Consultation for Erection and Premature Ejaculation Issues

Question #27573

45 days ago

245

Consultation for Erection and Premature Ejaculation Issues - #27573

Client_565ffd

Objet : Consultation pour problèmes d’érection et d’éjaculation précoce Bonjour Docteur, Je souhaiterais avoir votre avis concernant un problème sexuel que je rencontre depuis un certain temps. J’ai du mal à maintenir une érection avec ma partenaire. Souvent, l’érection ne dure que quelques secondes et j’éjacule très rapidement, parfois juste lors des préliminaires. Même en me masturbant, l’éjaculation survient en 1 à 2 secondes. La nuit, cependant, je peux avoir des érections normales pendant le sommeil. J’ai déjà utilisé des comprimés de type Cialis, achetés sans ordonnance, mais je ne suis pas sûr de leur efficacité ou sécurité. Quand je pense à une partenaire, je peux parfois avoir une érection, mais elle reste molle et insuffisante. Je souhaiterais savoir : Si je présente une éjaculation précoce sévère. Quelles sont les options sûres et efficaces pour améliorer mon érection et contrôler l’éjaculation. Les examens ou tests que vous recommandez pour comprendre la cause de ce problème.

How long have you been experiencing these sexual issues?:

- More than 6 months

Have you experienced any stress or anxiety related to sexual performance?:

- Yes, a lot

Have you tried any other treatments or therapies for this issue?:

- No, only Cialis

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Doctors' responses

Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

45 days ago

Hello
Your symptoms suggest severe Premature Ejaculation with possible performance-related Erectile Dysfunction.
The fact that you still have normal night erections is a good sign, meaning the physical function is likely normal and anxiety may play a big role.
What can help:
•	Behavioral techniques (start-stop or squeeze method)
•	Pelvic floor exercises
•	Medications prescribed by a doctor if needed (such as Dapoxetine or properly prescribed Tadalafil)
Tests sometimes recommended: blood sugar, testosterone level, and general health check.
⚠️ Avoid taking erectile medicines without medical advice.
Consider consulting a urologist or sexual health specialist for proper evaluation and treatment.
I trust this helps
Thank you
Take care

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Dr. Nikhil Chauhan

I am currently working as a urologist and kidney transplant surgeon at Graphic Era Medical College & Hospital, Dehradun. It's a role that keeps me on my toes, honestly. I handle a pretty wide range of urology cases—stones, prostate issues, urinary tract obstructions, infections, you name it. Some are straightforward, others way more complex than you expect at first glance. Every patient walks in with a different story and that’s what keeps the work real for me. Kidney transplant surgery, though, that’s a whole different zone. You’re not just working on anatomy—you’re dealing with timelines, matching, medications, family dynamics, emotional pressure... and yeah, very precise coordination. I’m part of a team that manages the entire transplant process—from evaluation to surgery to post-op care. Not gonna lie, it’s intense. But seeing someone who’s been on dialysis for years finally get a new shot at life—there’s nothing really like that feeling. In the OR, I’m detail-focused. Outside of it, I try to stay accessible—patients don’t always need answers right away, sometimes they just need to feel heard. I believe in walking them through what’s going on rather than just giving reports and instructions. Especially in transplant cases, trust matters. And clear, honest conversation helps build that. Urology itself is such a misunderstood field sometimes. People ignore symptoms for years because it feels “awkward” or they think it’s not serious until it becomes unmanageable. I’ve had patients who came in late just because they were embarassed to talk about urine flow or testicular pain. That’s why I also try to make the space judgment-free—like whatever it is, we’ll figure it out. At the end of the day, whether I’m scrubbing in for surgery or doing OPD rounds, I just want to make sure what I do *actually* helps. That the effort’s not wasted. And yeah, some days are frustrating—some procedures don’t go clean, some recoveries take longer than they should—but I keep showing up, cause the work’s worth doing. Always is.

