Suggest Treatment For Erectile Dysfunction

Brief Answer:
Please get evaluated

Detailed Answer:
Hello XXXX

Thanks for writing to us.

Erectile dysfunction (ED) is common problem nowadays and in the young people like you, cause is likely more psychological than physiological.

You have not provided much detail of your problem but I will try my best to solve your query.
If I were your treating doctor, I would approach in following manner.

I will check for your blood pressure, sugar level and testosterone level to rule out any specific cause for erectile dysfunction(ED).

If testosterone level is low, oral or injectable form of testosterone can be taken under medical supervision.

Considering your age, I don't think so you should have blood pressure or diabetes.

If testosterone level comes normal I will go for either medicinal approach and/or psycho sexual counseling therapy after discussion with you.

Medicines: Sildenafil 50 to 100 mg or Tadalafil up to 10-20 mg.These are same group(PDE-5 inhibitor) of medicines which should be taken one-two hours before sex after doctor's prescription.They are causing least side effects except morning headache in some patients, that is specifically with sildenafil less with tadalafil.

One recent molecule containing methylfolate and pyridoxal phosphate(vitamins, trade name tetrafol plus) taken to be two times daily after meal is also useful in some patients particularly with homocystiene deficiency.

Other medicines are trazodone and yohimbine which are useful in many patients in erectile dysfunction.But secondary choice.

Another option is intracavernous (in penis vein) injection of papaverine which must be used under medical supervision.Which is last resort if above not works.

Psycho sexual counselling cum psychotherapy for sex:
Sex is act of two.So preferably your partner should be involved in counseling, that's why it is called couple therapy.Master & XXXXXXX technique is specifically useful which can be learnt from psychiatrist/qualified sexologist.

If you have any use of smoking,tobacco or excessive alcohol, please stop that.

If you got the point and are satisfied with the answer, no need to provide more detail.You can go to your doctor and discuss above options and start the treatment.

But if you still have query, you are welcome and also tell,"Duration of your problem ,duration of married life or active sexual life,if any stress in life."


Regards,
Dr.Chintan Solanki.

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Brief Answer:
Yes you can start medicines

Detailed Answer:
Thanks for query again.

You are married since 5 months. So likely possibility of performance anxiety there.
Premature Ejaculation-PME is defined as ejaculation of man occurs before female partner reaches to orgasm during intercourse.
If you are suffering from, there are two types of treatment.

One is medicines: Clomipramine (Dose 10-25 mg), Paroxetine (10-20 mg) and depoxetine(30 mg) are useful.
Clomipramine or paroxetine can be taken initially daily and later on just before 2-3 hour of sex under doctor's guidance.While depoxetine should be taken 2 hours prior to intercourse only, however availability of depoxetine is the issue.
No significant side effects of these drugs.

If I were your treating doctor, I would go with 10 mg clomipramine to start with.

Second option is sex counseling which I mentioned before in which issue of performance anxiety can be solved out.

So you can start comipramine and sildenafil or tadalafil as I mentioned before.

Note: Any medicine must be taken with written prescription of doctor to be on safer side to get help of doctor in emergency.

regards,
Dr.Chintan Solanki.

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Brief Answer:
in morning at standard laboratory

Detailed Answer:
Hi XXXX

I am not able to see your exact location.

You can go to any standard laboratory in the morning around 7 am for sample of blood for testosterone level.Sometime to check average level other samples may be needed which can be advised by doctor at laboratory there.

regards,
Dr.Chintan Solanki.

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