Brief Answer:
No likely physical cause of your problem

Detailed Answer:
Hello,

Thanks for writing to us.

First of all clarification about your failure of erection.

Sometime due to fatigue, lack of mood, situational problem or environmental changes man can fail in sex. It is normal phenomenon. However when this failure makes person apprehensive about erection, sex life is affected. This is called performance anxiety. After such failure when person actively thinks about erection or success of intercourse during sex his mind is likely diverted to such thoughts. For constant erection continuous exciting/romantic/erotic feelings should be there in mind. If mind diverted to concern about erection, erection would not be possible.

So please do not think about this failure. Relax, do not involve in sexual activity for 2-3 days. After that you can do sex normally.

Other concern is size of penis.

Normal size of penis in flaccid state is 2 to 4 inches while in erect position 4 to 6 inches. It varies according to body structure and race. Size of penis does not matter much for satisfying partner.
Anterior 3 inches of female vaginal wall is sensitive to sexual stimuli. Only 3.5 inches of erect penis is sufficient to satisfy female. Hope you are clear about concern of size of penis now.


Now clarification and management of early ejaculation.

First of all Premature Ejaculation (PME) defined when male partner ejaculates early before the female partner reaches to orgasm. There is no absolute time by which we can diagnose PME. It is relative term and female partner is the best judge.

Treatment aspect for PME.

Medicines:
Clomipramine and paroxetine are choice of medicines which are used as antidepressants (For depression dose is higher).
I prefer clomipramine for PME. No significant side effects with these medicines. Initially say for 20-30 days daily after dinner and later on just on the day when you do the sex.
Paroxetine is more potent but it may cause side effects like headache, gastric discomfort, giddiness and sedation. In patients with blood pressure it should be used in consultation with physician/cardiologist.

One molecule called depoxetine has been used specifically for PME and should be taken before 2 hours of sex when required.
These medicines are prescription medicines and you need to consult doctor/psychiatrist/sexologist for prescription.

Behavioral approaches are as follows for your information:

1. Stop and Squeeze technique can be applied which you can learn from internet and ask me if any query in that.(In brief, method suggests that you should try to divert your mind for a moment when you feel ejaculation arousal and penis should be tightly squeezed with hand inwards by your partner preferably).

2. Master and XXXXXXX technique can also be learnt from qualified sexologist/Psychiatrist which includes sessions in couple as it is couple sex therapy. It can help in prolongation of time.

3. Sex counselling of your sexual behavior and methods. Like if you are down and female partner on top, gravity is going to help you for lengthening the time.

4. You should do masturbation before sex (at least 2 hours before ). It will make seminal vesicles somewhat empty and at time of sex semen will take more time to come out.

Another approach:
-Use of condoms. Sometime use of condom while sex helps in delaying ejaculation by reducing sensitivity of glans penis.

--Topical application of anesthetic gel/spray. For this you have to consult doctor.

You can select your choice of treatment for long hours.

Hope I have answered your query, I will be happy to help further.

Regards,
Dr.Chintan Solanki.

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Brief Answer:
clonil or clofranil

Detailed Answer:
Heloo,

Thanks for follow up.

Brand names of clomipramine are clonil, clofranil or clopin. But remember that these are prescription drugs and better to take this medicine after consulting doctor personally.

All the best.

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Brief Answer:
you can find psychiatrist from below link

Detailed Answer:
Hi,

Thanks for follow up.

I am not knowing anyone personally there. But yes you can search psychiatrist near to you with below mentioned link.After that you can search for contact on internet easily.
Or you can ask your family doctor for suggesting you a psychiatrist.

http://doctor.healthcaremagic.com/doctors/Psychiatrists-in-Goa/L18884S35

Take care.

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