Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Premature Ejaculation
Question: Hi,
I'm 29 years old and might get married later this year or next year. I have had a troubled sex life till now. I used to masturbate a lot since childhood (at XXXXXXX 5 times a week). After that I have tried having sexual relations with a friend and a prostitute.Â
I wasn't able to achieve hard enough erection to penetrate my friend. Although I did penetrate her a couple of times, it ended in premature ejaculation lasting only about 10 seconds. Getting an erection immediately was not easy as my penis immediately became flaccid after ejaculation. A couple of times when I did get solid erection, by the time she prepared herself in a penetrative position, my erection died or I ejaculated. This dented my confidence quite a lot.Â
Then I visited a prostitute in Thailand and had intercourse with her. I was keeping myself calm and I guess I had sufficient erection to penetrate (still not hard enough) . This time I thrusted myself slowly and lasted for maybe 30 seconds. Kind of a confident booster but still not good. I had some random kissing sessions with a couple of friends after that and guess what, even during kissing them I ejaculated which prevented myself to go any further.
After that I have been in a serious relationship with a girl who's supposed to be with my fiancee. When I have some foreplay with her I get an erection which is either not very hard or if it's hard I'm not able to sustain it. Since I have not yet had any intercourse with her, I'm unsure of what will happen. This is causing me anxiety attacks now that whether I should marry her or not. I do get morning erections and an occasional nightfall (because i have stopped masturbating as it hurts some nerve on my right leg joint which is because of a sports injury for which doc has prescribed a MRI).Â
So, based on all this you can easily say my mind is currently screwed which I know wont help me in any way possible. Please guide me. I know how ED can be psychological. Since i dont have any major diseases such as sugar etc, I think it might be psychological. But even if it were psychological, I should have been able to perform atleast once till now. Are there any tests or anything which I can do to make sure I'm not spoiling someone's life?
I'm 29 years old and might get married later this year or next year. I have had a troubled sex life till now. I used to masturbate a lot since childhood (at XXXXXXX 5 times a week). After that I have tried having sexual relations with a friend and a prostitute.Â
I wasn't able to achieve hard enough erection to penetrate my friend. Although I did penetrate her a couple of times, it ended in premature ejaculation lasting only about 10 seconds. Getting an erection immediately was not easy as my penis immediately became flaccid after ejaculation. A couple of times when I did get solid erection, by the time she prepared herself in a penetrative position, my erection died or I ejaculated. This dented my confidence quite a lot.Â
Then I visited a prostitute in Thailand and had intercourse with her. I was keeping myself calm and I guess I had sufficient erection to penetrate (still not hard enough) . This time I thrusted myself slowly and lasted for maybe 30 seconds. Kind of a confident booster but still not good. I had some random kissing sessions with a couple of friends after that and guess what, even during kissing them I ejaculated which prevented myself to go any further.
After that I have been in a serious relationship with a girl who's supposed to be with my fiancee. When I have some foreplay with her I get an erection which is either not very hard or if it's hard I'm not able to sustain it. Since I have not yet had any intercourse with her, I'm unsure of what will happen. This is causing me anxiety attacks now that whether I should marry her or not. I do get morning erections and an occasional nightfall (because i have stopped masturbating as it hurts some nerve on my right leg joint which is because of a sports injury for which doc has prescribed a MRI).Â
So, based on all this you can easily say my mind is currently screwed which I know wont help me in any way possible. Please guide me. I know how ED can be psychological. Since i dont have any major diseases such as sugar etc, I think it might be psychological. But even if it were psychological, I should have been able to perform atleast once till now. Are there any tests or anything which I can do to make sure I'm not spoiling someone's life?
Brief Answer:
you can go for serum testosterone and semen analysis
Detailed Answer:
Hello XXXXXXX
Thanks for writing us back.
Following point in your history suggest that you do not have major problem.
- History of masturbation for long.
- Current morning erections and nightfall.
- Ejaculation even with kissing!
These all suggest that you have capacity of erection and ejaculation which are required to satisfy a woman as well as to produce child.
For confirmation that you are physically normal, you can go for following investigations.
- Serum testosterone level : Fasting morning sample should be given and free and total testosterone should be assessed.
- Semen analysis: Do masturbation once, after 3 days of that give sample of semen for analysis. This will give optimum result.
