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Physically fit. Suffering from erectile dysfunction and premature ejaculation. Any treatment?

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Psychiatrist
Practicing since : 2006
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I am suffering from Erectile Dysfunction and premature ejaculation. Physically I am ok and no health issues.
Posted Mon, 15 Apr 2013 in Erectile Dysfunction
 
 
Answered by Dr. Gourav Monga 40 minutes later
Hello XXXXXX

Welcome to health care magic and thanks for your query.
I appreciate your concern to seek online support.

1) Erectile dysfunction -
Male erectile disorder is also called erectile dysfunction (ED) and impotence.A man with male erectile disorder has difficulty in obtaining an erection sufficient for vaginal insertion.In general, the psychological conflicts that cause erectile dysfunction are related to an inability to express the sexual impulse because of fear, anxiety or anger.Many developmental factors have also been cited as contributing to erectile disorder.Successive episodes of impotence are reinforcing, with the man becoming increasingly anxious about his next sexual encounter.

Various other causes of ED are Diabetes, infections; cardiovascular, renal or pulmonary disease, nutritional deficiency, drugs, substance abuse (alcohol, tobacco, opioids etc) and many more.

Treatment include drugs like nitric oxide enhancers such as sildenafil, tadalafil etc.Nitric oxide enhancers facilitate the inflow of blood to the penis necessary for an erection. Other treatment options are Prostaglandins, Behavioural exercises, Group therapy, Penile prosthesis etc.

The overall goal of treatment is to initiate an educational process, to diminish the fears of performance felt by both sexes, and to facilitate communication.

2) PME-
In premature ejaculation, the man recurrently achieves orgasm and ejaculates before he wishes to do so.Premature ejaculation is more common today among college-educated men than among men with less education and is thought to be related to their concern for partner satisfaction.
Treatment include Master XXXXXXX Technique (Squeeze technique), drugs like SSRIs (Paroxetine, Dapoxetine etc) and behavior therapies etc.

Don't worry and relax. Consult a qualified psychiatrist/sexologist for all these issues. However, rule out any medical/physical pathology by consulting a general physician.
Try some relaxation exercises like deep breathing, yoga or meditation.

Hope I have answered your query. If you have any further questions I will be happy to help.
If you do not have any clarifications, you can close the discussion, rate the answer and leave a review. Wish you good sexual health.

Regards
Dr. Gourav Monga
Consultant Psychiatrist

Above answer was peer-reviewed by
 
Follow-up: Physically fit. Suffering from erectile dysfunction and premature ejaculation. Any treatment? 10 hours later
Sir, what medication can I take to cure/treat erectile dysfunction
 
 
Answered by Dr. Gourav Monga 11 hours later
Hello XXXXXX

For ED following medication is advised-
1) Nitric oxide enhancers like sildenafil, tadalafil, vardenafil etc.
2) Herbal medicines like tentex forte can be helpful
3) Antianxiety agents can be used to alleviate anxiety associated with sexual act
4) Injectable and Transurethral Alprostadil (Prostaglandin E)

In case above medication fails, Vaccum pumps (mechanical device) and surgical treatment is advised (Male prostheses).

Don't self medicate. Take help of a qualified doctor and you will be definitely alright.

Kindly leave a review if you are satisfied with the answer. Wish you good sexual health.

Regards
Dr. Gourav Monga
Consultant Psychiatrist


Above answer was peer-reviewed by
 
Follow-up: Physically fit. Suffering from erectile dysfunction and premature ejaculation. Any treatment? 1 hour later
Sir, whether use of sildenafil, tadalafil safe. I have learnt long term use causes cardiac problem and permanent impotent also.
 
 
Answered by Dr. Gourav Monga 33 minutes later
hello XXXXXXX

Don't worry. Use of these drugs are contraindicated in those who are already having a history of Cardiac disease such as angina, MI etc.

The drugs do not by themselves confer an increased risk of death. Increased oxygen demand and stress is placed on the cardiac muscle by sexual intercourse.So, any person with a history of MI, stroke, renal failure, hypertension, or diabetes mellitus and any person over the age of 70 years should discuss plans to use these drugs with a cardiologist.
No data is available supporting permanent impotence due to sildenafil.

You can try herbal medication "tentex forte" after initial use of sildenafil.

Kindly leave a review if you are satisfied with the answer.

Regards
Dr. Gourav Monga
Consultant Psychiatrist
Above answer was peer-reviewed by
 
Follow-up: Physically fit. Suffering from erectile dysfunction and premature ejaculation. Any treatment? 48 minutes later
Sir, thank you for your advice. Sir, at present I am taking tadalafil 5 mg daily or 10 mg with two day gap (As reffered by an Urologist). Can I take tadalafil 10 mg daily. Also I am taking cap semento (2 cap) twice daily and Barozac 20 mg capsule once at 6 PM. Sir, does Tenxtex Forte work, because I have tried once but not fruitfull. Also can I take vitamin supplement with these medication.
 
 
Answered by Dr. Gourav Monga 56 minutes later
hello XXXXXX

Tadalafil has long half life. It is effective for upto 36 hours. So it is not advisable to take it daily.
Sementa is an antioxidant.
You can easily take multivitamins along with these medication.
Tentex forte is a herbal product and its effects varies from patient to patient. However, it should be continued for 2-3 months to have full benefit.

Barozac 20 mg contains fluoxetine which is an SSRI. SSRIs are known to cause sexual dysfunction (Erectile dysfunction). So it might be the offending agent in your case and IT IS ADVISED TO STOP IT or change it to some other agent.

Discuss all this with your treating doctor.

Hope I have answered your query. Kindly leave a review if you are satisfied with the answer.

Wish you luck
Regards
Dr. Gourav Monga
Consultant Psychiatrist
Above answer was peer-reviewed by
 
Follow-up: Physically fit. Suffering from erectile dysfunction and premature ejaculation. Any treatment? 1 hour later
Thank you sir for your helpful advise. I am satisfied with you helpful advise. Actually my mind was diverted by one Auyrvedic Doctor, by misinforming me. Thnx a lot.Sir, you have referred not to take Barozac 20 mg. But for premature ejaculation what can I take because Paroxetine and Depoxetine are also SSRIs
 
 
Answered by Dr. Gourav Monga 24 minutes later
Hello XXXXXX

You are right about that. What you can do is decrease the dose of Barozac to 10 mg or start other SSRI because side effects of these drugs also varies from patient to patient. You can choose Dapoxetine for PME as it has somewhat different profile than other SSRIs and is specifically prescribed for PME (not as antidepressant like other SSRIs).

Kindly leave a review.

Wish you good luck
Regards
Dr. Gourav Monga
Consultant Psychiatrist

Above answer was peer-reviewed by
 
Follow-up: Physically fit. Suffering from erectile dysfunction and premature ejaculation. Any treatment? 4 minutes later
Sir, can I take tadalafil and tentex forte along with one another.
 
 
Answered by Dr. Gourav Monga 2 minutes later
Hello XXXXXX

Yes you can easily take these drugs together. Don't worry.

Hope I have answered all your queries. Kindly leave a review if you are satisfied with the answers.

Wish you luck
Regards
Dr. Gourav Monga
Consultant Psychiatrist

Above answer was peer-reviewed by
 
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