Hi — thank you for reaching out and being honest about what you’re going through. Please know that concerns like premature ejaculation (PE), erectile dysfunction (ED), and low libido are more common than most people realize, and they are treatable.
Let me break this down to help you better understand your situation:
1. Premature Ejaculation (PE)
Defined as ejaculation within less than 1 minute of penetration, often with lack of control, and causing distress.
Causes can be:
• Anxiety or performance pressure
• Over-sensitivity
• Past conditioning (e.g., hurried masturbation habits)
• Sometimes hormonal or neurochemical imbalance
First-line treatment includes:
• SSRIs
• Behavioral techniques (like “start-stop” or “squeeze” methods)
• Desensitizing creams (local use) if hypersensitivity is present
2. Erectile Dysfunction (ED)
When maintaining or achieving erection is difficult. This could be psychogenic (due to anxiety, stress, fear of failure) or organic (vascular, hormonal, etc.).
We often use:
• PDE5 inhibitors
3. Low Libido (Sexual Desire)
This is usually linked to:
• Stress, depression, anxiety
• Hormonal issues (like low
testosterone)
• Chronic porn/masturbation habits (in some cases)
• Relationship or emotional issues
It’s best to check testosterone levels,
thyroid function, and rule out depression or anxiety — especially if libido has been persistently low.
What you can do now:
1. Please consult a psychiatrist or andrologist in person — especially because:
• You may need lab tests (hormones,
diabetes, thyroid, etc.)
• You should be evaluated before starting medications like Tadalafil or SSRIs
• Combining medication with sex therapy or CBT often gives the best results
2. Lifestyle habits make a huge difference:
• Regular exercise (boosts testosterone and confidence)
• Sleep, balanced diet, no smoking or alcohol
• Avoiding porn or compulsive masturbation for a while to “reset” your response
You are not alone, and you’re not broken.
With proper treatment and guidance, you can fully regain sexual confidence and function. And yes — your fear around physical intimacy will fade once you start getting support.
Let me know if you’d like help finding a nearby specialist or want a version to share with your partner.
You’ve already taken the most important step by asking for help. We’ll work through this.
Next Steps
Consultation