Dear service user, Thank you for writing to healthcaremagic. I have gone through your question and understand your concerns regarding no desire for sex and premature ejaculation and perceived small penis. Decreased desire for sex one of the common symptom seen in anxiety disorders, relationship problems and depression. Low hormonal levels may also cause it. There are several causes of insufficient erections. The common reasons are 1. Diabetes (nerve damage and vessels narrowing) 2. Some medicines like anti depressants and anti psychotics 3. Performance anxiety (the most common reason) 4. Alcohol use (nerve damage and testicular injury) 5. Smoking (vessels narrowing) 6. after some surgical procedures (nerve damage) I advise you to consult a psychiatrist, who will definitely assist you after getting your sexual history, medical history and psychosocial history followed by examination to find out the cause of decreased sexual desire and erectile dysfunction in your case. He will also help you for premature ejaculation. There are effective medicines like Sildenafil or Tadalafil and lifestyle modification which significantly improves erectile dysfunction but, they should be taken only under medical supervision. When clients with premature ejaculation come to my clinic, I recommend them following strategies which in combination often help them to delay the climax. 1. Stop-start technique of behavior therapy. 2. Female on top with active role. 3. Double condom 4. Medicines like Fluoxetine 20 mg day or Paroxetine CR 25 mg per day. (To be taken under medical supervision only) 5. Pelvic muscle strengthening exercise. (As if try to hold urine intermittently during voiding) 6. Penile squeeze technique applied at the point of ejaculatory inevitability. 7. Applying a local anesthetic ointment to glans penis prior to penetration. I hope this will help you. If you have any further questions I will be happy to help. Wish you good health.