Brief Answer:
Following guideline should be followed.

Detailed Answer:
Hello,

Thanks for writing to us. I am trying to solve your problem.

According to your given information, you are MOSTLY suffering from Premature Ejaculation. It can cause sexual dissatisfaction in married life, specially to your partner or wife.

In this condition, male ejaculate very quickly or prior to intimate or actual sexual intercourse with partner. If it combines with erectile dysfunction, then they can cause impotency, loss of libido or infertility.

Premature ejaculation or difficulty in penetration occurs mostly due to psychological causes like stress or anxiety etc rather than physical. Though we need to rule out some underlying causative factors in this context like low testosterone, habit of smoking/alcohol, effect of some drugs, prostatitis or urethritis, varicocele or hydrocele, autoimmune disorder, High BP, Diabetes, thyroid disorder, neurological causes etc.

A complete clinical examination and some investigation are needed to be carried out to confirm diagnosis. I suggest you to consult with XXXXXXX or sexologist for proper guidance regarding this.

Following things are helpful to prevent above condition:

1) Better to quit smoking and alcohol consumption if you have the habit. You may need proper counseling for the same. It should be limited or quit to improve sexual life.

2) Both of you can practice mutual masturbation or do fingering to your partner for widening of vagina. Use water based lubricant also.

3) Take healthy diet with more green vegetables and vitamin supplements, do physical exercise regularly and maintain personal hygiene.

4) Avoid mental stress/ emotional upset/ depression by regular deep breathing/ yoga (15 to 30 min). Need to be more relaxed.

5) Specific Treatment for Premature Ejaculation:

a) Some Controlling Method: Squeeze technique - In this type, female partner needs to start arousing the man. When the man feels that he is almost at the point of ejaculation, she should stop arousing him. She then needs to squeeze the head for between 10 to 20 seconds. She then lets go and waits for another 30 seconds before resuming masturbation. This process is carried out several times before ejaculation is allowed to occur.

Stop-go technique- It is similar to the squeeze technique except that the woman does not squeeze the penis.

b) Kegel exercise or strengthening of PC muscle by contraction and relaxation as on holding & releasing urine. Practice it several times (20-30 times daily): Here, you need to repeatedly contract and relax the muscles you use when you need to hold back urine. It needs to be done by sitting on your chair when you are actually not trying to hold back urine.

c) Use anesthetic gel to desensitize penis or condom for temporary delay. You can get a prescription for this from your physician.

d) Certain drug like Dapoxetine, a class of SSRI,short acting and well approved. This is required only if the exercises don't work. Please try the exercises for 1-2 months before this.

e) Give more time on foreplay to heighten partner's excitation and do actual intercourse (vaginal penetration) at the time of partner climax. Here both of you can get satisfaction/ pleasure.

f) Need proper sleep (at least 6-8 hrs daily) and avoid hot working place and tight underwear.

6) For erectile dysfunction (moderate to severe), you may need to take Sildenafil or Viagra group of drug after consultation with your doctor.

Hope, I have answered your query. Wish you good health and take care yourself.

For future query, you can directly approach me through

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326

Regards,

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