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Before moving directly to any treatment follow the advice as given below. You are indeed developing the signs of ED (erectile dysfunction) and PME (premature ejaculation). We may need the reports of the following tests to rule out physical causes of erectile dysfunction and premature ejaculation. The tests are CBC (complete blood count), T3, T4, TSH (thyroid-stimulating hormone), HbA1c (glycated hemoglobin), serum testosterone, and serum prolactin. To rule out psychological causes please answer my questions. How is your mood? How are your energy levels? How is your appetite? Do you have any sleep disturbances or do you oversleep? Any past history of anxiety or depression? Any family members suffering from anxiety or depression? Describe in detail about any use of cigarettes, tobacco, alcohol, cannabis or any other substances of abuse. Please respond to the above questions and send me reports to enable me to make a complete assessment of your condition and advise treatment accordingly. Depression can cause ED, PME, and masturbation guilt or compulsive masturbation. All that you may require is proper consultation and treatment about your sexual problems.