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Erectile dysfunction as stiffness loses fast - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Good Posted in: Premature Ejaculation
Answered by

General & Family Physician
Practicing since : 2005
Answered : 1720 Questions
Doctor :   Hi Dr.
User :   Hello Dr.
Doctor :   please type ur query
User :   I am with my husband and we would like to discuss a medical problem that we are facing with him.
User :   He has been diagnosed with clinical erectile dysfunction and we have also seen a doctor in Bangalore
Doctor :   ok
User :   The Doctor is not very communicative and only prescribed medicine without telling us anythin.
Doctor :   Go ahead...Be open.
Doctor :   I will suggest
User :   He is a very renowned doctor, but we would like to also understand the problem
User :   we have been seeing him for the last 8-9 months now with not much improvement.
User :   over to adi he will talk directly
User :   I have been on Tazzle, clofranil for some months
Doctor :   ok
User :   but now the doctor has given me tazzle and penegra. I read about penegra on the instructions that came with it and i got a little concerned about the side effects and precautions
User :   which i why i am talking to you now
Doctor :   So you are not getting enough stiffness enough to penetrate
Doctor :   or are yougetting enough hardness but loosing erections inside
User :   I am getting stiffness to penetrate but not very much
User :   and i cannot maintain it for too long. sometimes i can and sometimes i cannot..
User :   but i always ejaculate prematurely
Doctor :   so there are 2 components
Doctor :   Tazz works for erections
Doctor :   clofranil delays ejaculations
Doctor :   Did the Tazz help any thing?
User :   Yes it did. It is better when I am taking it.
User :   is it a lifelong medication?
Doctor :   I am sorry to say that .
Doctor :   We will find out the cause first
User :   ok sure.
Doctor :   If there are no causes, u may have to use it
Doctor :   how old are you and your wife?
User :   so my doctor said that because he could not see me improving with tazzle after stopping use he changed the medicine to penegra.
User :   is it a safe medicine?
User :   my wife is 30 yrs and I am 37
Doctor :   basically both works in the same fashion
Doctor :   they increase blood supply ro penis and makes it hard
Doctor :   of one mediction is not working they change
Doctor :   but more or less they work better
Doctor :   coming to causes: User :   yes
Doctor :   How long do you have the ED problem?
Doctor :   When were u married?
Doctor :   Do you have children?
User :   We have been married for 7 years and we have a 4 year old child.
Doctor :   ok
User :   i think always had a problem with premature ejaculation but rest was fine.
Doctor :   so when does this ED problem arise
User :   we had a stressful phase where we did not have sex much for 1-2 yrs.
User :   and we notice ED problem in the last 2 years in 2009 end
Doctor :   Why u did not seek medical help ?
User :   we thought it was psychological and we addressed that first.
Doctor :   Why u did not seek medical help when u had stressful phase ?
Doctor :   ok
User :   i think i kept delaying as it was awkward.
Doctor :   that is some what acceptable but partner pleasure is imp
Doctor :   do u have any medical problems like diabetes, high BP, high cholesterol?
User :   yes and we have talked about it and that area has certainly improved. we can talk about this comfortably now with each other.
User :   yes i have thyroid and cholestrol
User :   and am taking treatment for it.
Doctor :   but not diabtes and high BP
User :   no
Doctor :   good
Doctor :   I hope thyroid and cholesterol under control
User :   yes they are now under control
Doctor :   Sta y on medicines
Doctor :   ok
User :   i am taking regular medication for both
Doctor :   What abt emotional issues like Depression, stress, anxiety
User :   Also doctor in one of my tests my estradiol was 32 and the doctor had given an injection
User :   no emotional issues at all. I am a very happy go lucky person.
User :   but yes workwise past 3 years have been extremely hectic
Doctor :   hum
Doctor :   have you checked the testosterone levels?
Doctor :   what is ur profession?
User :   yes they are fine. I have my own software company.
User :   have checked testosterone.
User :   We also want another child which is why we want atleast a temporary cure for this
Doctor :   was it normal
Doctor :   was it on low end
Doctor :   do u have the value with u now?
