Erectile dysfunction (ED):- It means difficulty getting erection during or at the start of sexual intimacy, problem could be in initiation and/or maintenance of erection.

Causes of ED:-

• Organic causes:- diabetes, hypertension, spinal injury, thyroid disorders, obesity, chronic alcohol use, hypercholesterolemia, hypogonadism, CKD, some medications.


• Psychological causes:- stress, anxiety, depression, relationship problems, performance pressure, sexual trauma.



Treatment of ED:- Its treated by various oral medicines, therapies, counseling, treatment of causative factors, intracavernous injections and at last surgery and implants.

Premature ejaculation (PME):- It means discharge of semen occurring just before or shortly after beginning of sexual intercourse.

Causes of PME:-

• Organic causes:- imbalanced sexual hormone levels, diabetes, infection in urethra/prostate, thyroid disorders, hypersensitivity of foreskin of penis, some medications


• Psychological causes:- stress, depression, anxiety, relationship problems with partner, being with new partner, having sex after long period of time, performance anxiety.

Treatment of PME:- Its treated by various oral medicines like SSRIs (mainly paroxetine, fluoxetine, depoxetine), clomipramine, lidocaine jelly/spray to numb the part of penis, some techniques like start and stop method, squeeze method, ejaculatory delay method, performing kegel exercises etc.

Dhat syndrome:- Multiple somatic symptoms(weakness, muscle loss, fatigue, loss of appetite, guilt feeling) produced by belief of ‘’semen loss’’. It is culture bound syndrome. Treatment is by removing myths regarding masturbation, semen loss, night fall. Explaining patient about proper way of doing masturbation is a key.

Loss of libido:-called decreased sex drive

Causes:- stress, depression, tiredness, hormonal changes, some medications, alcohol, smoking, few illnesses like cancer, diabetes, surgery, relationship issues.

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