Hello doctor, after marriage i am feeling that my penis is not hard

Patient: Hello doctor, after marriage i am feeling that my penise is not so harder as it was before 3 to 4 years and i am not able to do physical relationship with my wife

Doctor: Hello,Thank you for your query at AskTheDoctor.comI understand your concern.The problem of erection that you are having is probably due to psychological reasons. The fact that you are able to achieve an erection on and off suggests that there is nothing wrong with your penis. Probably it’s that you are afraid of premature ejaculation that you are losing the erection. It is very common among males after marriage. Many times when we correct the premature ejaculation, the problem of erection may settle down.Now it’s a type of anxiety disorder and the person normally suffers from performance anxiety wherein he is anxious if he can perform or not.First you can try the start-stop technique. Your wife is supposed to start stimulating you and the moment you are about to ejaculated she is supposed to stop all the stimulation and hold your penis head hard. Now this should be repeated.Perineal exercises also help. These are the muscle exercises that occur when you contract the perineal muscles like when you are trying to stop the urine or feces. You have to do these contractions repeatedly daily to tone up the perineal muscles.One solution is medications. Some patients are not willing to wait for these acts to produce results and instead demand medicines. For them, 12.5 mg paroxetine at night should be taken. Normally one should try until 25mg of Paroxetine. If paroxetine is not effective then Dapoxetine is an option. It has to be given 1 hour before having sex and will prolong the sexual interval.Hope this was helpful.Regards