I am not getting hard erections and facing premature ejaculation. Please help.

Hi doctor,

I am 25 years old and suffer from premature ejaculation (20 seconds or so). I think it started with my masturbation when I was 14 or 15 years old. Even though I took longer to masturbate, I forced myself to cum sooner. I released this only when I had my first sexual experience at 21, and I ejaculated prematurely. My normal refractory period is like two days. Of course, I can get another erection in a couple of hours or so, but, it is generally not that hard enough for easy penetration. Also, I do not enjoy that sex if I am not fully hard (despite the fact that I can last longer, like once 15 minutes or so, but I was losing my erection there from time to time but this only happened once, otherwise I last like 1.5 to 2 minutes or so with steady erection if I already ejaculated before the same day).

I normally tend to cum a lot if I had my full refractory period (otherwise, it is less, also if I am not aroused, it is less but I am always forcing myself to ejaculate these days even more). I have no other known health issues, also I do not smoke and drink only occasionally, and have no long-term stress issues. My penis length is average but my testicles are smaller than average.

How can I resolve this problem of PE and is there a way to decrease my refractory period? I believe the two are correlated because of my relatively smaller testicles.

Thank you doctor,

No, I do not do any kegel exercise, and I am also not under any medication.

I do have a sexual desire but, the problem is my body does not respond to it (as I described my problem above, my refractory period is long and I suffer from premature ejaculation). Sure, this would then have an adverse effect mentally, I agree with you there.

I would also like to point out that I had asked another doctor online, and he said that I was suffering from erectile dysfunction. He suggested Avanafil (Stendra) 50 mg medication (one each day before sexual activity for one or two months). He also recommended that I do TRT (a week). He also asked me to first try counseling.

Now, I see that you have a totally different conclusion. I would like a second opinion from you.

Also, I am not residing in India at the moment. And, due to Coronavirus and so on, I am not sure if traveling back to India is the effective approach. How serious will be the treatment for my condition? Can I travel while I am undergoing TRT? Shall I see a doctor here in my country? But, I feel less embarrassed talking with an Indian doctor. What do you suggest I do?