Brief Answer: Hi Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. I can understand your concern related to penis size as it is very distressing condition. It is frequently associated with anxiety and poor self esteem. Let me know about your penis in erected stage and in non-erected stage. Premature ejaculation is a very common and treatable problem. Premature ejaculation is diagnosed when ejaculation time is less than 3 Min, or both partners are not satisfied with sex like in your case (half minute only). Premature ejaculation (PE) is common problem and depends on multiple factors like: **Psychological factors: most common. The psychological factors may include stress, performance anxiety and depression **Medical causes: Reflex activity of ejaculatory system, thyroid problems, diabetes, hypertension, excessive alcohol use and neurological causes. Following steps will be helpful for treatment by increasing ejaculation time: -Treatment of above conditions (if present) after examination. -Start jogging in morning for 20-30 minutes daily, as it reduces performance anxiety and improve blood circulation. - Try distracting yourself when you feel you are about to ejaculate. Take a deep breath and stay relaxed during intercourse. - Do not worry about performance and talk to your partner openly about any apprehensions if you have. Conversation with partner during sex also delay ejaculation. - Stop-start or squeeze-pause technique - In stop start technique, near ejaculation stop all movements, relax and think about something else. Then wait for 1 minute before starting movements. According to number of stops, ejaculation time will come under your control. -Squeeze- pause technique: squeeze the end or the tip of the penis for 10 to 20 seconds when you are close to ejaculation and then resume stimulation after withholding for half a minute. -In many persons woman on top position increases ejaculation time, so try this position and experiment with other positions also. -Condoms with desensitizing creams (marketed as Kohinoor extra time) help in increasing ejaculation time. -As you are newly married, then you also need to know that ejaculation time also increases with experience in sex. Follow all these above methods regularly and your problem will solve in few weeks. You can also seek help of nearby psychiatrist for the problem as they have work experience in marital and sexual clinics during their training. Swelling over some part of body after eating something indicate allergic reaction to that food. You should made list of these food and avoid their intake. Please accept my answer and give feedback in case there is no further query and you found reply helpful. In case of doubt, I am here to help you. Wish you good health. Regards,

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Brief Answer: Hi Detailed Answer: Hello again, Thanks for follow up. Your penis size is normal, there is no need to worry about it. Period between 1 week before and 1 week after the 1st day of menstruation considered as safe period. For contraception safe period method is not very safe, as you already have 3 children. It is better to use oral contraceptive pills and intra-uterine device (IUD) for contraception after consulting gynecologist. 5-10 minute foreplay time is normal for your wife. There is no need to treat it. Your ejaculation time need increment by treatment. Tips to increasing ejaculation time: -Start jogging in morning for 20-30 minutes daily, as it reduces performance anxiety (like feeling panic) and improve blood circulation. - Try distracting yourself when you feel you are about to ejaculate. Take a deep breath and stay relaxed during intercourse. - Do not worry about performance and talk to your partner openly about any apprehensions if you have. Conversation with partner during sex also delay ejaculation. - Stop start technique, near ejaculation stop all movements, relax and think about something else. Then wait for 1 minute before starting movements. According to number of stops, ejaculation time will come under your control. -Squeeze- pause technique: squeeze the end or the tip of the penis for 10 to 20 seconds when you are close to ejaculation and then resume stimulation after withholding for half a minute. -In many persons woman on top position increases ejaculation time, so try this position and experiment with other positions also. Condoms with desensitizing creams (marketed as Kohinoor extra time) help in increasing ejaculation time. If you are not comfortable with condoms, there is no need to use them on every occasion. Use it 20-30% of time. As it will boost your confidence by increasing ejaculation time. Follow all these above methods regularly and your problem will solve in few weeks. You can also seek help of nearby psychiatrist for the problem as they have work experience in marital and sexual clinics during their training. They can give you some prescription medicines (like Dapoxetine, paroxetine or fluoxetine) to increase ejaculation time and to decrease panic. So do not worry and I believe your problem will solve after following my advice. Please accept my answer and give feedback in case there is no further query and you found reply helpful. In case of doubt, I am here to help you. Wish you good health. Regards

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Brief Answer: Hi Detailed Answer: Hello again, Thanks for follow up. There is need for urgent consultation from urosurgeon as your penis size has reduced to 9-10 cm in erected stage (in past query you mention size upto 13-14 cms). For that investigation like penile doppler may be needed to find out cause. Let me know about urosurgeon advice and doppler result in follow up. Penis size between 4 inch and 10 inch usually considered normal in erected stage. Size in non erected stage do not matter for sexual performance. You can discus about oral contraceptive pills and intra-uterine device (IUD) from nearby gynecologist. Or you can ask specialist query from some gynecologist in healthcaremagic platform. Q. What are the treatments available to increase the ejaculation time and let me know the test those needs to be taken to check it. Ans: Method already explained in previous reply and use them at-least for 1 month. Following test needed to understand your case better: -FBS (fasting blood sugar), Complete blood count, Lipid profile -Serum TSH/Prolactin and free testosterone level -Urine routine and microscopy, Semen analysis test Let me review with reports. Q. Please let me know some methods to make the wife to prepare for intercourse quickly. Ans: In my opinion it is not needed. Q. I tried Stop start technique, near ejaculation stopped all movements, relax and thought about something else. Then waited for 1 minute before starting movements. I did not get erection after that stoppage. little bit (droplets) of sperm had ejected. After that that entire night I couldn't able to get required ejection to have sex. Please advise. Apart from the start /stop technique, squeeze past technique and using condoms with desensitizing creams is there any other techniques that are available to increase the ejaculation time. Ans: Atleast follow these techniques for 1 month to see response. There is no short cut to treatment. Other methods I already explained in form of medical management (like Dapoxetine). Let me review with reports (as mentioned above with Urosurgeon opinion) to understand problem better specially related to poor erection. Q.You had advised me to take medicines like Dapoxetine, paroxetine or fluoxetine to increase ejaculation time and to decrease panic after consultation with doctor, Will this have any side effects or future effects like having bone weakness or nervous weakness in future. Please suggest on this. Ans: These medicine do not cause bone or nervous weakness. Even these medicine reduce nervousness. But medicines need to be taken under psychiatrist supervision. Q. During my earlier days of marriage I used to to have sex for several times in a session. Now a days if I do intercourse Once, then I am not able to do the next time for the entire night. Neither I am getting erection nor I am having the energy to involve in it, Please suggest. Ans: Please review with lab reports as mentioned above to understand this issue better. Wish you good health. Regards

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