• Normal male sexual function occurs in five adversely regulated phases:

  • 1. LIBIDO: Initiated by psychological factors and androgens levels.
  • 1. ERECTION: Is a neurovascular event. It is a complex interplay between somatic and autonomic innervations of penis,the smooth and stimulated musculature of corpora cavernosa. and pelvic floor and the arterial inflow,provided by pair of pudendal arteries Nitric oxide, vasoactive polypeptide,, acetylcholine and prostaglandins, all initiate and contribute to erection.Quality of erection can be expressed by intracavernous pressure.

  • c. THIRD PHASE: Ejaculation.
  • d. FOURTH PHASE: Orgasmisa cortical sensory phenomena in which the rhythm contraction of bulb cavernous and ischio cavernous is perceived as pleasure.
  • e. FIFTH PHASE: Detumescence i.e, penile flaccidity.


Erectile dysfunction is a condition in which man is unable to maintain erection to complete the sexual activity.


1. Organic
2. Psychogenic
3. Both
  • 1. Organic: can be neurological, vascular, endocrine, pharmacological. There is gradual onset of deteriorating function.
  • a. Neurological: Can be due to multiple sclerosis, tamours, peripheral neuritis, injuries: pernicious anaemia, syphilis, spinal cord trauma.
  • b. Vascular: Can be due to arteriosclerosis, hypertension, stroke, myocardial infarction.
  • c. Endocrine: Can be due to low testosterone levels, increase progesterone which can cause low libido and affect sexual function.
  • d. Pharmacological: Can be due to antihypertensive, anticholinergics, antihistaminic, disulfuram and estrogens, nicotine, alcohol, stimulants, narcotics.
  • e. Trauma
  • 2. Psychogenic: Episodic, sudden onset preceded by episodes of high stress. Patients’ frustration about erectile dysfunction further exacerbates the problem itself.
  • In hypertension there is less or no production of nitric oxide in the vessel wall. Intracavernous injections of nitro vasodilators overcome erectile dysfunction. Side affects of sexual dysfunction occurs even with normal therapeutic doses of antihypertensive. ACE inhibitors are drugs which do not impair sexual function. Calcium channel blockers also do not inhibit sexual function.

  • TREATMENT: Is knowing the cause and treating it.


    There are only 5 reasons why you get premature ejaculation in most cases.Yed it’s true most men trace their premature ejaculation to one of these 5 reasons. Here they are, see which of these applies for you.

  • 1. GENES: The fact is your body is programmed to use sex for reproduction and it wants to do that as efficiently as possible. The body wants to ensure your genes are carried down through the years, do it makes you climax quickly to try and achieve that.
  • 2. MASTURBATION: Too much in your teen years may have rewired your body for a super quick response. Like it or not, excessive masturbation can cause premature ejaculation. Why? Simple, it teaches your body to focus on the wrong things and when it happens, its all over.
  • 3. INTENSITY: For some people, the arousal and stimulation of sex just too much. That’s why it feels like there’s no way of stopping once you start. It really can be like a run way train plummeting down the hill. It almost feels like everything’s completely out of your control.
  • 4. LACK OF BODY KNOWLEDGE: Most people have no idea how or why the ejaculatory process works and this leads to encouraging premature ejaculation without knowing. Once you understand the process though it does not have to be so quick and out of control.
  • 5. SENSITIVITY: Some of us guys just have bodies that are more sensitive than others. If you have ever felt completely overwhelmed and out of control during sex, this could be you. But don’t worry; it’s actually an advantage if it applies to you.


  • Is actually a very simple 3 step process.

  • a. MENTAL CONTROL: Believe or not thoughts running through your head during sex make a huge difference to how long you can last. With a little guidance you will learn how to focus on the good stuff and still last way longer than you can now.
  • b. HORMONAL REGULATION: Understanding the actual process of ejaculation will help get a long way to sustaining your lovemaking. And once you understand it, you will know how to regulate the exact hormones that cause you to climax.So you will automatically last longer.
  • c. PHYSICAL CONTROL: lastly there are handfuls of things that are guaranteed to make you climax way sooner than you want to. If you know what they are, you can regulate or eliminate them, and suddenly the whole thing is completely under your control.

    A combination of these 3 factors can make a huge improvement in your lovemaking.
  •  Dr D.K Jagpal MBBS,MSS
    Consultant General & Sex Problems
    Kothi No. 654, Sector 7 ,Panchkula. Haryana. India-134109
  •   +91172 4629987
  •   +91 9876532149