Im 32 years old and Ive been facing some issues with ejaculation during sex. I also have trouble maintaining an erection. Its starting to affect my confidence and relationship, and Im really concerned. Can anyone advise what might be going on or what I can do about it?

Ejaculation and Erection Issues_1. _Premature ejaculation_: If you're experiencing ejaculation soon after penetration or before penetration, it might be premature ejaculation.2. _Erectile dysfunction (ED)_: Difficulty maintaining an erection can be a sign of ED.3. _Underlying medical conditions_: Certain medical conditions, such as diabetes, high blood pressure, or hormonal imbalances, can contribute to these issues.4. _Psychological factors_: Stress, anxiety, or relationship issues can also play a role._Possible Causes_1. _Hormonal imbalances_: Low testosterone or thyroid hormone imbalances can affect ejaculation and erection.2. _Neurological issues_: Conditions like multiple sclerosis or nerve damage can impact ejaculation and erection.3. _Medications_: Certain medications, such as antidepressants or blood pressure medications, can contribute to these issues.4. _Lifestyle factors_: Smoking, excessive alcohol consumption, or lack of physical activity can also play a role._Next Steps_1. _Consult a healthcare professional_: Schedule an appointment with a urologist or a sexologist to discuss your concerns.2. _Medical history and physical exam_: Your healthcare professional will take a detailed medical history and perform a physical exam to identify underlying causes.3. _Diagnostic tests_: Your healthcare professional may order diagnostic tests, such as blood work or imaging studies, to rule out underlying medical conditions.4. _Treatment options_: Based on the diagnosis, your healthcare professional will discuss treatment options, which may include medications, lifestyle changes, or therapy.