Brief Answer:
Masturbation does not cause any sex problem, upload image please

Detailed Answer:
Hello XXXXXX,

Thanks fro writing to us.

I can understand your concern.

Masturbation(hand ob) is normal process done by 95% of men during their lifetime. It is safe and effective way to satisfy sexual desire.Specifically in adolescents, unmarried men and married men who are away from wife do the masturbation normally.
It is same process like sex. Just technique differs. It neither affects sexual life nor health of the person.
Though you have masturbate before, it has no relation with current problem.

Night fall in dream is not disease.It is physiological process. In this semen comes out during sleep as there is excessive semen in seminal vesicles.Specifically it occurs when masturbation or sex frequency is less or absent.

Acne can occur due to multiple reasons. masturbation does not responsible for acne. Hormonal disturbance (or changes in hormones after puberty, skin structure of the persons, digestive system problem and overall health are responsible factors. You can use clindamycin gel with adapaline for acne. If acne is sever consult dermatologist for treatment. Antibiotic like doxycyline may be needed.

For different change in shape and size of penis, I need to see image of your penis from different angles. Please take few photographs and upload the same.

During sex you are probably talking about premature ejaculation(uncomfortable and doesn't hold time at all). Treatment of PME is there.Please clarify penis loosen early before ejaculation after ejaculation.

Hope I have answered your query, I will be happy to help further.

Regards,
Dr.Chintan Solanki.

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Brief Answer:
clinically penis is normal,treatment for PME is available

Detailed Answer:
Hello XXXXXXX

Thanks for information and images. Two images can not be opened due to some error(image 163, 174).After seeing images I did not find any abnormality. It seems normal in shape.So no need to worry about the same.

If your ejaculation is early and you are sexually active, treatment for PME is there.
Premature Ejaculation (PME) or early discharge defined when male partner ejaculates early before the female partner reaches to orgasm. There is no absolute time by which we can diagnose PME. It is relative term and female partner is the best judge.

There are medicinal and non medicinal approaches to treat PME.

Medicines:
Clomipramine and paroxetine are choice of medicines which are used as antidepressants(For depression dose is higher).
I prefer clomipramine for PME. No significant side effects with these medicines. Initially say for 20-30 days daily after dinner and later on just on the day when you do the sex.
Paroxetine is more potent but it may cause side effects like headache, gastric discomfort, giddiness and sedation.
One molecule called depoxetine has been used specifically for PME and should be taken before 2 hours of sex when required.
These medicines are prescription medicines and you need to consult doctor/psychiatrist/sexologist for prescription.


Behavioral approaches are as follows:

1. Stop and Squeeze technique can be applied which you can learn from internet and ask me if any query in that.(In brief, method suggests that you should try to divert your mind for a moment when you feel ejaculation arousal and penis should be tightly squeezed with hand inwards by your partner preferably).

2. Master and XXXXXXX technique can also be learnt from qualified sexologist/Psychiatrist which includes sessions in couple as it is couple sex therapy. It can help in prolongation of time.

3. Sex counselling of your sexual behaviour and methods. Like if you are down and female partner on top, gravity is going to help you for lengthening the time.

4. You should do masturbation before sex(at least 2 hours before ). It will make seminal vesicles somewhat empty and at time of sex semen will take more time to come out.

Another approach:
-Use of condoms. Sometime using condom while sex helps in delaying ejaculation by reducing sensitivity of glans penis.

--Topical application of anesthetic gel/spray. For this you have to consult doctor.

Hope I have answered your query.I will be happy to help further.

Regards,
Dr.Chintan Solanki.

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