### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I m a 21 year old male, I believe i devoloped Gynecomastia during puberty and also have premature ejaculation. I have tried to put up with both these problems since i was 13 years old but its finally broke me. I m to embarrassed to go and see a doctor about these problems, and have checked online for treatments to these problems, Gynecomastia seems to be treated with surgery and PE is treated with anaesthetic creams or Anti depressant medication which needs to be taken 1 - 3 hours before sex.. what if you are unaware if your going to be having sex.. ? I don t feel its worth it to see a doctor about this if I m unsatisfied with what I have read already about treatments for these problems but i cant live with them any longer. Is this possibly a hormone imbalance that can be sorted out with a different course of treatment? Please advise thank you.

### output:

Dear, as I can understand here is that you are having two problems1) gynecomastia and 2) premature ejaculation with a possible underlying depression. Now if you are being treated or advice a treatment for gynecomastia, I would need to know the cause and treatment you are taking. As you have rightly guessed, there could be common central pathology that can lead to both the conditions, here a hormonal assessment is essential to check or rule out any endocrinology pathologies. If you have already undergone such investigations I need to know the results or kindly get one done. Secondly, for the treatment part of premature ejaculation there is mainly a symptomatic treatment for it. Anti-depressant will help you, which you will have to take for minimum period of Theo years. Tab fluoxetine is a good Chat Doctor. I would advise you take up an issue of hormonal assessment with your treating doctor and think of adding tab fluoxetine. I'll be glad to know the results of your test as I am in not a position to advice you any definitive treatment plan. Extremely sorry if I fail to satisfy your query. Thank you.