suffering from erectile dysfunction, premature ejaculation and passing smelly urine. Any cure? 33 hours later
Regarding your psychological problems like performance anxiety, masturbatory guilt, porn addiction, etc. you need counselling....

what type of the counselling needed ?
 
 
Answered by Dr. Jonas Sundarakumar 11 hours later
Hi XXXXXXX

Conselling will be aimed at:-
- Reducing your anxiety and feas
- Removing your feelings of guilt and self-doubts
- Helping you overcome your addictions to porn, masturbation, etc.
- Improving your self-confidence

The specific counselling methods which can be used to achieve these aims are:-
- Motivational Enhancement Therapy
- Cognitive Behavioural Therapy
- Relaxation therapies, Hypotherapy, etc.

The usual duration of these therapies is 2 to 3 months, where you may have to go for weekly sessions. Counselling can be done by a psychiatrist or a trained psychologist.

Wsh you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist & Sexologist
Above answer was peer-reviewed by
 
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