Hello,
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     32 year old male
•     Complaints of: difficulty in intercourse inspite of normal test reports
•     Concern related to pregnancy.

First in my view you should focus on problem of intercourse. as poor sexual life frequently lead to depression and conflict in couple. Second, sexual problems are treatable in most of the cases if diagnosed correctly.

Please provide me following information which will help me to understand your case and help you better:
•     Duration of marriage.
•     Any history of successful intercourse in past.
•     Describe difficulty you face during intercourse: erection problem or premature ejaculation or both or pain during intercourse.
•     Intravaginal ejaculatory latency time IELT (time taken to ejaculate) : it is better if it measured with clock or stopwatch
•     Any effect of condom on intercourse.
•     Which treatment or techniques you have used and effects.
•     Drug name and doses used by you for this problem
•     Age at which sexual activity was started
•     Frequency of sexual activity
•     Any other information which may have relevance with your problem.
•     Presence of stress, anxiety or depression.

But let me assure you again that sexual problems are very much treatable and I will guide you to overcome it in best possible means.

Waiting for further information

Wish you good health.
Regards,

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Hello again,
Thanks for follow up.

Sexual dysfunction can be a result of a psychological or physical problem.

Psychological causes: Most common cause in young patients. These include performance anxiety, emotional weakness, inferiority complex, stress, marital or relationship problems, low mood, feelings of guilt, and the effects of a past sexual and emotional trauma. Men with psychological problem usually have normal nocturnal erections and erections upon awakening, whereas men with physical problem often do not.

Physical causes: Include neurological disorders, alcoholism, drug abuse, hormonal imbalances, diabetes, hypertension, blood vessel disease and chronic diseases.

I hope you are not taking any alcohol or smoking as sometimes these can also cause erectile dysfunction.

The commonly prescribed drug by the doctors is sildenafil (Viagra) or Tadalafil (Megalis), which causes erections to be stronger and long lasting. It is important to rule out medical conditions specially related to cardiovascular system before starting such treatment. Both of these medicines have excellent result in physical causes of erectile dysfunction.

For premature ejaculation you can use Dapoxetine 30 mg 1 hr before intercourse +/- Kohinoor extra time condom.

With above measures these steps help help you:
-First of all, quit smoking and alcohol (if you are taking any)
-eat a healthy diet
-Have faith in yourself and do not take any stress. You can talk to your partner openly and indulge in plenty of foreplay before sex.
-Exercise, particularly aerobic exercise is very effective.

We need to rule out certain medical conditions. These include diabetes, high blood pressure, heart or thyroid conditions, poor circulation, penile venous incompetency and neurological causes. For that comprehensive evaluation and tests, help of other specialist may also needed.

Apart from that in person evaluation and examination by psychiatrist may be necessary in your case to identify and treat psychological cause of ED.

Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.

Wish you good health.
Regards.

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