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Suggest treatment for small penis size and premature ejaculation

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Posted on Mon, 16 May 2016
Question: I'm 27y,m,single,I'm masturbating from the age of 12yrs ,I don't know how I started masturbation, this habit came to me naturaly ,at that age I even don't know what is sex,masturbation etcetc,now the problem is with my size(nearly 4 inch but not more than 4inch) and I discharges in 15-20 sec,I visited local surgeon he prescribed me tadafil5,exciter,niloxcin q10(dietary supplement) ,exciter and that i went to urologist in XXXXXXX he replied size normal without checking it in erection mode ,actually my penis is very small without erection,he suggested me agripreg 6g a day and he also suggested to take duralast + tadafil before sexual activity if needed in future.
My query is if I can marry with above problem,as I'm going to be 28 and my parents are forcing for marriage,
2.is above suggestion right or do I need 2nd opinion .
3.I'm very much tense abt size .
4:earlier my ejaculation vol is large & shoots away,now vice versa ie.small volume and drips
Doctor told me to marry but I don't have confidence to marry,I have never engaged in any sex .
Pls reply ,I'm writing u with great hope.
doctor
Answered by Dr. Chintan Solanki (1 hour later)
Brief Answer:
You have only psychological problem likely

Detailed Answer:
Hello XXXXX,

Thanks for contacting me directly with relevant information.

First of all I want to clarify about the masturbation.
Masturbation is natural and normal thing. It is done by 95% of the males in the world, mostly before marriage as well as when wife is away, in menses or pregnant after marriage. It is not at all harmful. Frequency of masturbation done by an individual varies from once a day to once a week. It depends upon individual libido, wish and timing. It neither causes any weakness nor any problem in sexual activity. No need to worry about your habit of masturbation.

I also want to clarify about size of penis.

Normal size of penis in flaccid state is 2 to 4 inches (5 to 10 cm) while in erect position 4 to 7 inches (10 to 15 cm). It varies according to body structure and race. Size of penis does not matter much for satisfying partner.
Anterior 2-3 inches of female vaginal wall is sensitive to sexual stimuli. Only 3.5 inches of erect penis is sufficient to satisfy female. The average girth for an erect penis is 12-13cm (4.7-5.1 inches).

According to the latest diagnostic criteria by DSM 5, premature ejaculation should be defined when there is ejaculation within one minute after entering tin to vagina or even before penetration.
According to DSM - 5 definition, Erectile dysfunction (ED) can be diagnosed when person fails most of the time (say more than 50%) in last 6 months during intercourse. You are able to masturbate that means there is no major issue.

From above information you can understand that there is no physical problem likely.

You can go for serum testosterone level. When it comes normal we can conclude that your sex problem is psychological and not at all physical.

During masturbation early ejaculation is common. You can increase the duration by increasing frequency of masturbation.

Many of the young males like you have concern before marriage about sex life now-a-days. You can go for marriage without any apprehension. At present I also feel that you do not need any medication.

For further guidance I need more information.

- Do you have any physical illness, specifically diabetes or high blood pressure? If yes describe details with medicines.

- Is there any history of history of smoking or alcohol?

- Since when do you have problem?

- When did you do your last successful masturbation?

- Is there any difficulty in urinating?

- Do you have any stress in life? Any emotional or social problem is there?

- Is there morning erection present?

- Are you able to enjoy masturbation? What is frequency of masturbation?

- What is average amount of semen per ejaculation?

- Have you taken any of the above medications? If yes, let me know how did you feel after that.

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

Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (28 hours later)
thnx for looking into the matter,here r answer to ur queries
no physical illness including BP and diabetes, however sometimes I feels BP to be high but found normal,however, at border.
never touched alcohol and tobacco products.
last mastrbate: yesterday, but from somedays I'm not feeling that pleasure at discharge time as I use to get earlier.
no stress.
morning erection: yes
frequency: from age 12-15 5-6 times daily ,after that 3-4time weekly
avg ejac vol: how can I calculate it,also I feels inflammation and mild pain in penis after masturbation which lasts upto 20 hours.
any medication : I visited surgeon in December 15 who prescribed tadafil5 mg,exciter, niloxinq10
all once daily for 20 days.
recently I visited urologist last week who prescribed agripreg 6.5 GM XXXXXXX twice a day.
also I hadn't got answer on problem that my semen now drips instead of shoot out,is it a problem?
also my glans is visible by 40% in normal mode and 20% in erection mode ,urologist told me to better remain in this condition, if u undergo surgery there will be itching problem,if u allow I can attach photo so that u can check.
I always fears when it comes to marriage talk ,I fears partner will make fun after seeing 4 inch and early ejaculation problem.
however both surgeon & urologist told me to marry but om not getting guts to marry,pls help
doctor
Answered by Dr. Chintan Solanki (8 hours later)
Brief Answer:
there is no serious problem

Detailed Answer:
Hi XXXX,

Thanks for information.