44 days ago

Hello, and thank you for sharing your concerns so clearly.
Here is a concise, point-wise assessment of your situation:
Quick Summary
You are experiencing difficulty maintaining an erection and very rapid ejaculation (during sex and masturbation), despite having normal nighttime erections. You have significant performance anxiety.
Key Observations
· Erection Quality: The fact that you have normal erections during sleep suggests the blood flow and nerve function are physically intact. This often points to a psychological or situational cause (like performance anxiety) rather than a physical vascular issue.
· Ejaculation Timing: Ejaculating in 1-2 seconds, even during masturbation, indicates a probable lifelong (primary) severe premature ejaculation.
· Medication: Using Cialis without a prescription is risky. It may not address the root cause (especially if the issue is mainly anxiety or ejaculation control) and can have side effects.
Answers to Your Questions
1. Do I have severe Premature Ejaculation?
· Yes. Ejaculation consistently occurring within about one minute of penetration (or before) is clinically defined as lifelong premature ejaculation.
2. What are the safe options for Erection and Ejaculation control?
· For Anxiety: This is a major trigger. Therapy (CBT) or medication to manage anxiety can significantly help.
· For Erection: Prescription PDE5 inhibitors (like Cialis or Viagra) are effective, but they must be prescribed by a doctor after a check-up to ensure they are safe for your heart and to find the right dose.
· For Ejaculation: Doctors often prescribe specific SSRI medications (daily or on-demand) or topical anesthetics to help delay ejaculation. Behavioral techniques (like the “squeeze technique”) are also very effective.
3. What tests do you recommend?
· A physical exam of the genitals.
· Blood tests: Testosterone levels, blood sugar (diabetes check), and lipid profile.
· A specific ultrasound (Doppler) of the penile vessels is usually only needed if medications fail, but given your nighttime erections, it may not be the first step.
Next Step: You need a combined treatment plan. Do not rely on over-the-counter tablets. A consultation will help us create a tailored approach to manage both the anxiety and the physical symptoms simultaneously.
Please book a consultation for a full assessment and prescription.
Dr. Nikhil Chauhan
Urologist

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Dr. Nirav Jain

I am a qualified medical doctor with MBBS and DNB Diploma in Family Medicine from NBEMS, and my work has always been centered on treating patients in a complete, not just symptom based way. During my DNB training I rotated through almost every core department—Internal medicine, Pediatrics, Obstetrics & Gynecology, Surgery, Orthopedics, ENT, Dermatology, Psychiatry, Emergency medicine. That mix gave me the skill to manage acute illness, long term disease and preventive care together, something I find very important in family practice. In psychiatry I worked closely with patients who struggled with depression, anxiety, stress related problems, insomnia or substance use. I learned not just about medication but also about simple psychotherapy tools, psycho education and how to talk openly without judgement. I still use that exp in family medicine, specially when chronic disease patients also face mental health issues. My time in General surgery included assisting in minor and major procedures, managing wounds, abscess, sutures and emergencies. While I am not a surgeon, this gave me confidence to recognize surgical cases early, provide first line care and refer fast when needed, which makes a big difference in online or OPD settings. Now I work as a consultant in General medicine and Family practice, with focus on both in-person and online consultation. I treat conditions like fever, infections, gastrointestinal complaints, respiratory illness, and also manage diabetes, hypertension, thyroid disorders, and lifestyle related chronic diseases. I see women for PCOS, contraception counseling, menstrual health, and children for common pediatric issues. I also dedicate time to preventive health, lifestyle counseling and diet-sleep-exercise advice, since these small changes affect long term wellness more than we often realize. My key skills include holistic diagnosis, evidence based treatment, chronic disease management, mental health support, preventive medicine and telemedicine communiation. At the center of all this is one thing—patients should feel heard, safe, and guided with care that is both professional and personal.

39 days ago

Bonjour,
Merci d’avoir expliqué votre situation en détail.
D’après ce que vous décrivez, il semble que vous puissiez avoir deux problèmes possibles : une éjaculation très rapide et une difficulté à maintenir une érection. L’éjaculation qui survient en quelques secondes peut correspondre à ce que l’on appelle Éjaculation Précoce.
Le fait que vous ayez des érections normales pendant le sommeil est un point important. Cela suggère souvent que les mécanismes physiques fonctionnent normalement et que le problème peut être lié à l’anxiété de performance, au stress ou à des facteurs psychologiques, plutôt qu’à un problème physique sévère.
Examens recommandés
Pour mieux comprendre la cause, il est utile de faire quelques examens de base :
Testostérone totale (le matin)
Glycémie à jeun ou HbA1c (dépistage du diabète)
Bilan lipidique
Fonction thyroïdienne (TSH)
Parfois le dosage de la prolactine
Ces examens permettent d’évaluer les causes hormonales ou métaboliques possibles de Dysfonction Érectile.
Concernant le Cialis
Le médicament Tadalafil (Cialis) est souvent utilisé pour améliorer l’érection. Cependant, il est préférable de ne pas l’utiliser sans avis médical, surtout si vous l’avez acheté sans ordonnance, afin de vérifier la dose et la sécurité.
Options de traitement
Le traitement peut inclure :
Techniques de contrôle de l’éjaculation (comme la méthode start-stop)
Réduction du stress et de l’anxiété sexuelle
Exercice physique régulier
Parfois des médicaments spécifiques pour l’éjaculation précoce
Quand consulter
Si les symptômes persistent depuis plus de 6 mois, il est conseillé de consulter un médecin ou un urologue pour une évaluation complète et un traitement adapté.
Avec une prise en charge appropriée, ces problèmes s’améliorent souvent beaucoup.

