Hi,
Your problem is most commonly due to psychological issue like performance anxiety, stress, marital disharmony. It could be due to medical causes like obesity, problem in back nerve, low
testosterone,
diabetes, excessive alcohol and smoking.I would suggest to
consult urologist and undergo complete health check up, routine blood tests, serum testosterone, USG pelvis/scrotum.If all tests will come with in reference range then require sex counseling and psychiatric consultation.
Meanwhile take following advises:Avoid stress during sex, and avoid sex when you feel fatigue/low. Spend more time in forepaly and also do foreplay during sex. Use stop and start technique of sex (divert your mind to some another thing before time of ejaculation). Try women on top position, use double condom and apply
lidocaine gel.
Do pelvic exercise like Kegel's exerciseTake healthy diet and do regular exercise like walking, running for 45-60 minutes followed by medication. Avoid stress, smoking and alcohol. If problem persists then drugs like
Sildenafil, Tetrafol plus and Paroxentine after complete evaluation will help you.
Hope this may help you. Contact further if follow up needed.
Best regards,
Dr. Sagar