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Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Sir I am 48 yrs old. I am suffering early

Answered by
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Dr. Parth Goswami

General & Family Physician

Practicing since :2012

Answered : 8327 Questions

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Posted on Sat, 29 Dec 2018 in Premature Ejaculation
Question: Sir I am 48 yrs old. I am suffering early ejaculations and erectile dysfunction. my problem is that my penis not stands properly. It will stand for some time and then slowly it fells down .Suggest treatment to increase the erection and premature ejaculation time of the penis.
doctor
Answered by Dr. Parth Goswami 3 hours later
Brief Answer:
Underlying cause for erectile dysfunction has to be ruled out.

Detailed Answer:
Hi,
Welcome to the 'Ask A Doctor service'.
You are suffering from erectile dysfunction.

Kindly answer the following questions to guide you further...
_Are you taking anti hypertensive or anti depressant medication???
_Are you having smoking habit??
_What is your BMI??
_Have you ever been suffering from diabetes, heart disease ?
_Have you ever been having prostate problem??
_Are you having any spinal disease??
_Any other specific disease??

Meanwhile you can investigate with doppler penile arteriogrphay and serum testosterone estimation for further work up.

Answer the above questions to do further conversation.

Regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Parth Goswami 22 minutes later
As per your questions, my answer is NO to all questions
doctor
Answered by Dr. Parth Goswami 9 minutes later
Brief Answer:
Follow up.

Detailed Answer:
Hello,
Welcome back to 'Ask A Doctor service'.

So diabetes, prostate, smoking and cardiac disease can be ruled out in your case.

Now you can investigate further with colour doppler USG penis to look for any arterial disease if present. Most common cause for erectile dysfunction is disturbance of blood flow in artery of penis.

It's advisable to investigate with serum testosterone and prolactin estimation as well.

I suggest practice following to help in erectile dysfunction.
_Take healthy diet with more green leafy vegetables and fruits
_Antioxidant tablet can be prescribed
_You can practice more foreplay before sex
_Do regular exercise

If no improvement than tadalafil tablet can be prescribed that has to be taken 40 minute before sex.
For detailed evaluation you can consult nearby psychiatrist.

Hope I have answered your question.

Best regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Parth Goswami 33 minutes later
_can you prescribe the below medicine so that i can try
Antioxidant tablet
_tadalafil tablet

Also when i do foreplay, penis will be erected but goes normal when i stop
doctor
Answered by Dr. Parth Goswami 13 minutes later
Brief Answer:
Follow up.

Detailed Answer:
Hi,
Welcome back to the 'Ask A Doctor service'.

The tadalafil like medication cannot be prescribed online. For getting written prescription and for detailed evaluation you have to consult nearby psychiatrist.
The antioxidant medication will also be prescribed by doctor after your examination.

I can help you regarding approach in your case which has been already discussed.

After foreplay you are not able to maintain penis erect that is due to erectile dysfunction and tadalafil like medication will help in maintaining penis erect as well after foreplay.

However you have to rule out psychogenic cause like anxiety, social guilt, lack of interest in partner etc. For that behavioural counselling by psychiatrist will also be beneficial.
Hope I have answered your question.

Best regards.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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