When both these reports will come normal, you can be sure that you can marry without spoiling anyone's life.
Reason for your psycho-sexual problem is performance anxiety. You have tried a lot to prove yourself that you can do sex normally. In trying to do so actively you forgot to enjoy the sex.
Sometime due to fatigue, lack of mood, situational problem or environmental changes man can fail in sex. It is normal phenomenon. This is called performance anxiety. After such failure when person actively thinks about erection or success of intercourse, his mind is likely diverted to such thoughts. For constant erection continuous exciting/romantic/erotic feelings should be there in mind. If mind diverted to concern about erection/ejaculation, erection becomes weak or lost.
Try to enjoy without being conscious about erection or ejaculation.
While doing sex keep yourself relax.
Whenever you go for sex, spare enough time in foreplay. You should not think actively about erection, your mind must be occupied with sexual/romantic feelings. During foreplay your partner should try to arouse you and note that your penis gets erection or not. When she feels that penis is sufficiently erect she herself should try to put erect penis in vagina gradually and you should continue your foreplay feelings without being conscious about ejaculation. You must try to enjoy and only enjoy.
I am sure you can do sex. Practice makes the man perfect. With your wife you will be able to do without any apprehension or in hurry. And also note that even if you cannot succeed after initial attempts, medicines are there to treat psychosexual problem - Clomipramne for premature ejaculation and sildenafil/tadalafil for erection. I think you will not need it.
Revert back to me with reports.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
you can go for serum testosterone and semen analysis
Detailed Answer:
Hello XXXXXXX
Thanks for writing us back.
Following point in your history suggest that you do not have major problem.
- History of masturbation for long.
- Current morning erections and nightfall.
- Ejaculation even with kissing!
These all suggest that you have capacity of erection and ejaculation which are required to satisfy a woman as well as to produce child.
For confirmation that you are physically normal, you can go for following investigations.
- Serum testosterone level : Fasting morning sample should be given and free and total testosterone should be assessed.
- Semen analysis: Do masturbation once, after 3 days of that give sample of semen for analysis. This will give optimum result.
When both these reports will come normal, you can be sure that you can marry without spoiling anyone's life.
Reason for your psycho-sexual problem is performance anxiety. You have tried a lot to prove yourself that you can do sex normally. In trying to do so actively you forgot to enjoy the sex.
Sometime due to fatigue, lack of mood, situational problem or environmental changes man can fail in sex. It is normal phenomenon. This is called performance anxiety. After such failure when person actively thinks about erection or success of intercourse, his mind is likely diverted to such thoughts. For constant erection continuous exciting/romantic/erotic feelings should be there in mind. If mind diverted to concern about erection/ejaculation, erection becomes weak or lost.
Try to enjoy without being conscious about erection or ejaculation.
While doing sex keep yourself relax.
Whenever you go for sex, spare enough time in foreplay. You should not think actively about erection, your mind must be occupied with sexual/romantic feelings. During foreplay your partner should try to arouse you and note that your penis gets erection or not. When she feels that penis is sufficiently erect she herself should try to put erect penis in vagina gradually and you should continue your foreplay feelings without being conscious about ejaculation. You must try to enjoy and only enjoy.
I am sure you can do sex. Practice makes the man perfect. With your wife you will be able to do without any apprehension or in hurry. And also note that even if you cannot succeed after initial attempts, medicines are there to treat psychosexual problem - Clomipramne for premature ejaculation and sildenafil/tadalafil for erection. I think you will not need it.
Revert back to me with reports.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Prasad
Hi doctor, thanks for your response. I masturbated last on Monday around 2 PM. And I gave the sample today Thursday at around 1035 AM. I was just realizing whether did I wait for the right amount of time or did I give the sample too soon?
Brief Answer:
Yes you have kept good duration, this is sufficient
Detailed Answer:
Hello,
Thanks for follow up.
You have masturbated on Monday and given semen on Thursday. This is absolutely fine duration. No need to give other sample.
Take care.
Yes you have kept good duration, this is sufficient
Detailed Answer:
Hello,
Thanks for follow up.
You have masturbated on Monday and given semen on Thursday. This is absolutely fine duration. No need to give other sample.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor,
Attaching my results. I'm particularly worried about low sperm motility and the value of total testoterone being closer to the lower range. Please advise.