User :   yes
User :   serum testosterone 4.440 ng/ml
User :   serum free testosterone 122 pg/ml
Doctor :   do uhave normal values on the page
User :   yes
User :   for the first it is 0.280 - 11.000
User :   ad for the second it is 50.00 - 210.00
User :   hello?
User :   are you here?
Doctor :   y
Doctor :   analysisng the vakues
Doctor :   I am with u
User :   ok
Doctor :   Low testosterone is defined as less than 300 nanograms per deciliter of blood.
User :   ok
Doctor :   but urs is fine in average
User :   so what do you think I should do
Doctor :   but I will take advantage of increase the serum free testosterone
Doctor :   u r average . My thought is make it above average
User :   how do we do that
Doctor :   Let us bring it upto 200
Doctor :   for that you need testosterone patches or injections
Doctor :   replace harmonies for few months and measure the levels
Doctor :   maitain around 175-200
User :   isnt the injection temporary? any side effects? and should i take it while continuing with tazzle and penegra
Doctor :   consult urologist or sexologist or endocrinilogist and request the harmone replacement when there is genuine problem
Doctor :   we are appprorcohing multiple ways
Doctor :   when u r fine on harmones and problem is resoleved u do not need penegra
Doctor :   Is it temporary?
User :   doctor has asked me to take for 10 days and report back to him
Doctor :   answer depends on repeat lab values and sexual performace
Doctor :   if the increased levels increases ur performce u may take monthly one injection
User :   is that also a lifelong thing. Are there no natural ways to increase testosterone levels?
Doctor :   there are none
Doctor :   it is harmone produces in testes
User :   is the testosterone injection like a steroid?
Doctor :   it steroid class
Doctor :   but it is not completley having the steroid effeects
Doctor :   every drug has own action
Doctor :   u r taking for medical purpose and that too under doctor scrutinity
Doctor :   carefully repeating the labs so tat levels do not go sky high
Doctor :   Do u follow me?
Doctor :   Many people try this.
User :   ok
User :   so u are saying that i have to be on lifelong medication for my problem
Doctor :   really this Q puts me in very awkward position, because I am one time chatting doctor, if the condition improves the doctor will stop the medicines if no improvement he will continue it.
Doctor :   How can i completely tellu u need it lie long
User :   ok
User :   so now i should continue with tazzle and penegra
User :   and cnsult my doctor for increasing testosterone levels
Doctor :   rather asking permanent or temporary, think how can u resolve the CURRENT ISSUE
User :   and observe for some time
Doctor :   exactly
User :   will do.
Doctor :   And second issue is: stress makes performace poor
Doctor :   do not perform intercourse when u r over worked
Doctor :   cut down intercourse 2-3 /wekk
Doctor :   do it only when u sleep 8 hrs and relaxed at home
Doctor :   do not try failure attempts and do not feel inferior
Doctor :   Do u follow?
User :   we have intercourse 2-3 times a month
Doctor :   Even that one is problematic right!
User :   overwork is unavoidable.. i have a startup both of us
Doctor :   x Even when u do 2-3 /mo be cautioius, take rest
Doctor :   and relaex
Doctor :   I understand work is unavoidable
User :   ok
User :   thank you for your time.
Doctor :   The success of treatment for sexual problems depends on the underlying cause. The outlook is good for dysfunction that is related to a treatable or reversible physical condition. Mild dysfunction that is related to stress, fear, or anxiety often can be successfully treated with counseling, education, and improved communication between partners.
Doctor :   limit alcohol
Doctor :   if u drink
Doctor :   quit smoking if u smoke
User :   i do drink evryweekend with friends and sometimes in weekdays but rare
Doctor :   Increase communication with your partne
Doctor :   go out
Doctor :   dine out
User :   i smoke only upto 2 cigeretes a day
Doctor :   keep the child away from you when u romance out side
Doctor :   please stop smoking
Doctor :   that aggravates the problem
User :   ok
Doctor :   thank you for consulting
User :   doctor one last question. Please tell me if penegra is safe. it says on literature that it is indian viagra
Doctor :   it is safe
User :   am sorry for repeating again
Doctor :   when people take nitates for chest pain it cause low BP
Doctor :   but u r not taking nitro pills
Doctor :   so go ahead.
Doctor :   take and enjoy
User :   thank you then i will keep your suggestions mind
Doctor :   Bye
User :   bye
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