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

Answered by
Dr. Chhel Narayan
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jul 29, 2020

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.

Dr. Chhel Narayan

Family Physician General Practitioner


Welcome to

I think you have lost stamina and have gone into sexual anorexia condition. Are you doing proper kegel exercise, and taking any medication?

Follow up for medical treatment.

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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?

Dr. Chhel Narayan

Family Physician General Practitioner


Welcome back to

I have understood your problem deeply.

First thing, I would like to tell you that it has become a general problem in all persons. Secondly, I would like to tell you that you have to keep your mind tension-free. Third one, avoid smoking. These things will maintain your stamina.

In the view of increasing stamina and reduce the refractory time you have to do the following things:

1. Kegel exercise.

2. Physical exercise.

3. Energetic diet.

4. Decrease fat.

5. Medical treatment.

6. Last thing I would like to tell you that is best and getting confident is to try to sex with different place, climate, position, and partner help.

If your partner is understands your problem then you may solve these problems. Try to tell everything about your weakness and ask her to give help in the outcome.

Medical treatment includes two types:

1. Short acting - it may work whenever you want sex, then you have to take medicines.

2. Long acting - in this type of treatment you may keep your stamina constant.

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