Thanks,
XXXX
Attaching my results. I'm particularly worried about low sperm motility and the value of total testoterone being closer to the lower range. Please advise.
Thanks,
XXXX
Brief Answer:
report is fine
Detailed Answer:
Hi XXXXXXX
Thanks for follow up.
Sperm motility is slight low. But it is not a big issue. Just improve your diet with fruits, vegetables and dry fruits.
Testosterone level varies according to time of the day. The best sample is morning fasting sample. You have given the sample after 10.30 am which is likely responsible for lower side value but it is normal so no need to worry at all.
With these reports I can definitely say that you can be father after marriage.
I recommend one supplement for you - tetrafol plus containing pyridoxal-5-phosphate, mecobalamin and l-methylfolate (trade name tetrafol plus) is very helpful in my patients. It has shown improvement in 50-60 patients of mine with ED as well as patients with low or absent libido. You should take it after meal twice a day. You should continue for at least 2 months. You may get this medicine over the counter as it is vitamin product.
Take care and feel free to discuss further.
report is fine
Detailed Answer:
Hi XXXXXXX
Thanks for follow up.
Sperm motility is slight low. But it is not a big issue. Just improve your diet with fruits, vegetables and dry fruits.
Testosterone level varies according to time of the day. The best sample is morning fasting sample. You have given the sample after 10.30 am which is likely responsible for lower side value but it is normal so no need to worry at all.
With these reports I can definitely say that you can be father after marriage.
I recommend one supplement for you - tetrafol plus containing pyridoxal-5-phosphate, mecobalamin and l-methylfolate (trade name tetrafol plus) is very helpful in my patients. It has shown improvement in 50-60 patients of mine with ED as well as patients with low or absent libido. You should take it after meal twice a day. You should continue for at least 2 months. You may get this medicine over the counter as it is vitamin product.
Take care and feel free to discuss further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I'm a lot worried about the report. I checked online about Sperm motility and it looks to be quite on the lower side. Can it be improved with good diet and exercise? Does the immotile sperm being over 50% cause any issue? Does that sperm becomes motile with diet or exercise?
Actually this is causing me more anxiety now. Regarding the tablet that you subscribed, does that need to be taken forever or only for 2 months? I'm also taking a Omega3 fish oil tablet supplement in the afternoons after lunch. Should I continue with that or stop?
Actually this is causing me more anxiety now. Regarding the tablet that you subscribed, does that need to be taken forever or only for 2 months? I'm also taking a Omega3 fish oil tablet supplement in the afternoons after lunch. Should I continue with that or stop?
Brief Answer:
you can take tetrafol plus
Detailed Answer:
Hi,
You are more anxious than you should. Your anxiety in turn can affect your sex life which is likely case. Yes you note it right that sperm motility is on lower side. There is a different aspect to see the report. At least 30% sperms should be with normal morphology according to criteria to be called normal.IN your case it is 60% (almost double). If you have more normal sperms then we can ignore mild lower result of motility. Sperms motility depends on many factors like duration between sample collection and reach to lab, movement of sperm during transportation and duration between lab collection and examination. It is possible that if you can give sample in lab and immediately examination done, better results will be there.
Sperm motility easily improves with overall healthy lifestyle.
Terafol plus is just supplement and no more than 2 months course is required at resent. You can continue Omega3 fish oil tablet.
Be relax and take care.
you can take tetrafol plus
Detailed Answer:
Hi,
You are more anxious than you should. Your anxiety in turn can affect your sex life which is likely case. Yes you note it right that sperm motility is on lower side. There is a different aspect to see the report. At least 30% sperms should be with normal morphology according to criteria to be called normal.IN your case it is 60% (almost double). If you have more normal sperms then we can ignore mild lower result of motility. Sperms motility depends on many factors like duration between sample collection and reach to lab, movement of sperm during transportation and duration between lab collection and examination. It is possible that if you can give sample in lab and immediately examination done, better results will be there.
Sperm motility easily improves with overall healthy lifestyle.
Terafol plus is just supplement and no more than 2 months course is required at resent. You can continue Omega3 fish oil tablet.
Be relax and take care.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
