Hello,

Thanks for posting your query.

Methadone may cause reduced libido or potency as its side effect but it is not known to cause erectile dysfunction. However erection dysfunction is a known side effect of the drug Paxil and this may be potentiating the erection problems that you are already having. Constipation has no significant effect on ejaculation and does not stop you from ejaculating.

However the basic problem of erectile dysfunction is less likely related primarily to Paxil and it acts just as an adjuvant to the medical condition that may be causing erectile dysfunction. Hence it is better to get evaluated for all the causes of erectile dysfunction so as a confirmatory diagnosis can be made.

I will describe some simple measures which you can incorporate and these should help you. First of all, quit smoking and alcohol (if you are taking any), indulge in physical exercise and eat a healthy diet. Have faith in yourself and do not take any stress.

You can talk to your partner openly and indulge in plenty of foreplay before sex. Exercise, particularly aerobic exercise is very effective. If however the symptoms persist then we need to rule out certain medical conditions. These include diabetes, high blood pressure, heart or thyroid conditions, poor circulation, low testosterone and neurological causes (like the back surgery done in your case).

The commonly prescribed drug by the doctors is sildenafil, which causes erections to be stronger and long lasting. However it is not safe to take this drug without a doctor’s advise and moreover it is important to rule out these medical conditions as well.

So please consult a urologist if even after the lifestyle modifications you have difficulty in ejaculation.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

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