From history it is almost clear that you do not have any physical problem.

Due to your concern you visited doctor and he had given medicines which I think are not appropriate. Tadafil should be taken before sex not daily. Other two drugs I could not get the content.

Agripeg contains amino acid so urologist also indirectly conform that you do not have any serious problem.

Performance anxiety sometime plays the role.

Sometime due to fatigue, lack of mood, situational problem or environmental changes man can fail in sex. It is normal phenomenon. However when this failure makes person apprehensive about erection, sex life is affected. This is called performance anxiety. After such failure when person actively thinks about erection or success of intercourse during sex/masturbation 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, erection would not be possible.
Now onward try enjoy masturbation without thinking about erection. Orgasm matters much than erection. Same thing applies when you go for sex.

If you cannot retract your foreskin completely behind glans, circumcision is the best surgery. Please attach photo in erect and in flaccid state with maximum possible retraction of foreskin.

Considering pain after masturbation I recommend following investigations.
- Urine routine-micro
- Semen analysis
- Serum testosterone (total+free) level (morning sample)

Also let me know how you masturbate? (place, position, stimulation material for arousal etc.)
You can calculate the semen amount by measurement of teaspoon like 1 or 2 teaspoonful.

Revert back to me with photos and reports.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (16 hours later)
good evng ,I had attached photos 1st two belongs to erection mode(also pls check size) ,then semen collected (performed without erection just to check ejaculation amount,before this I mastrbtd yesterday 11 PM,and this sample is of morning 11:15 am.
then is flaccid mode.
may I assume all these to be confidential.
do masturbation decreases ejaculation amount,as I told earlier that from age of 12-15 I did it daily for 4-5 times.
I'm facing one more problem im addicted to porn ,from last 3-4 days I'm not getting erections (hard) after watching porn.
I noticed my discharge carefully yesterday ,when penis pumps after going through orgasm,first pumping I gets semen,2nd pumping nothing out ,3rd pump again semen ,this I'm talking that happens in 1 masturbation ,not in 3 mastrbate ,is it normal ,or one should constantly ejaculate in each pumping in 1 mastrbate.
how to prepare myself for marriage,I'm very much feared of consequences ( mujhe lagta hai mera majak banega or partner mujhe nichi najro se dekhega)
doctor
Answered by Dr. Chintan Solanki (12 hours later)
Brief Answer:
photos are not there, please try again or take help of customer care

Detailed Answer:
Hi,

Thanks for information. This communication is totally personal and confidential and you even can delete from our record with your request.

I am sorry that there is no photograph. Please attach them again or ask customer care department to help you out.

First of all understand some normal physiology. Semen production occurs in prostate gland daily after boy reaches to puberty around age of 16.
Semen stored in seminal vesicles of prostate. This stored semen has to come out after sometime to give space to newly produced semen. Normally boys and unmarried male do the masturbation regularly so semen comes out and no excessive storage of semen in seminal vesicles. When there is excess frequency of masturbation/sex and semen production rates becomes relatively lower than of semen production, there is no sufficient semen which can come out after erection, so sometime ejaculation does not occur. This is not a problem. Again person can ejaculate after a break.


When person becomes anxious about erection performance anxiety occurs and affects erection later on as I mentioned above. Give yourself break from watching porn for 1 week.

You have carefully noted your discharge. Yes it is normal sometime person can feels stroke/pumping but semen does not come out as it is still there inside urethra. It is normal, no need to worry.

Mere hisab se tumhe XXXXXXX lagta hai vaisa kuchh nahi hoga. Tum thik tarah se sex XXXXXXX paoge. Photos bhejo or maine XXXXXXX reports ke bare me bola he wo krva lo.

