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

### input:
Hi ! I am 28 yrs. Recently I got married in January. Problem is I can keep an erection during masturbation, hand jobs, but as soon as get into my partner during intercourse, I lose my (sperm ) erection in a minute and my dick starts going soft.I can get erections when I fantasize and masturbate and easily make myself cum, but during vaginal sex its a lot more difficult for me. This is very frustrating. Pls suggest me som solution for long erection

### output:

Hello misunderstand your concernTreatment of erectile dysfunction is depended on the cause of it. It can be treated by both psychologically and Chat Doctor.  Following are the causes of erectile dysfunction:psychological like Excessive stress and relationship issues, Diabetes, Hormone problem like Low testosterone levels, Prostate Enlargement, alcohol & tobacco consumption (constriction of penile blood vessel), obesity. I think k you have anxiety or relationship issue. So first consult the best urologist or psychiatric and get the following test done: He, CBC, ESR, blood sugar, lipid profile, urea, creatinine, Vitamin B12, folic acid levels iron, etc. Hormones (total and free testosterone, corticosteroids, RHEAS, Thyroid hormone, seminal fluid analysis, Doppler USG of scrotum and penile area to find out the blood flow problem.Meanwhile, take following advice:Engage in more foreplay before sex, do discussion with your partner that help in gaining psychological trust, Stop sex when ejaculation soon and divert your mind in other activities, use more than one condom. Following medicine can be provided by doctor after evaluation: Tablet Viagra: about one hour before sexual activity, testosterone Replacement Therapy, paroxetine 30-40 min before sex, Lifestyle modification, Start exercising (60-80 minutes in morning with relaxation and yoga), losing weight, stopping smoking and alcohol, Healthy diet with proteins and vitamin A, C, E. Take anti oxidant like CO Q. Hope this may help you Best regards