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Q. How to help a man with erectile dysfunction and premature ejaculation who has lost interest in sex?

Answered by
Dr. Ashok Kumar Choudhary
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 06, 2022

Hello doctor,

My husband is 36 years old. He has erectile dysfunction and premature ejaculation and has lost interest in sex.

Kindly advise.

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#

Hello,

Welcome to icliniq.com.

I understand your concern.

I have reviewed the attachments (attachment removed to protect the patient's identity). Erectile dysfunction (ED) and premature ejaculation can occur due to multiple factors, and psychological factors have a substantial contribution. In the second case, there is no abnormality in the system, but excessive anxiety makes penetration impossible. This is the most common cause of ED worldwide; fortunately, it is treatable.

Before we proceed further, I have a few questions for you and your husband:

  • Since how long is he facing the problem?
  • Is the problem with erection? If yes, how often is he able to penetrate you in a week?
  • What do you mean by premature ejaculation? What is the average duration of sexual intercourse?
  • Does he have morning erections before waking up?
  • Does he have any illness like hypertension?
  • How are his work stress and general health?
  • Do you have a cordial relationship, or is the day-to-day stress spoiling your relationship?
  • Does he have a normal erection while watching porn?
  • Does he masturbate? If yes, what is the monthly frequency?

Regarding the attached investigation reports, only their lipid profile is deranged, and there is a possibility that he has another problem. I suggest he get a hormone profile done that includes LH (luteinizing hormone), FSH (follicle-stimulating hormone), and testosterone. Do revert with the details so that I can determine whether it is psychological or otherwise, and appropriate treatment can be planned. Be assured that treatments are available for your husband.

I hope this helps.

Thank you.

Hello doctor,

Thank you for the response.

I have answered all your questions and also attached the hormone profile.

  • He has been facing the problem for six months.
  • He is able to penetrate once in ten days.
  • Our average duration of sexual intercourse is 10 to 15 minutes.
  • He does not have morning erections.
  • He does not have any health complaints.
  • He does not have any work-related stress.
  • We have a cordial relationship. We dated for 15 years and got married.
  • He loses erection during penetration.
  • He used to masturbate before marriage.

Kindly advise.

#

Hello,

Welcome back to icliniq.com.

After a detailed evaluation of your husband's laboratory reports, two physical abnormalities were detected. The first is a deranged lipid profile, and the second is low testosterone. Both of these can cause decreased sexual interest and loss of erection while having sexual activity. Among these, low testosterone is a significant factor compared to high blood lipids. Based on your answers, I feel your husband has erectile dysfunction and not premature ejaculation, as the intercourse lasts for 10 to 15 minutes. However, as he is getting aroused quickly and only has problems with erections, he has psychological issues that must be addressed.

I suggest he start lipid-lowering medications like tablet Atorvastatin 10 mg and testosterone supplements like capsule Testosterone Undecynelate 40 mg. Consult a specialist doctor, talk to him or her, and start the medicines with their consent.

Do revert after 15 days for assessment.

I hope this helps.

Thank you.


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