Brief Answer: Cause of ED need attention Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 37 year old male • Known case of alcohol dependance (3-4 peg daily) • Concern related to manforce use. Manforce contain sildenafil (Viagra), which causes erections to be stronger and long lasting, but it should be taken after prescription. It is very important to rule out medical conditions specially related to cardiovascular system before starting such treatment by general physical examination. If every thing is ok, it can be used once in a week. Alcohol should be avoided with its use. It can be taken 30 min before dinner and 1.5 hour before sex. Erectile dysfunction (ED) can be a result of a psychological or physical problem. Psychological causes: Most common cause in young patients. These include performance anxiety, emotional weakness, inferiority complex, stress, marital or relationship problems, low mood, feelings of guilt, and the effects of a past sexual and emotional trauma. Physical causes: Include neurological disorders, alcoholism, drug abuse , vitamin deficiencies, hormonal imbalances, diabetes, hypertension, blood vessel disease and chronic diseases. Considering your age (37 years), in treatment of ED cause of the problem should be treated. In your case alcohol and alcohol induced anxiety/vitamins deficiency may be cause for ED. Following steps will be helpful to improve erection in your case: -Stop alcohol or do not take alcohol more than once a week. -Daily morning jogging for 30 min to increase blood circulation in body. -Start multivitamins like: Cap Cobadex CZS + Tab Neurobion forte 2 times a day I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups. Wish you good health. Regards, http://bit.ly/Dr-Ashish-Mittal

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