Hello and welcome to Healthcare Magic. Thanks for your query.

I understand that your concerns about your sexual health and functioning before marriage. Now, to answer your questions:

1) The genital area in males is in fact, colder than the other areas. This is because the sperms in the testes have to be maintained at a lower temperature in order to remain healthy. So, if you are able to get sexually aroused normally, have a normal erection and orgasm / ejaculation, then you don't have to worry about this at all.

2) Regarding passing of 'semen' in urine, there could be two possibilities:
- After ejaculation, there could be one or two small drops of semen in the urinary passage which then comes out when you pass urine soon after ejaculation
- The turbid or whitish discolouration of urine could be due to a symptoms like pain or burning sensation while passing urine, then you need to heve a urine testing done.

3) Your sexual problem of pre-mature ejaculation is a very common problem in young males, especially, in the unmarried. Now, the good news is that in more than 90% of persons with this sexual problem, there is no medical abnormality found. Most of the times, the underlying subconscious anxiety / fears / doubts about inadequate sexual performance (called as "performance anxiety") or a hypersensitive response of the penis or inproper sexual arousal are the underlying causes.

One of the important problems which many young men have before marriage, which causes sexual dysfunction is a subconscious performance anxiety. This can result from the following doubts or fears.
- Doubts that you won't be able to perform well and satisfy your partner.
- Anxiety or fear about ejaculating prematurely.
- Worries about your attractiveness or body image or penis size

So, I would advise you to try the folowing suggestions:

1) First get rid of thoughts that you may be sexually inadequate or dobts that you may not be able to get an proper erection. Remember that sex is not just a physical act but also a psychological process involving an expression of emotions, intimacy and love. So, just involve yourself in those feelings and stop focussing on your "performance" alone.

2) There are certain 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.

3) 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.

So, you can try the above suggestions which I have given and if you follow them correctly - reduce your performance anxiety, improve your confidence and try the sexual techniques, you will be able to get rid of your problem. In case, you still continue to have the problem, then you need to see a sexologist or psychiatrist for a dtailed evaluation.

Wish you all the best.

Dr. Jonas Sundarakumar
Consultant Psychiatrist

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