Take care



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (2 days later)
Good evng doctor,my urine microscopic reports are normal except 2 parameters Leucocyte esterase positive,pus cells are 5-7wbc/hpf,while testosterone total 308.99ng/DL(normal),I had attached reports but I'm telling manually coz last time images didn't uploaded.
I had also attached foreskin condition how much it opens in both modes ,also pls comment about size in erection mode,which I thinks small,making me embarrass.
Im unable to find details about u except that u r in naroda,how can I meet u personally ,what r numbers available for appointment/ queries,plz reply,also r u available on Sunday or not,I can come on Sunday only.
Regarding testosterone free it's report ll be available after 3-4 days.
Semen analysis facility isn't available in my area,I have to go to XXXXXXX for that,pending reports ll be available to me by next week,how can I contact u wid den wid my reports,I have to pay 799 once again or is any dere option,
Pls provide me ur contact details, so if possible for me I can meet u personally in ur clinic,
My mail ID is YYYY@YYYY ,
I'm from XXXXXXX very far from ahemdabad,pls provide me details so that I can contact,also I forgot to mention one thing,besides mild pain after masturbation, I also feels inflammation on penis head.
Thanks
doctor
Answered by Dr. Chintan Solanki (11 hours later)
Brief Answer:
antibiotics needed at present

Detailed Answer:
Hello,


Thanks for photographs and reports.Sorry for delayed response.

You have some urinary tract infection and you need antibiotic medicines for the same like ofloxacin. This is likely reason for pain after masturbation. Please consult your family doctor to prescribe medicines after seeing reports. Till then drink lots of water.

From images it seems that you are not able to retract your foreskin completely behind the glans penis. This is likely reason for your erection problem. Otherwise your testosterone level is fine. You should be examined by general surgeon. If there is inflammation of foreskin local tube with mild steroid is given and you should try to retract foreskin gradually manually. If at all it is not possible circumcision is the best option.

Size of penis is not so small to be called abnormal.

Amount of semen is approximately 2 ml which is near normal.

Basically you need treatment for infection, inflammation and tight foreskin (phimosis).

As you are from XXXXXXX and I am from XXXXXXX I think we cannot meet personally. I would like to give one reference. Dr XXXXXXX Mehta is from XXXXXXX XXXXXXX and he is very active on healthcaremagic also. You can consult him personally after searching information. You can mention my name also that I have recommended.

In any case you want to consult me you can contact me directly on

http://bit.ly/drchintansolanki

by creating new account of yours and you may ask query with Rs.599 or you can ask customer care to continue follow up at Rs. 599 if feasible.

or you can email me on YYYY@YYYY and I can give consultation through email with some affordable rates.

Take care dear.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Suggest treatment for small penis size and premature ejaculation

Brief Answer: You have only psychological problem likely Detailed Answer: Hello XXXXX, Thanks for contacting me directly with relevant information. First of all I want to clarify about the masturbation. Masturbation is natural and normal thing. It is done by 95% of the males in the world, mostly before marriage as well as when wife is away, in menses or pregnant after marriage. It is not at all harmful. Frequency of masturbation done by an individual varies from once a day to once a week. It depends upon individual libido, wish and timing. It neither causes any weakness nor any problem in sexual activity. No need to worry about your habit of masturbation. I also want to clarify about size of penis. Normal size of penis in flaccid state is 2 to 4 inches (5 to 10 cm) while in erect position 4 to 7 inches (10 to 15 cm). It varies according to body structure and race. Size of penis does not matter much for satisfying partner. Anterior 2-3 inches of female vaginal wall is sensitive to sexual stimuli. Only 3.5 inches of erect penis is sufficient to satisfy female. The average girth for an erect penis is 12-13cm (4.7-5.1 inches). According to the latest diagnostic criteria by DSM 5, premature ejaculation should be defined when there is ejaculation within one minute after entering tin to vagina or even before penetration. According to DSM - 5 definition, Erectile dysfunction (ED) can be diagnosed when person fails most of the time (say more than 50%) in last 6 months during intercourse. You are able to masturbate that means there is no major issue. From above information you can understand that there is no physical problem likely. You can go for serum testosterone level. When it comes normal we can conclude that your sex problem is psychological and not at all physical. During masturbation early ejaculation is common. You can increase the duration by increasing frequency of masturbation. Many of the young males like you have concern before marriage about sex life now-a-days. You can go for marriage without any apprehension. At present I also feel that you do not need any medication. For further guidance I need more information. - Do you have any physical illness, specifically diabetes or high blood pressure? If yes describe details with medicines. - Is there any history of history of smoking or alcohol? - Since when do you have problem? - When did you do your last successful masturbation? - Is there any difficulty in urinating? - Do you have any stress in life? Any emotional or social problem is there? - Is there morning erection present? - Are you able to enjoy masturbation? What is frequency of masturbation? - What is average amount of semen per ejaculation? - Have you taken any of the above medications? If yes, let me know how did you feel after that. Hope I have answered your query, I will be happy to help further after your response. Regards, Dr.Chintan Solanki.