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

### input:
Dear sir, I am 58 yeras old,weight 95kg; height 1.65m, Type 2 diabetic patient since 15 years, but under control. I am having lumbar spine stenosis at three levels, by doing special exercises I don t have back pain but my doctor advised me not to have intercourse in future. My penis size is 1.5 inches, when erected 3.5 inches without any hardness and immediately gets ejeculation at this loose stage when I try to enter in vagina, thereby cannot satisy my wife any more. I am working in Abu Dhabi, UAE since last 30 years and used to go to India on vacation once in every two years. Last week I rejoined duty and my problem still continues even after taking soft VIAGRA - 100 mg. pills many times before each intercourse and sometimes other unani herbal medicines, but of no use. Please advice. My doctor says because of my age, weight, diabetes and lumbar stenosis, this problem will never be solved permanenetly. Kindly help me to solve this long lasting problem once for all. I request you to write me in detail. I appreciate your quick response in this regard. Thanks.

### output:

Hi, Well if your power of will to find a solution then with personalized therapeutic plan under close medical monitoring you should be able to overcome the issue.  This won't be easy. This requires long detailed therapeutic plan to help. I will gladly give a short glimpse of such a plan. Feel free to contact me for detailed plan and step-by-step action.  First, your first goal would be to lose weight. It is easier said than done.  This can be done using caloric deficit, that will result in weight reduction without suffering.  Second, you need to include daily exercise. I know this will be hard due to the stenosis. At start this could be simple gradual exercise plan.  In a period of 1-3 months you will start noticing difference. During this period, If I were your treating physician I would prescribe you Metformin, medications that can help you will be premature ejaculations.  I would monitor your testosterone levels closely too. Prescribe supplements if needed. From what I read, It is great that the stenosis pain responded to physiotherapy. With aforementioned therapeutic intervention you will not only add years to your life but also quality to your life. Hope I have answered your query. Let me know if I can assist you further. Take care 