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Dr. Prasannajeet Singh Shekhawat

I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.

45 days ago

Hello
Hey there! Thanks for sharing your concerns so openly. It sounds like you’re dealing with a couple of interconnected issues regarding erections and premature ejaculation, and it’s great that you’re seeking help.
### Understanding Your Situation
1. Erections: The fact that you can achieve normal erections during sleep suggests that the physical ability to get an erection is there, but it may be affected by psychological factors or anxiety when with a partner.
2. Premature Ejaculation (PE): Ejaculating very quickly, especially during foreplay or masturbation, can be frustrating. It’s important to know that PE is quite common and can be influenced by various factors, including anxiety, stress, or even relationship dynamics.
### Assessing Severity
- Severe PE is often defined as ejaculating within 1-2 minutes of penetration or even before. Since you mentioned ejaculation occurs within 1-2 seconds during masturbation, it may indicate a significant concern, but it’s best to consult a healthcare professional for a proper assessment.
### Safe and Effective Options
1. Behavioral Techniques:
- Start-Stop Technique: Practice stopping stimulation before ejaculation and then starting again after a brief pause.
- Squeeze Technique: Squeeze the base of the penis just before ejaculation to help delay it.
2. Topical Anesthetics: Creams or sprays that numb the penis can help delay ejaculation. These are available over-the-counter but should be used with caution.
3. Counseling or Therapy: Sometimes, talking to a therapist or counselor can help address any underlying anxiety or relationship issues.
4. Medications:
- SSRIs (Selective Serotonin Reuptake Inhibitors) are sometimes prescribed off-label for PE as they can help delay ejaculation.
- Consult a doctor: It’s important to discuss any medications you’ve taken, like Cialis, with a healthcare provider to ensure they’re safe and appropriate for you.
### Recommended Examinations or Tests
- Physical Examination: A healthcare provider can assess for any physical issues.
- Hormonal Tests: Checking testosterone levels can be helpful.
- Psychological Evaluation: If anxiety or stress is suspected, a mental health assessment may be beneficial.
### Next Steps
- Consult a Healthcare Professional: It’s best to see a doctor or urologist who specializes in sexual health. They can provide personalized advice, conduct necessary tests, and discuss treatment options tailored to your needs.
Remember, you’re not alone in this, and many men experience similar issues. Seeking help is a positive step toward finding a solution.
Thank you

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Dr. Shayeque Reza

I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.

45 days ago

Your symptoms of difficulty maintaining an erection along with ejaculation occurring within 1–2 seconds suggest a combination of Premature Ejaculation and possible Erectile Dysfunction. The fact that you still experience normal erections during sleep is an encouraging sign and often indicates that the physical structures are functioning, while performance anxiety, psychological stress, or heightened sensitivity may be contributing factors. Medications like Tadalafil (Cialis) can help with erections but should ideally be used under medical supervision. A proper evaluation may include basic tests such as fasting blood sugar, lipid profile, testosterone levels (morning sample), and thyroid function to rule out hormonal or metabolic causes. Treatment often involves a combination of lifestyle improvements, stress management, behavioral techniques for ejaculation control, and sometimes medications specifically used for premature ejaculation. Consulting a doctor in person or urologist for a structured evaluation would help determine the safest and most effective treatment plan.

