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Male

A.  Inability to maintain an erection good enough to complete sexual activity satisfactorily either masturbation, oral / vaginal/sexual.

A.  There are two main causes – physical and psychological. Main physical causes includes diabetes, atherosclerosis, alcoholism, side effect of certain drugs, spinal cord injury, prostate gland surgery, etc while psychological causes includes relation ship conflicts , stress and anxiety, depression , sexual boredom etc.

A.  With healthy style, no smoking, no alcohol consumption, regular exercise and low fat diet one can prevent ED.

A.  As soon as the problem is noticed by the man, he should consult a doctor and if he is on treatment for a medical or psychiatric problem one should consult specialist to solve the problem.

A.  The treatment include oral/ injectables, mechanical aids, hormonal replacements &/or psychological therapy.

A.

• share your worries by communicating with your partner
• spend more time with other form of sexual intimacy like kissing, cuddling, licking and massaging.
• Seek a doctors help

A.  Less interest in sex is called lack of libido or loss of sexual desire.

A.

• Natural cause includes – naturally a person has low desire for sex
• Psychological cause – like relationship difficulties , sexual boredom with a partner, depression and stress
• Physical cause – low level of testosterone

A.  Ejaculation which occurs quickly during penetration itself or very soon afterwards is called premature or rapid ejaculation.

A.

• Sex – therapy:- Stop start [Do-Redo method]
  Men should stimulate the penis near the point of ejaculation and then stop for 30-60 seconds and again stimulate it. Repeat the process for five to six times.
• Squeeze:- Stimulation to penis should be done near the point of ejaculation and then firmly squeeze around the penis just below the head. It has effect of preventing ejaculation.
• Medicine:- Local anesthetic gel or spray will reduce the penile sensation. Some times antidepressant drugs are also prescribed when a man has some religious reason for not touching the penis with his hand.
  Give some tips to reduce the premature ejaculation :
  1. Condom, &/or anesthetic spray will reduce the sensitivity of penis
  2. Don’t attempt intercourse until your partner had an orgasm
  3. Increase frequency of ejaculation [masturbation] this might help to delay subsequent ejaculations.
  4. Communicate with your partner
  5. Do stress relieving exercise.
  6. Firm determination will also help you to control ejaculation.

A.  Inability to ejaculate or a delay in ejaculation is called delayed ejaculation.

A.  As described earlier there are mainly two causes

• Physical causes :
  1. Age – Aging is associated with decreased penile sensitivity
  2. Drugs – Because of side effects Antidepressant or any other drug
  3. Hormone imbalance – It can also lead to delayed ejaculation.
  4. Nerve damage
• Psychological causes :
  1. Performance anxiety
  2. Self – consciousness
  3. Stress
  4. Relationship difficulties
• Treatment :
  1. Relaxation exercise
  2. Use of vibrator
  3. Sex therapy
  4. Avoid penetration till the point of ejaculation
  5. Check with doctor if you are on any medication
  Please provide healthy guidelines for better sex life and to prevent in / sub fertility Following are the few tips:-
• Healthy food habit and supplements : Obesity is a major problem in sexual dysfunction, diabetes and hormones. To keep yourself fit avoid refined carbohydrates, sugar, oil, fatty food etc and take more of protein [chicken, fish for non vegetarians], vegetables, salads etc. Dietary supplements like multivitamin or multi minerals. Vitamin E improves blood vessels of penis and also of heart. 400-800 IU vitamin E per day will help in normal erectile function Arginine – It increases production of nitric oxide [which expands blood vessels] – and as a result helps in maintaining erection. Dosage is 1000 mg twice a day. Testosterone – this hormone may increase sexual libido and activity.
• Quit smoking / alcohol : Tobacco is having hazardous molecules called free radicals which is associated with in/sub fertility
  1. Avoid wearing tight underwear
  2. Regular exercise.
  3. Healthy Life style

A.

• Viagra [Sildenafil Citrate] is a medicine to restore erectile function, it selectively works on penis. Viagra will work by increasing the smooth muscle relaxation in the penis, and with this efficiency of the erection will increase. PDE-5 [Phosphodiesterase type-5], enzyme exclusively found in penis – Viagra works on this enzyme.
• The only contraindication to Viagra is the use of nitrates [sublingual nitroglycerin, long acting nitrates, and nitrate paste]. Both cannot be used at a time. The severe side effect will be drop in blood pressure.
• Viagra is taken half an hour before desired sexual activity. The dosage is once a day.
• Viagra will work if the man is aroused. 60-70% men with erectile dysfunction can achieve erection with Viagra. One point to be remembered is Viagra has no effect on libido; it will not increase the sex drive.

A.

• Erection mechanism is complex – it begins in the brain, thoughts and stimuli sends signal to penis through the nervous system. Released chemicals in penis triggers sponge – like tissue in the penis to become filled with blood – which causes erection.
• Some time if signals from brain are unclear or other conflicting stimuli prevents the erection. Some worries, anxiety, work pressure, stress or performance anxiety will cause the problem. You can take help of sex therapist, counsellor to rule out the possibilities.

A.

• This problem needs medical attention.
• Pain during intercourse will fall in three categories.
• Pain in penis while erection It can be because of
  1. Peyronie’s disease- due to this you might also observed curve or Bend in the penis when it is erect.
  2. Irritation of the skin along the shaft of the penis [balanitis]
  3. Infection of the prostate gland or urethra either case you should contact the doctor.
• Pain during ejaculation / and pain in pelvis It can be because of
  1. Infection of the urethra
  2. Sexually transmitted disease.

A.  A dry orgasm is a sexual climax that does not result in ejaculation that is no discharge of semen. The semen back flows into bladder rather than emerging through penis. This condition is called “Retro Ejaculation”. The possible causes for this condition are

• Diabetes
• Prostate surgery
• Certain medicine [eg.alpha blockers used to treat benign prostatic hyperplasia [BPH]
• Damage to the Prostate or seminal Vesicles [because of Prostatectomy, Cystetomy,Radiation therapy]

In this condition is selected to infertility, and then sperm is recovered from urine for use in artificial insemination.

A.  Average length of penis is 4 to 8 inches [10-20 centimeters]. Penis size can be increased and there are two procedures, medical and surgical procedures.

1. Medical Procedure:
   • By repeated stimulation
   • Frequent masturbation
   • Frequent sex
   • Massage with cream, oil etc
   • Vacuum pump
2. Surgical Procedure:
   • Fat injection
   • Penile Augmentation surgery