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

### input:
Im suffering from premature ejaculation and erectile dysfunction as well as anxiety. Im not sure but I think the anxiety is causing both other symptoms. Ive tried all the methods to control my orgasm stop start techniques, pc muscle clenches, and squeezing the tip of the penis before cuming it doesnt help.  Ive also tried delay condoms and gels, which work sometimes but often cause me to loose my erection. If it is down to anxiety then Ive also read that the anti anxiety causes impotence so that might solve the problem that causing it this time but create a new one, the same with anti depressants.  This problem has lasted over a year before I had no problems in this area. Can you give me some advice as it is making me depressed and ruining my relationship.

### output:

Hi and welcome to Chat Doctor. Thank you for your query. I am Chat Doctor, I understand your concerns and I will try to help you as much as I can. Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration. It happens with minimal sexual stimulation and before the person wishes. Most cases of premature ejaculation do not have a clear cause. With sexual experience and age, men often learn to delay orgasm. Premature ejaculation may occur with a new partner. It may happen only in certain sexual situations or if it has been a long time since the last ejaculation. Psychological factors such as anxiety, guilt, or depression can also cause it. In some cases, it may be related to a medical cause such as hormonal problems, injury, or a side effect of certain medicines. In many cases premature ejaculation gets better on its own over time. Treatment may not be needed. Practicing relaxation techniques or using distraction methods may help you delay ejaculation. For some men, stopping or cutting down on the use of alcohol, tobacco, or illegal Chat Doctor. I hope I have answered you query. If you have any further questions you can contact us in every time.