<s>[INST] hi i m 24 years old man and i have problem with sex the problem is in normal time my penis standproperly but when i want to do sex with girls it does not stand and some water comes in my penis and it is difficult to stand ...because of this my sex activity is become weak..so can u tell me a solution and treatment please. [/INST] Hi,Your problem is most commonly due to psychological issue like performance anxiety, stress, marital disharmony. It could be due to medical causes like obesity, problem in back nerve, low testosterone, diabetes, excessive alcohol and smoking.I would suggest to consult urologist and undergo complete health check up, routine blood tests, serum testosterone, USG pelvis/scrotum.If all tests will come with in reference range then require sex counseling and psychiatric consultation.Meanwhile take following advises:Avoid stress during sex, and avoid sex when you feel fatigue/low. Spend more time in forepaly and also do foreplay during sex. Use stop and start technique of sex (divert your mind to some another thing before time of ejaculation). Try women on top position, use double condom and apply lidocaine gel. Do pelvic exercise like Kegel's exerciseTake healthy diet and do regular exercise like walking, running for 45-60 minutes followed by medication. Avoid stress, smoking and alcohol. If problem persists then drugs like Sildenafil, Tetrafol plus and Paroxentine after complete evaluation will help you.Hope this may help you. Contact further if follow up needed.Best regards,Dr. Sagar </s>