Hello and thank you for submitting your question.

Your question is a very good one and I will try to provide you with some good information and recommendations regarding what is going on.

First of all let me reassure you that this concern is very common among men. This can happen at any age and is not something that is always associated with men who are very old well with men who have medical problems such as diabetes or blood pressure issues.

I suspect that in your case their are more than one contributing factor which is causing you to experience these difficulties. One factor which plays a role very often is mental health. If you are anxious about good performance it will sometimes cause you to have issues performing when it comes time to do so. This is something which usually will improve over time as it has for you in the past. Sometimes regular exercise will help men overcome this issue. If you are not exercising currently I would recommend that you spend at least 30 to 45 min. per day five days per week engaging in good aerobic physical activity. Also while you did not mention this in your initial question if you are carrying any extra weight this can also affect your performance. If this is the case for you a weight loss of five or 10 pounds can make a significant difference.

Also while it is very unlikely it is possible there may be some hormonal imbalance going on. This usually happens with a fluctuation in testosterone. It would be extremely rare for you to have a true testosterone deficiency. Some physicians however would advocate that you have a blood test done to evaluate your testosterone level. I would not recommend at all that you purchased any over-the-counter preparations which claim to promote sexual function.

Also I have not discussed the possibility that masturbation could be playing a role here. I would recommend that you refrain from masturbation as much as possible. The fewer times that you ejaculate in a 24 hour. The more rigid your erection will usually be.

The last thing I would like to mention would be caffeine or stimulant medication. It is important for you to avoid excessive amounts of caffeine in the form of coffee or soda. Excessive consumption of these products can exacerbate premature ejaculation.

I thank you again for submitting your question. I hope I have provided you with some helpful information and recommendations. If you have any additional concerns I would be happy to address them.

Sincerely,

Dr. Robert

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Hello again,

Let me reassure you that your function will get better over time - much better with some patience. I think this is an issue of mind over matter in your case.

Focus on relaxing. Try mediating. Clear your mind and picture yourself in an intimate encounter with her - doing and functioning at an optimal level. Do this each day for a few minutes and over time this will help your confidence. Try not to worry about the whole thing also. She is right in telling you not to. She sees it causes anxiety in you and obviously she cares for you. I am confident that with a few minor adjustments that your sexual function will be optimized within a few weeks.

Also the Angiokeratoma has nothing to do with ED whatsoever.

Thanks again for the query.

As always I am here if you have additional concerns.

Sincerely,

Dr. Galamaga

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Hi,
Thanks for the follow up.

As far as meditation is concerned the main thing is to set aside some time where you are not disturbed by anyone or anything and you can clear you mind.

Here is a helpful link which shows information regarding getting started with meditation.

WWW.WWWW.WW
Slowly but surely I think this will help you.

Thanks again for submitting your query. I am here for you if you have additional concerns.

Sincerely,

Dr. Galamaga

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