Hello dear Understand your concern Treatment of erectile dysfunction and premature ejaculation is depend on the cause of it. So first we have to find the causes behind that. Following are the causes: Diabetes, Prostate Enlargement, psychological like Excessive stress and relationship issues, alcohol & tobacco consumption (constriction of penile blood vessel), obesity, Problems in low back nerves, Hormone problem like Low testosterone levels. So first consult the best urologist and get the following test done: Blood tests:Hb,CBC, ESR, blood sugar, lipid profile, urea, creatinine, Vitamin B12, folic acid levels iron, etc.Hormones (total and free testosterone, corticosteroids, DHEAS, Thyroid hormone, seminal fluid analysis, Doppler USG of scrotum and penile area to find out the blood flow problem. Meanwhile take following advice: Start exercising (60-80 minutes in morning with relaxation and yoga), losing weight, stopping smoking and alcohol, Healthy diet with proteins and vitamin A, C, E. Take anti oxidant like CO Q, More fore play before sex will lead to more excitement, Do discussion with your partner that help in gaining psychological trust, Use more than one condom and apply lidocaine gel. Try women on top position and be relax while having sex Do pelvic exercise like kegel s If above advises will not responds then Following medicine can be provide by doctor: Tablet viagra: about one hour before sexual activity, Testosterone Replacement Therapy, paroxetine 30-40 min before sex Hope this may help you Best regards Dr. Sagar