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Suggest Treatment For Erectile Dysfunction
Question: I am 22 and I have symptoms of ed(Erectile dysfunction). I even have ankylosing spondilytis. It makes me very depressed and disheartened to go through something like this in such an early age.
What should I do..?
What should I do..?
Brief Answer:
Erectile dysfunction and treatment
Detailed Answer:
Hello XXXX.
You age is just 22 years and you are also having "ANKYLOSING SPONDYLITIS" beside erectile dysfunction.
You are so depressed but I want to tell you that this is a curable disease , so don't be so disheartened .
Some times PROSTATITIS has been reported to have an increased prevalence in men with ankylosing spondylitis , so consult a surgeon and get his opinion regarding this.
One more point I want to mention that spinal cord injury is very common in ankylosing spondylitis patient so please mention about that also.
ED ( Erectile Dysfunction ) is associated with certain physiological and psychological changes related to age .
Physiological reasons are:
Vasculogenic , disturbance of blood flow to and from the penis .
Neurogenic , the disorder related to sacral spinal cord or autonomic fibers to the penis.
endocrinologic ,increased level of prolactine decreases libido.
Since you are just 22 years and having ankylosing spondylitis and also taking treatment , so I recommend you first of all consult a physician and rule out any pathophysiological reason ( disease ),which may be responsible for erectile dysfunction.
Psychogenic , as you are so depressed so this depression may be responsible for erectile dysfunction ,so I recommend you please consult a psychiatrist and get his opinion.
After reading your query I recommend you first of all consult a physician and find out the proper cause of E D , if no reason then consult a psychiatrist and get his opinion.
Certain drugs also causes E D , so please mention .
TREATMENT.
Sildenafil is the only approved and effective oral agent for the treatment of E D because it is effective for the treatment of a broad range of causes of E D including psychogenic as well vasculogenic , spinal cord injury .
Dosage are 25 , 50 and 100 mg and enhances erection after sexual stimulation.
If you don't respond this treatment then deal as mentioned above.
Hope this will help you.
Further , if any question I will reply in follow up.
Good luck.
Erectile dysfunction and treatment
Detailed Answer:
Hello XXXX.
You age is just 22 years and you are also having "ANKYLOSING SPONDYLITIS" beside erectile dysfunction.
You are so depressed but I want to tell you that this is a curable disease , so don't be so disheartened .
Some times PROSTATITIS has been reported to have an increased prevalence in men with ankylosing spondylitis , so consult a surgeon and get his opinion regarding this.
One more point I want to mention that spinal cord injury is very common in ankylosing spondylitis patient so please mention about that also.
ED ( Erectile Dysfunction ) is associated with certain physiological and psychological changes related to age .
Physiological reasons are:
Vasculogenic , disturbance of blood flow to and from the penis .
Neurogenic , the disorder related to sacral spinal cord or autonomic fibers to the penis.
endocrinologic ,increased level of prolactine decreases libido.
Since you are just 22 years and having ankylosing spondylitis and also taking treatment , so I recommend you first of all consult a physician and rule out any pathophysiological reason ( disease ),which may be responsible for erectile dysfunction.
Psychogenic , as you are so depressed so this depression may be responsible for erectile dysfunction ,so I recommend you please consult a psychiatrist and get his opinion.
After reading your query I recommend you first of all consult a physician and find out the proper cause of E D , if no reason then consult a psychiatrist and get his opinion.
Certain drugs also causes E D , so please mention .
TREATMENT.
Sildenafil is the only approved and effective oral agent for the treatment of E D because it is effective for the treatment of a broad range of causes of E D including psychogenic as well vasculogenic , spinal cord injury .
Dosage are 25 , 50 and 100 mg and enhances erection after sexual stimulation.
If you don't respond this treatment then deal as mentioned above.
Hope this will help you.
Further , if any question I will reply in follow up.
Good luck.
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank You doctor for your reply. The spinal injury you were talking about, i doubt that is the problem with me because my x-rays and MRI reports are clear. I was only HLA B-27 positive and had a pain in my back since 2 years.
Second the medication I am currently on is Nucoxia 90, but i have been witnessing the symptoms of ed and loose erections since I was 16, when i became sexually active. So i dont know if the medication for AS are causing the problem.
I have a bend in my organ which is downwards and a little towards left and i do believe the size of my penis and testicles did not mature well and went uptill the average adult size. I could attach a photo for you to examine it and respond.
This Ed does not concerns me with all sexual partners, there has been one partner with whom i have never had a problem, but yes the erection could never be so strong may be because of the curve as it struggles to go inside straight.
About visiting a doctor am very nervous for that, I have been trying to gather courage for that for almost 2 years now and could not go and visit one yet, and at the same time the treatments and the urologist fee is too high for me to afford as this is something i cant share with my parents and ask for the money for treatment for them being a student m dependent on them for financial assistance.
hope you ll be helpful
Thank you
Second the medication I am currently on is Nucoxia 90, but i have been witnessing the symptoms of ed and loose erections since I was 16, when i became sexually active. So i dont know if the medication for AS are causing the problem.
I have a bend in my organ which is downwards and a little towards left and i do believe the size of my penis and testicles did not mature well and went uptill the average adult size. I could attach a photo for you to examine it and respond.
This Ed does not concerns me with all sexual partners, there has been one partner with whom i have never had a problem, but yes the erection could never be so strong may be because of the curve as it struggles to go inside straight.
