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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Should Erectile Dysfunction Be Treated?

Hi, may I answer your health queries right now ? Please type your query here...
HELLO SIR, MY PENIS ERECTION LITTLE BIT LOW FOR LAST TWO MONTH... i AM GETTING QUICKLY OFF. STILL I DID NOT GET WED. i HAVE DESIDED TO GET WED WITH IN TWO MONTH. MY PENIS SIZE IS 4.5" WHEN IT ERECT. BUT RECENTLY ERECTION IS SEEMS TO BE LOW.. CAN I SATISFY MY PARTNER. PLEASE NOTE IAM A ASIAN
Wed, 15 Jun 2016
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Psychiatrist 's  Response
Dear service user,
Thank you for writing to healthcaremagic.
I can understand your concerns regarding losing established erection for last couple of months. I can understand that you also have premature ejaculations and there are concerns about partner satisfaction after marriage.
Let me know whether you achieve and maintain a good quality of erection in sleep, in the early morning, during masturbation but not at the time of coitus? If you are able to achieve and maintain erection in any one of the above mentioned situations than your problem is more likely psychological rather than physical.
An occasional episode of erectile failure due to functional or situational reasons like fatigue, tension or own ''pressure to 'perform' rather to enjoy'' is very common. This seems more likely in your case. This happens to newly married ones or those who are likely to get married in near future.
These individuals are highly concerned about their performance and 'unfortunately' focus on their penis for performance.
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’.
Avoid being judge of your own performance. Simply enjoy kindling and joy of lovemaking.
Size of erect penis anything more than 2 inches is sufficient to satisfy the partner. ‘Bigger is better’ logic do not apply here.
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.

I hope I addressed all the concerns properly.
Wish you great sexual life ahead.
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How Should Erectile Dysfunction Be Treated?

Dear service user, Thank you for writing to healthcaremagic. I can understand your concerns regarding losing established erection for last couple of months. I can understand that you also have premature ejaculations and there are concerns about partner satisfaction after marriage. Let me know whether you achieve and maintain a good quality of erection in sleep, in the early morning, during masturbation but not at the time of coitus? If you are able to achieve and maintain erection in any one of the above mentioned situations than your problem is more likely psychological rather than physical. An occasional episode of erectile failure due to functional or situational reasons like fatigue, tension or own pressure to perform rather to enjoy is very common. This seems more likely in your case. This happens to newly married ones or those who are likely to get married in near future. These individuals are highly concerned about their performance and unfortunately focus on their penis for performance. 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’. Avoid being judge of your own performance. Simply enjoy kindling and joy of lovemaking. Size of erect penis anything more than 2 inches is sufficient to satisfy the partner. ‘Bigger is better’ logic do not apply here. 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. I hope I addressed all the concerns properly. Wish you great sexual life ahead.