Brief Answer:
It needs evaluation first

Detailed Answer:
HI XXXXXXX

Thanks for posting your query .

For Pre mature Ejaculation there are 2 methods :

1. Self Control Methods : While Masturbating just stop before ejaculation , do this many times . Also you can do this even while having sex , just pull out before ejaculation .

2. Medications : There are certain medications called SSRIs which can delay the ejaculation time . But before starting this you need to get your heart , kidney and liver tested to see if they are normal.

For Erectile Dysfunction ( ED ) : For this we need to find out the cause of ED. There are many causes for this like Diabetes , Varicocele, Low serum Testosterone and other Hormonal Imbalances .
I advise you to get the following tests done and revert back :

Fasting Blood Sugar , Postprandial Blood sugar, Scrotal Ultrasound , Serum Prolactin , Testosterone and revert back with reports .

Any clarifications or Queries feel free to ask.
Happy to help you.
Regards.

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Brief Answer:
Still required to get the test done mentioned.

Detailed Answer:
HI XXXXXXX

Thanks for the follow up

I went through your reports . You have Vitamin D deficiency and elevated Homocysteine levels . But these tests results in not related to your Erectile dysfunction or Premature ejaculation problems .

Your doctor has given medications to correct the Vitamin D deficiency and elevated Homocysteine levels Continue those . But you need to get the test mentioned by me earlier also .

Scrotal Ultrasound , Serum Prolactin , Testosterone and revert back with reports .
Any clarifications or queries feel free to ask.
Happy to help you.
Regards.

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Brief Answer:
NOrmal Tests

Detailed Answer:
HI XXXXXXX

Among the tests I have mentioned Serum Prolactin , Testosterone are blood tests which will be done in any good laboratory , no need for any specialised lab.
Scrotal Ultrasound is a scan of your genital region , even this will be done in normal scanning centres .

Also I want you to start doing Kegel's Exercise daily as many times as possible . This will help for you pre mature ejaculation .

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Brief Answer:
Kegel exercise detailed.

Detailed Answer:
Hi XXXXXXX

Kegel exercise will be helpful for both pre mature ejaculation and ED.

Kegel exercise is the exercise of Pelvic floor muscles . First you need to identify pelvic floor muscles .

To identify pelvic floor muscles do the following :

. Try to stop and start your urine stream while you stand at your toilet to
urinate (pee). Try to do this two or three times. The muscles you use to stop your urine flow are your pelvic floor muscles.

Now that you have located your pelvic floor muscles, you can exercise them even
when you do not have to urinate (pee) by following these simple steps:
1. Tighten and hold your pelvic floor muscles for five seconds (count 1 one
thousand, 2 one thousand, 3 one thousand, 4 one thousand, 5 one thousand).
2. Relax your pelvic muscles.
You have just done one Kegel exercise. You should plan to do 10 to 20 Kegel
exercises three to four times each day.

Any clarifications feel free to ask.
Regards.

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Brief Answer:
...

Detailed Answer:
HI

Will be looking forward for your reports .

Good Day .

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Brief Answer:
Reports normal .

Detailed Answer:
HI XXXXXXX

THanks for follow up .

I went through your report , it's normal . So there is no physical problem in you .

NOw I want to ask you one personal question . How is the relation between you and your wife --- I am not asking the sexual life but the normal life ? It is important because one more cause for Erectile dysfunction and Pre mature ejaculation is Stress in the relationship . In that case just resolving the personal issue by taking will help a lot . Sometimes a couple counselling by a psychologist also helps in great deal .

I hope you have started doing Kegel exercise . Your Pre mature ejaculation problem will take time to improve but no need for medicine to be started right now .

For your Erectile dysfunction you can start Tab Tadafinil 10mg 30 minutes before sex . Use this for 2 weeks on as and when required basis and stop after 2 weeks . If problem persists revert back .

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Brief Answer:
There are alternatives.

Detailed Answer:
HI

Since you mentioned that you have taken Viagra I need to know what was the response to it. Did you have a sustained erection with that ? If yes there are alternatives that can be tried without side effects.

You can take either Megalis 10mg or Tadacip 10mg are other alternatives to Viagra. This will not cause headache. They are prescription only medications should be obtained from local practitioner. Please do not take this as my prescription.

Thanks

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Brief Answer:
Try Kegels for 1 month before starting medication.

Detailed Answer:
HI XXXXXXX

Yes it is a temporary solution but few days of normal and sustained erection can make the muscles of penis taut .

For the permanent solution Kegels exercise is the answer but for that you need to be patient . It will take 2 weeks to month to show some effect but it will help for sure .

The same answer for Premature ejaculation also. Keep doing kegels daily .

If no improvement then it would be an indication to start medication. But still if you need to start medication you can start Tab Fluoxetine . Ask your doctor for the prescription.

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Brief Answer:
Happy to answer you .

Detailed Answer:
Thank you XXXXXXX .

Wishing you good health .

Regards.

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Brief Answer:
Mild problem ,

Detailed Answer:
Hi

Sorry i didn't mention that. A cyst is a small fluid filled bubble like lesion . It is very small and hence doesn't require any removal.

Also that is not causing premature ejaculation or Erectile dysfunction. So don't bother about it.

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