Brief Answer:
serum testosterone level should be checked

Detailed Answer:
Hello,

Thanks for writing to us.

At age of 74 erectile dysfunction(ED) is common.

Due to aging erection capacity and ejaculation capability are naturally reduced. However if someone is physically active and without any disease he can perform well in sex at this age also.

You have good libido but erection is not sufficient. Viagra is useful drug but it must be used under doctor's guidance.

I would recommend to go for serum testosterone once. If it is quite low, supplements can be given.

Treatment for ED is there:

5- PDE inhibitor group of medicines like sildenafil(Viagra) or tadalafil(cialis) are used. One of them should be used 2 hours prior to sex. They causes headache,stuffy nose nausea and gastric discomfort like common side effects. Proper physical check up of cardiac system should be done by a doctor before starting the same.These are prescription medicines and you need to consult doctor/psychiatrist/sexologist for the prescription.

You can use another medicine cum vitamin supplement containing pyridoxal-5-phosphate, mecobalamin and l-methylfolate (trade name tetrafol plus in some countries)is very helpful in my patients. It has shown improvement in 50-60% patients of mine with ED.You should take it after meal twice a day. If you feel some improvement in 15 days you should continue for at least 1 month. You may get this medicine over the counter as it is vitamin product.

There are some natural lifestyle measures which help to improve blood flow to penis and overall sexual performance.

- The most important factor is healthy heart. Blood is pumped in to body by heart.So regular exercise and avoidance of fatty fast food are important measures to prevent heart disease. Regular walking, swimming or running overall improves blood flow to whole body circulation including penis and keep the mind fresh.

- Healthy diet

- Avoid smoking and alcohol. Low amount of alcohol can help in increasing blood flow but more amount can cause opposite effects. So better to avoid the same.


Let me know more.

- Do you have any problem in urinating?

- Is there morning erection when you wake up from sleep?

- Do you have any physical problem like blood pressure or diabetes? If yes, let me know the details with medicines going on.

- Do/did you have any habit of smoking or any other substance use?

- How was the response with Viagra?

- How much your partner is cooperative and fit for sex?

I will be happy to help further.

Regards,

Dr.Chintan Solanki.

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