Premature ejaculation is the commonest sexual problem in human males. It is, in fact, the default evolutionary norm. Primitive man had very little time in which to inseminate his partner -- there was always the risk of a lion eating him up or lightning striking him during the sexual act.

Thus, delaying ejaculation has to be learned -- it is an acquired skill. Pills like some anxiolytics (drugs that treat the symptoms of anxiety -- they must be used through prescription only) do help, but dubious topical sprays and applications are a strict no-no. Relationship and personal sexuality issues are other contributors that must be addressed by sexual medicine experts. Further information on this can be found on www.andrology.com/ejaculatorydisorders.htm.

Sir,
I am 30 yrs old, married,my problem is that I can maintain my erection while I am resting on bed (on back) but as soon I stand, my penis loses erection in few seconds. Kindly suggest solution as I am very much disturbed as I can not perform my intercourse well.

Sustaining an erection requires continued stimulation, mental and physical. Anxiety about being able to sustain an erection is itself an important cause of erectile failure. So is distraction.

There could also be other important vascular causes for this that will require special investigations, but, in general, if one is able to sustain an erection in one situation and not in another, it is the situation that needs to be addressed first, not the penis.

Resp doctor,
Here at the age of 44, the premature ejaculation problem is persisting since the beginning, although the duration goes up with the impact of hard drinks sometimes. Pls advise.

If your premature ejaculation (PE) improves with small to moderate quantities of alcohol, then it suggests that the PE is probably anxiety-related, but if you need a lot of alcohol to delay ejaculation, it is probably because of the hypoesthesia (reduced sensation, numbness) that large amounts of alcohol cause.

Neither approach is a recommended treatment for PE. In fact, alcohol used as a drug for PE will put you at a higher risk of alcohol dependence. Effective oral medication is available nowadays to treat PE.

Dear Sir
I have early discharged problem. One bad habit is there to watch porn movies...I have two kids and my age is 37 years old. I am thin and my diet is also poor.
Thanks
Qadirs

Watching porn can cause/aggravate your premature ejaculation (PE) problem. If you watch porn with your partner, the situation can be adjusted. Your age, the number of children you have, your leanness and your diet have no relationship with your PE. But yes, in general, a good, balanced diet is recommended. If you are looking for a diet that can enrich your sex life, read Chapter 38, The Better Orgasm Diet, in my book, Sexx is Not a Four-Letter Word.

Your PE, however, must be treated medically by an expert in andrology and sexual medicine.

Respected Sir,
I am 26 year sold and hopefully getting married next year. I am having a problem that my skin on the penis do not opens up. So what can be done to open it. I am not having any problem about the sperms, but whenever I tried to open up the skin of my penis it felt painful. So if u can suggest me something regarding this, i will feel very much obliged.

Regards
Ranjan

The condition you have is known as 'phimosis'. The simplest and most effective permanent cure for this is a circumcision operation, a procedure that removes the foreskin from your penis. I normally do this surgery as a 'walk in-walk out' case. The results are permanent. Other attempts to conserve the foreskin or perform plasties (repair procedures) without circumcision will likely cause the problem to recur.

Hi Doc,
I need your suggestion. Recently I am having a burning sensation in my penis after I masturbate or have sex with my wife. The inner skin appears as if blood will come out. I feel somewhat okay if the skin is wet. Please suggest. How will I get to know your reply?

You cannot be advised for this problem over the Internet. You will need an examination and tests. Your wife and you are probably suffering from an infection that is getting transmitted to and fro between you. See an andrologist.

Respected Sir,

I want to to know that during sexual activity when I insert my penis the foreskin gets pushed and it is very painful -- what to do please? I think from the joint it pains please help me and guide me. You are requested to kindly advise me whether oil or any drug can be used for late discharge? Pls suggest name of the drug/oil which has no side effects?

Thanking You,
Regards,
Mahesh*

You seem to have a tight frenum. As explained above, this is best treated with a circumcision operation. Drugs can provide only temporary pain relief and may actually be harmful because they lull you into complacence even as the condition is getting worse. This is why you must correct your tight frenum first and then address your PE. For advice on oils, you must contact an ayurvedacharya or a hakeem. I am a specialist in andrology and sexual medicine.

