<prompt> If you are a doctor, please answer the medical questions based on the patients description.i donot have a good mental relation with my wife. i cannot satisfy her physically,ejaculation doesnot take place with her.but seeing holding my my lady of my choice who had been my crush in school ejaculation immediately took place.is ejaculation psychological?  <response>: Hello misunderstand your concerns think you have delayed ejaculation. It is broadly due to psychological cause or medical cause diabetes, obesity, enlarged prostate, smoking, alcohol, hypertension. I think your problem is due to psychological mainly relation problem. You should have to consult the psychiatric and need the treatment like active cognitive behavioral therapy, talk to your partner about your problem. After resolving psychiatric problem following advice will helpful: engage more in foreplay before sex, use condoms with lidocaine jelly, make romantic environment, after evaluation you can use sildenafil plus paroxetine 30 minutes before sex Hope this may help you Best regards 