Find out the cause of the problem

QI am a 35-year-old married woman, and my husband is 45 years old. We have been married for six months, but have not been able to have successful intercourse. My husband is facing a problem of premature ejaculation, after which his penis shrinks. We have consulted a gynaecologist who prescribed Promaetil, Verilex, and Penegra Xpress. However, these drugs haven’t helped. Please suggest a remedy for our problem.

The ideal method of management is to first find out the cause(s) of the problem and then plan a treatment strategy. Premature ejaculation can be caused by physical factors (Eg: diabetes, short frenulum, sensitivity reactions, certain neurological problems etc.), psychological problems (conditioned response, anticipatory anxiety, personality traits etc.) or a combination of both. If it is due to a physical problem then pharmacotherapy (treatment with medicines) should be the method of choice. If the problem is due to psychological factors sex therapy will be useful. In some couples, a combination of both these therapeutic strategies has to be used. I suggest that you consult a specialist in Sexual Medicine.

Q I am 28 years old, unmarried and a virgin. I started masturbating when I was eight. However, I suffer from severe constipation that leads to anal fissures. Is masturbating in any way related to constipation?

Masturbation is no way related to constipation. Your constipation may be due to consumption of certain medicines (for other medical problems), lack of adequate fibre in your diet, hormonal disorders (especially hyperparathyroidism), pelvic floor dysfunction (muscles surrounding the rectum not functioning due to loss of tone), lifestyle changes like pregnancy, depression and physical abuse. Get checked by your doctor and take appropriate remedial measures.