Hi,
I am 29 yrs male. We were trying to conceive since last 2 years. We found out that the problem is with me. Sperm count is 10 million, and only 10 percent active motile and 10 percent sluggishly motile. So my doctor (Dr Vasan S S ) suggested to take other tests, then in tests it was found that I've got bilateral varicocele with largest vein measuring on left side is 3.9 mm and right side is 3.8 mm. The doctor suggested me to go for surgery and micro-surgery will be better.
My queries are:
What are the post operation complexities in surgery/micro surgery for varicocele?
What is the success rate ( in conceiving) after surgery ?
How many days shall I've to stay in hospital after operation?
Can I travel from Hyderabad to Bangalore if I have the operation at Andromeda?
Is your hospital there in Bangalore ? If not, who is the best surgeon (micro surgeon) and hospital for varicocele in Banglore ?

Please help me in this issue and thanks in advance.

Varicocoele (an abnormal dilatation of the veins) is the commonest correctable cause of male infertility. You will find more information relating to your questions on www.varicocoele.com. The first microsurgical varicocelectomy in India was performed by me in 1987-8, but I recommend surgery only if absolutely necessary. I am based in Hyderabad. I perform surgery in other cities in India and abroad only by invitation and for academic purposes, eg demonstrating at conference workshops and for teaching.

I do not think that it is ethical for me to use this platform to recommend names of doctors in other towns. I suggest you perform an internet search under the terms 'andrology' or 'varicocoele'. There is also a chapter (number 26) on varicocoele in my book, Sexx is Not a Four-Letter Word.

Hi,

Pls dont publish my name. i am aged 40 years. i married when i was 26. i had one girl child in 1999. even though i could not have proper sex with my wife, i just used to masturbate and just fill (i could not insert). after that till 2006 april (for close to 7 years) i had no sex. then we got separated in the april 2006.

in 2008 april i got divorce and remarried again in 2008 november. but i am not able to have sex (i dont get erection) in this marriage also. every day i used to masturbate from the past 25 years. i am also a regular smoker.

my wife is very upset about this. i think there is also another problem. my present wife who is a divorcee also got divorce bcz she could not conceive. but that one she does not say but some how i came to know. she is taking advantage of my position and i think she is happy inside so that she wont be exposed. and she also abuses me so that i am completely down psychologically. she keeps abusing me for not able to properly have intercourse.

i am a salaried man with just Rs 10,000 per month. and i have taken lot of loan for settlement of my divorce. so i am not able to take costly treatment.

is there anyway to get both of us out of this mess and have kids? my first daughter does not stay with me and stays with my first wife and her parents. so i desparately want kids also.

Thanks

I think that you need to get out of your male chauvinistic trance in a hurry or your second wife is going to take you to the cleaners worse than your first. For someone who cannot even obtain an erection, you certainly have great demands of your wife. Get real. See an andrologist and get your erectile dysfunction (impotence) treated. Love and intimacy should come first in a marriage, and children only afterwards. We can address that later.

Dear Sir,

It is possible to acquire infections even with 'just' oral sex. The time to get checked is NOW!

Hi Doctor,

Should i go for marrige or is there any defficiency in my body causes this kinda feeling or this is my mindset to go for sex.

please tell me what to do ? how should i divert myself or do i take any medicine for this. I dont have any kinda bad habits not smoking drinking nothing...

please suggest me what do i do?

Do you seriously believe that it is abnormal, at 26, to feel sexual urges ?! If you believe that sex is wrong and sinful, then I have nothing to tell you. I preach and practice sexual medicine, not asceticism. But do think twice before you eventually succumb to parental and societal pressure and ruin a girl's life.

Hi, Can i marry my maternal cousin ( my mother's brother's daughter )? Is any genetic (medical) test available? so that we can get it done to confirm wether we can give birth to a healthy baby?

Regards,
Jagadeesh

Consanguinous marriages are strongly dissuaded by the medical community. However, if you can't avoid it, you must go in for genetic counselling right now.

Do you have a question for Dr Krishnamurti? Simply e-mail him at sexualqueries@rediffmail.com; responses will be published each week and names will be withheld upon request.

Dr Sudhakar Krishnamurti is an international award-winning andrologist and microsurgeon. He is the only Indian on the world's first-ever batch of sexual medicine fellows (Oxford, 2007). Best known for the Krishnamurti Operation for Peyronie's Disease, he is also the founder of Andromeda, India's first andrology center, and author of the bookSexx is Not a Four-Letter Word.