About visiting a doctor am very nervous for that, I have been trying to gather courage for that for almost 2 years now and could not go and visit one yet, and at the same time the treatments and the urologist fee is too high for me to afford as this is something i cant share with my parents and ask for the money for treatment for them being a student m dependent on them for financial assistance.
hope you ll be helpful
Thank you
Brief Answer:
Erectile dysfunction and its treatment
Detailed Answer:
Hello XXXX
You are taking nucoxia 90 mg ( etoricoxib ) for AS and its side effects are nervousness and depression ( but these are not so sever and usually don't interfere in sexual dysfunction ).
As you mentioned in follow up question is that erection is not so strong i.e.erection is there, so need not to be desperate .
As you mentioned that size of penis is short but for this NO treatment is there .
2nd point , you didn't uploaded the photo .
When such patient visit I prescribe FLUOXETINE 20 mg one tablet twice in day for 3-6 month and gradually reduce the dosage 1/2 twice a day for another 6 months.
I tried this tablet on so many patients and all responded very well so take this .
Hope this will help you.
In the beginning , you may feel some fine tremors but within 3-4 days you will feel relaxation not only in depression but also in sexual dysfunction.
Further any question I will reply.
Erectile dysfunction and its treatment
Detailed Answer:
Hello XXXX
You are taking nucoxia 90 mg ( etoricoxib ) for AS and its side effects are nervousness and depression ( but these are not so sever and usually don't interfere in sexual dysfunction ).
As you mentioned in follow up question is that erection is not so strong i.e.erection is there, so need not to be desperate .
As you mentioned that size of penis is short but for this NO treatment is there .
2nd point , you didn't uploaded the photo .
When such patient visit I prescribe FLUOXETINE 20 mg one tablet twice in day for 3-6 month and gradually reduce the dosage 1/2 twice a day for another 6 months.
I tried this tablet on so many patients and all responded very well so take this .
Hope this will help you.
In the beginning , you may feel some fine tremors but within 3-4 days you will feel relaxation not only in depression but also in sexual dysfunction.
Further any question I will reply.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Thank you so much for the help doctor.
I really appreciate your time and patience.
I ll start with the medication as u suggest and hope it works in the best way as u say.
2nd I would like to clear, the problem of weak erection is constant and is not strong enough to penetrate but some times which is very rare I have to struggle to get an erection.
I have uploaded the photos please take a look and please tell me if something is to be done.
I wasn't being desperate, the problem persisted thats why for the first time I consulted someone.
I guess this is the last follow up question I have got for my payment, i ll be grateful if all my doubts will be cleared in your reply.
Thank you so much you were of great help.
I really appreciate your time and patience.
I ll start with the medication as u suggest and hope it works in the best way as u say.
2nd I would like to clear, the problem of weak erection is constant and is not strong enough to penetrate but some times which is very rare I have to struggle to get an erection.
I have uploaded the photos please take a look and please tell me if something is to be done.
I wasn't being desperate, the problem persisted thats why for the first time I consulted someone.
I guess this is the last follow up question I have got for my payment, i ll be grateful if all my doubts will be cleared in your reply.
Thank you so much you were of great help.
Brief Answer:
Erectile dysfunction and treatment
Detailed Answer:
Hello,
Thanks for the question.
As you mentioned that erection is weak, even so much so that unable to penetrate. But as I mentioned in earlier reply fluoxetine 20 mg will help you.
I usually treat my patients with similar problems with "SILDENAFIL " 25 mg once in 48 hours as this will help in getting full and hard erection.
Also fluoxetine 20 mg for first 10 days and after this start sildenafil 25 mg once in 48 hours . These two drugs will serve dual purpose ( help in erection and well hard and full ). You can discuss regarding this with your doctor.
Once you will get hard erection and successful intercourse there develop confidence and you will be fine within short period.
I have seen your photos. The size, structure, shape of your penis is perfect ( this not come under category of hypogonadism ), mild curve is normal as it is on the left side in your case.
Another test is somewhat costly, but due to financial condition ( as you mentioned in your query ) I don't recommend.
If possible get in testosterone ( blood test ) and if there is deficiency then discuss with your doctor regarding "TESTOSTERONE UNDECANOATE " 40-120 mg in divided dosage till level reach at its target.
Hope this will help you.
Erectile dysfunction and treatment
Detailed Answer:
Hello,
Thanks for the question.
As you mentioned that erection is weak, even so much so that unable to penetrate. But as I mentioned in earlier reply fluoxetine 20 mg will help you.
I usually treat my patients with similar problems with "SILDENAFIL " 25 mg once in 48 hours as this will help in getting full and hard erection.
Also fluoxetine 20 mg for first 10 days and after this start sildenafil 25 mg once in 48 hours . These two drugs will serve dual purpose ( help in erection and well hard and full ). You can discuss regarding this with your doctor.
Once you will get hard erection and successful intercourse there develop confidence and you will be fine within short period.
I have seen your photos. The size, structure, shape of your penis is perfect ( this not come under category of hypogonadism ), mild curve is normal as it is on the left side in your case.
Another test is somewhat costly, but due to financial condition ( as you mentioned in your query ) I don't recommend.
If possible get in testosterone ( blood test ) and if there is deficiency then discuss with your doctor regarding "TESTOSTERONE UNDECANOATE " 40-120 mg in divided dosage till level reach at its target.
Hope this will help you.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
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