Q. What can be done to improve libido?

Answered by
Dr. Ashok Kumar Choudhary
and medically reviewed by Dr. Divya Banu M
Published on Oct 29, 2019

Hello doctor,

I am 36 years old, male. Recently I am not feeling as much libido as it used to be. My penis does erect but not to its fullest all the time. The erection does not last longer and I have frequent difficulty in penetration during intercourse. I ejaculate very early (typically after two minutes of penetration) and after ejaculation I do not feel like having next sex for many hours. I have some performance anxiety prior to intercourse which also affects my erection. My BP is sometimes slightly high, but most of the time it is normal. My blood sugar is normal and I have no other health issues and not on any medicine. But I have some work and family related stress currently. I am not statisfied with my sexual health. Kindly suggest me a way for immediate result.

Dr. Ashok Kumar Choudhary

Andrology Geriatrics Psychiatry Psychologist/ Counsellor Psychotherapy Sexology
#

Hi,

Welcome to icliniq.com.

I read your query and understand your concerns. Before I can answer you, I request you to provide the following details. This is important because without proper information the suggested intervention is unlikely to help you completely.

1. Your age?

2. Duration of problem?

3. How it started?

4. Do you have early morning erections? If yes, how frequent and strong they are?

5. What effect it caused to your relationship?

6. Do you have any medical illness? If yes, details.

7. What treatment you received so far and its effects?

8. Partner details? Whether she is very critical or demanding?

9. Tests undergone till date and results?

Thank you doctor,

1. My age: 36 years.

2. Last four years.

3. I am unmarried but I have a girlfriend since last five years and about to marry her soon. We do have sex very rarely, once in four months. But every time my performance is poor. This is worrying me too much since we are getting married soon. We love each other a lot. She is not demanding, but she does not feel the sexual pleasure she deserves due to my problems. She is 30 years old.

4. It started four years ago.

5. Morning erection is there but not regular and it is not strong enough always.

6. My relationship has been slightly afftected as she complains sometimes but it is not somthing that will spoil this relation. But it is not right for us as a couply to be sexually unsatisfied.

7. I do not have any serious illness, no blood sugar issues. But I do have my BP slightly high occasionaly but most of the time, it is under control.

8. I have not received any treatment so far.

9. No test done so far.

10. I drink rarely and some occasionaly (one cigarette in two days).

Dr. Ashok Kumar Choudhary

Andrology Geriatrics Psychiatry Psychologist/ Counsellor Psychotherapy Sexology
#

Hi,

Welcome back to icliniq.com.

Although provided details are not enough to diagnose a condition (no laboratory tests are available and I do not have the opportunity to examine you personally) but the available details are more indicative of psychological erectile dysfunction with premature ejaculation as primary cause. In other words the performance anxiety is primary cause for early discharge and having lack of interest in sexual activity.

Although complete treatment is advisable only after doing physical examination and laboratory investigations, I feel doing the following sort of intervention can help you partially if not completely.

Now regarding the problem, I would like to inform you that psychological ED or performance anxiety can be handled with use of right psycho therapeutic approach. In my own experience around 70 % of individuals report dramatic improvement in erections once the psychotherapy is started leading to decrease in performance anxiety.

Below here I am delineating few of the strategies which will help you in the problem.

Firstly, get rid of thoughts that you may be sexually inadequate or your doubts that you may not be able to perform properly. This is because performance anxiety, feelings of sexual indequacy, self-doubts, guilt, past negative sexual experiences, poor communication or understanding with the partner, etc., can all affect sexual functioning and performance. Removing such ideas will eliminate the majority of causes for your poor sexual performance. Removing the person's doubts and fears, and improving his self-confidence levels will definitely help in improving sexual performance.

Remember that sex is not just a physical act but also a psychological process involving an expression of emotions, intimacy, and love. So, just involve yourself in those feelings and stop focusing on your "performance" alone. Once you do that, then I assure you that your sexual performance will automatically improve. Most importantly, performance anxiety soon becomes a "vicious cycle" That is, anxiety leads to poor performance and poor performance then leads to further anxiety and this keeps on increasing.

One more problem responsible for performance anxiety is inadequate sexual arousal. When the person is not properly aroused, the blood flow to the penis is not maximal, and so, after a few strokes, the erection weakens and ejaculation occurs. The way to tackle this is not to rush into intercourse quickly, but wait till you get fully aroused. So, increase and spice-up your foreplay. Make sure that you initiate penetration only after both of you are fully turned on. Good foreplay not only arouses you but also sparks off the mood in your partner. So, when she is also aroused and involved, then things keep flowing smoothly and effortlessly, and you do not have to be constantly anxious if you are satisfying your partner or not. Distract yourself, stop "monitoring" your sexual performance. Try putting on some romantic music or mild lighting while you make love. Think about the things that turn you on. Taking your mind off of your sexual performance can remove the worries that are stopping you from getting fully aroused.

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