I can't seem to stay hard for long. And i ejaculate way too early

Professional Assessment: The described symptoms suggest erectile dysfunction (ED) and premature ejaculation (PE), which in a 21-year-old male often have psychological factors (performance anxiety, stress) as primary contributors, though organic causes should be considered including hormonal imbalances (testosterone levels), vascular issues, or medication side effects. The pathophysiological mechanism likely involves sympathetic nervous system overactivity and potential dysregulation of serotonergic pathways, particularly for the PE component, while ED symptoms may relate to inadequate nitric oxide release or psychological inhibition of normal erectile mechanisms. Given the patient's young age, additional testing should include comprehensive hormonal screening (testosterone, prolactin, thyroid function), metabolic panel, and cardiovascular assessment, while a detailed psychological evaluation may be warranted to address potential underlying anxiety or relationship concerns.

For erectile issues and premature ejaculation at your age, start with Kegel exercises (pelvic floor muscle training) 2-3 times daily to improve control and stamina. Implement the "start-stop" technique during self-stimulation, pausing when close to climax, and practice deep breathing to reduce performance anxiety. Consider using delay sprays containing lidocaine or climax control condoms, and maintain a healthy lifestyle with regular exercise and reduced alcohol consumption. For additional treatment recommendations, ask in the chat.