instruction: hello doctor I suffer from erectile dysfunction and also ejaculate even just with holding a women how can I solve this problem I am a healthy person who exercises regularly is not over weight and my lab reports are also fine I know I suffer from lack of libido but do not know how to handle it
output: hi your blood test are normal except low vitamin and b12 attachment removed to protect patient identity erectile dysfunction and premature ejaculation can be due to many causes if erectile dysfunction is more prominent then first try sildenafil and if it is improving then okay otherwise go for penile doppler study for both premature ejaculation and erectile dysfunction sildenafil plus depoxetine may be helpful take this tablet 30 minute prior to sexual activity also try the behavior methods called start stop technique or coitus interruption or squeeze technique you can read these online and start practicing any one these methods give good result but you need to do these daily and results are only evident after a few weeks also take vitamin and vitamin b12 supplements serum testosterone ed and me sildenafil plus depoxetine regular exercise avoid alcohol or tobacco