What should I do if the first ejaculation is fast and the second is difficult and hard?

Patient's question:

Before, everything was normal. Last year, I experienced premature ejaculation on the first time and difficulty maintaining erection on the second time with a woman. After a long time, I had normal experiences with another woman, even having sex six times in one night. In the past two days, I had the same issue with a woman—premature ejaculation on the first time and difficulty maintaining erection on the second time. Is it because I work overtime a lot?

Doctor's answer:

Hypothesis of the issue: Generally, if ejaculation occurs within five minutes, it is considered premature ejaculation; within ten minutes, it is considered early ejaculation; and beyond ten minutes, it is considered normal. If premature ejaculation is present, a specific examination is necessary to determine the cause, such as high penile nerve sensitivity, psychological factors, or prostatitis. The condition of premature ejaculation tends to be recurrent, requiring long-term oral medication. Additionally, for male patients, it is important to actively seek treatment at professional and reputable hospitals. Treatment should be considered based on thorough examination results. Moreover, it is necessary to control sexual activity and maintain a positive mood.

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