Hello doctor,I am 70 but until recently have been very sexually active with my wife. I am in good health overall but have suffered from anxiety and depression my entire life. That usually has not interfered with my sex life. I have had a penile implant several years ago so getting an erection is not an issue. But for the past couple of months, I have not reached orgasm and ejaculated except when my wife tries through hand jobs to complete the orgasm. Even that is very delayed and seems like it takes forever. Sometimes I just give up because my wife gets weary and I feel guilty. My libido seems to be mostly in low gear but sometimes I am desiring but it does not work. I just had my testosterone level checked. It is in the mid 500. For 30 years, I have had to inject Depo-T 5 mil per week because I had low T related. I think of the long-term use of Prednisone to treat Crohn's. It has been in remission for 10 years but I still take 10 mg Prednisone daily because my adrenals no longer function. My penile implant was due to Peyronies disease. For my depression, I am on 450 mg of Bupropion and just 2 mg of Abilify. I exercise one hour a day seven days a week, mostly swimming. But lately, during my sexual efforts, I sweat and get tired fast. I had a stress test and did great. So I am now desperate to be able to ejaculate during intercourse.
Hello. You are in good health and has no serious co-morbid issue. You have main problem of delayed or no ejaculation. This could be occurring due to poor erection or reduced libido or anxiety. You are not on any anti-hypertensive so we can think of adding Sildenafil to your prescription. You can take 25 mg tablet and this should help in hard erection and should help in ejaculation. You should talk to your doctor before starting this drug.