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Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

44 days ago

Hello dear
Yes it has permanent solution which requires comprehensive evaluation.
However it will require in person consultation with gynaecologist or sexologist in person for better clarity.
Iam suggesting some preventive measures.
Please follow them for atleast two months
Avoid heavy meals and alcohol
Take ashwagandha or triphala once a day for 2 months
Do meditation
Do physical exercises atleast for half an hour
Especially kegel exercises
Take shilajeet for 1 month once a day
Hopefully you recover soon
Regards

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

43 days ago

Ces symptômes, impliquant à la fois une difficulté à maintenir une érection et une éjaculation rapide, pourraient indiquer deux problèmes distincts: le dysfonctionnement érectile et l’éjaculation précoce. Quand les érections nocturnes sont normales, cela suggère souvent que le problème puisse être plus psychologique que purement physique. Cependant, une consultation médicale est essentielle pour évaluer les causes sous-jacentes. Ça pourrait impliquer des facteurs comme le stress, l’anxiété de performance, ou encore des habitudes de vie comme le tabagisme, l’alcool ou la sédentarité. Dans certains cas, des conditions médicales comme le diabète ou une maladie cardiovasculaire peuvent également influencer la fonction érectile et l’éjaculation. L’utilisation de médicaments comme le Cialis sans prescription peut être risquée sans un diagnostic approprié, car ces médicaments ne sont pas automatiquement recomandés pour chaque individu. Vous pourriez bénéficier de parler à un professionnel préférablement un urologue, pour un examen détaillé. Les tests possibles incluent des tests sanguins pour vérifier les hormones, ou une échographie pour évaluer le flux sanguin vers le pénis. Concernant l’éjaculation précoce, des traitements médicamenteux tels que les inhibiteurs spécifiques de la recapture de la sérotonine (ISRS) ou des gels anesthésiants peuvent aider à allonger la durée avant l’éjaculation, en combinaison éventuellement avec des techniques comportementales. Améliorer le mode de vie, en incluant une alimentation équilibrée, une activité physique régulière, et la réduction de l’anxiété, peut aussi beaucoup contribuer. Il est crucial de faire un suivi médical et ne pas s’auto-médicamenter, surtout si vous avez des inquiétudes sur la sécurité ou l’efficacité de ce que vous utilisez actuellement.

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Dr. Alan Reji

I'm Dr. Alan Reji, a general dentist with a deep-rooted passion for helping people achieve lasting oral health while making dental visits feel less intimidating. I graduated from Pushpagiri College of Dental Sciences (batch of 2018), and ever since, I've been committed to offering high-quality care that balances both advanced clinical knowledge and genuine compassion for my patients. Starting Dent To Smile here in Palakkad wasn’t just about opening a clinic—it was really about creating a space where people feel relaxed the moment they walk in. Dental care can feel cold or overly clinical, and I’ve always wanted to change that. So I focused on making it warm, easygoing, and centered completely around you. I mix new-age tech with some good old-fashioned values—really listening, explaining stuff without jargon, and making sure you feel involved, not just treated. From regular cleanings to fillings or even cosmetic work, I try my best to keep things smooth and stress-free. No hidden steps. No last-minute surprises. I have a strong interest in patient education and preventive dentistry. I genuinely believe most dental issues can be caught early—or even avoided—when patients are given the right information at the right time. That’s why I take time to talk, not just treat. Helping people understand why something’s happening is as important to me as treating what’s happening. At my practice, I’ve made it a point to stay current with the latest innovations—digital diagnostics, minimally invasive techniques, and smart scheduling that respects people’s time. I also try to make my services accessible and affordable, because good dental care shouldn’t be out of reach for anyone.

40 days ago

Vos symptômes depuis plus de 6 mois (éjaculation en 1–2 secondes, difficulté à maintenir l’érection malgré des érections nocturnes normales) évoquent une éjaculation précoce sévère associée à une dysfonction érectile probablement d’origine anxieuse/performance, surtout avec beaucoup de stress.
Je vous recommande de consulter un Urologue et/ou un Sexologue pour un bilan comprenant glycémie, bilan lipidique, testostérone totale, TSH, et éventuellement un bilan cardiovasculaire, et d’éviter l’automédication par Cialis sans avis médical.
Les traitements efficaces peuvent inclure thérapie sexologique (techniques stop-start), traitement de l’anxiété, inhibiteurs de la PDE5 prescrits médicalement, ou ISRS à faible dose selon le diagnostic — une prise en charge spécialisée est fortement conseillée.

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