Please clarify your exact nature of problem,then only we can give an opinion.

You require clinical examination/investigation, without  this we are unable to give an opinion.

There are multiple causes for erectile dysfunction. It can be broadly classified into organic and psychogenic causes. Organic causes include the presence of any systemic illness, side effects of medicines, hormone imbalances, problems with the blood supply to the penis etc. Psychogenic causes include performance anxiety, unhealthy mental state, depression, anxiety, traumatic experiences, relationship problems with wife etc. From the letter it appears that you have a difficulty to sustain the erection which you get initially. This indicates two possibilities. Either it is due to a psychogenic cause or a VOD. What ever may be the cause there is a definite treatment. It may be sex therapy, medicines, a combination of both or a surgery. Treatment can be decided only after identifying the exact cause. So you may consult a doctor and take an opinion. In your case it may be better to go to a hospital where all facilities are available.

Varicocele causes progressive and duration dependent damage to the testis. As a result sperm motility will be reduced first followed by count. Over the years testis become atrophied and the production of male hormone (testosterone) will reduce. It will cause loss of sexual desire and erection. In other words you may develop an early andropause.

If there is a varicocele in an unmarried man one must undergo microsurgical varicocelectomy. This is the latest scientific view and standard teaching on this matter. How ever in most of the places varicocele is usually operated using laparoscopic surgery or conventional surgery.

It appears to be a psychogenic erectile dysfunction.Commonly it happens with the couples who are undergoing treatment for infertility. As far as possible try to forget about the pregnancy and engage sexual contact daily or alternative dates without looking at the calendar. If you cannot overcome this problem it can be solved with treatment.

It appears that you are suffering from premature ejaculation. This may be due to various causes such as infection, inflammation, hypersensitivity, habituation or any other factors. First we have to find out the cause. Treatment may vary from medication to sex therapy or a combination of both based on the causes. To plan the treatment you need to undergo a clinical evaluation including physical examination and investigations. Based on the results it can be successfully treated.

Your husband require clinical examination/investigation, then only we can give an opinion.

You require detailed clinical examination/investigation, then only we can give detailed opinion.

You require clinical examination,/lab investigations/scanning before any advise can be given. You may consult a nearby Urologist or visit our hospital during the next vacation.

You require detailed examination/investigation by a gynaecologist.