Brief Answer:
Treatment for erectile dysfunction and premature ejaculation is there

Detailed Answer:
Hello,

Thanks for writing to us. I can understand your concern.

I want to mention here details of the treatment for erectile dysfunction (ED) and premature ejaculation (PME). The answer will be long but it is needed for your understanding. I also want some more information to help you further.

Medical treatment for ED:

5- PDE inhibitor group of medicines like sildenafil or tadalafil are used. One of them should be used 2 hours prior to sex. I prefer tadalafil in patient with hypertension and diabetes. These are prescription medicines and you need to consult doctor/psychiatrist/sexologist for the prescription.

Another medicine cum vitamin supplement containing pyridoxal-5-phosphate, mecobalamin and l-methylfolate (trade name tetrafol plus)is very helpful in my patients. It has shown improvement in 50-60% patients of mine with. You should take it after meal twice a day. If you feel some improvement in 20 days you should continue for at least 2 months. You may get this medicine over the counter as it is vitamin product.

There are some natural lifestyle measures which help to improve blood flow to penis and overall sexual performance.

- The most important factor is healthy heart. Blood is pumped in to body by heart. Regular exercise and avoidance of fatty fast food are important measures to prevent heart disease. Regular walking, swimming or running overall improves blood flow to whole body circulation including penis and keep the mind fresh.

- Good healthy food is also an important aspect. Bananas, Garlic, dry fruits (they contains vitamins), eggs, cow milk, cow butter are good food which may help in erectile dysfunction.

- Avoid smoking and alcohol. Low amount of alcohol can help in increasing blood flow but more amount can cause opposite effects. So better to avoid the same.

As you are likely form XXXXXXX I would like to also mention ayurvedic medicine option. Tentex forte is the medicine which is used for ED. No side effects have been reported.

Treatment for PME:

Medicines:
Clomipramine and paroxetine are choice of medicines which are used as antidepressants (For depression dose is higher).
I prefer clomipramine for PME. No significant side effects with these medicines. Initially say for 20-30 days daily after dinner and later on just on the day when you do the sex.
Paroxetine is more potent but it may cause side effects like headache, gastric discomfort, giddiness and sedation. In patients with blood pressure it should be used in consultation with physician/cardiologist.

One molecule called depoxetine has been used specifically for PME and should be taken before 2 hours of sex when required.
These medicines are prescription medicines and you need to consult doctor/psychiatrist/sexologist for prescription.


Behavioral approaches are as follows for your information:

1. Stop and Squeeze technique can be applied which you can learn from internet and ask me if any query in that.(In brief, method suggests that you should try to divert your mind for a moment when you feel ejaculation arousal and penis should be tightly squeezed with hand inwards by your partner preferably).

2. Master and XXXXXXX technique can also be learnt from qualified sexologist/Psychiatrist which includes sessions in couple as it is couple sex therapy. It can help in prolongation of time.

3. Sex counselling of your sexual behavior and methods. Like if you are down and female partner on top, gravity is going to help you for lengthening the time.

4. You should do masturbation before sex (at least 2 hours before ). It will make seminal vesicles somewhat empty and at time of sex semen will take more time to come out.

Another approach:
-Use of condoms. Sometime use of condom while sex helps in delaying ejaculation by reducing sensitivity of glans penis.

--Topical application of lignocaine anesthetic gel/spray. For this you have to consult doctor.

In ayurvedic products confido can be used for premature ejaculation. It is likely available over the counter without prescription.

Let me know some information:

- Are you married?
If yes duration of marriage and since when are you suffering from this problem? How was previous sex life?
If not married, provide details about sex life with girlfriend. Where and in which circumstances you do sex?

- How did problem started? Any specific incidence was there?

- Do you pay more attention to erection while trying for intercourse?

- Do you have any physical illness, specifically diabetes or high blood pressure?

- Is there any history of smoking or alcohol?

- Is there any difficulty in urinating?

- How is relationship with your partner? Any emotional or social problem is there?

- Is there morning erection present?

- Are you able to masturbate?

- What treatment did you receive form doctor until now?

I will be happy to help further after getting response.

Regards,

Dr.Chintan Solanki

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Brief Answer:
masturbation is safe

Detailed Answer:
Hi,

Thanks for answers.

First of all clarification about masturbation.

Masturbation is natural and normal thing. It is done by 95% of the males in the world, mostly before marriage as well as when wife is away, in menses or pregnant after marriage. It is not at all harmful. Frequency of masturbation done by an individual varies from once a day to once a week. It depends upon individual libido, wish and timing. It neither causes any weakness nor any problem in sexual activity.

Yes it happens in many males that after few years they do not enjoy masturbation as before. This is psychological issue not the physical one.

If I were your treating doctor I recommend one tablet of terafol plus twice a day after meal for 2 months then one tablet per day.In that I would like to add tentex forte and confido one tablet each at night with one cup of milk.

Above pills are without side effects.

Delay spray is lignocaine spray available. As such no side effects but you need to check it for allergy before using the same. Spray small amount and wait for 2 hours to check for any local pr physical energy. Sometime it may also lead to less sensation if used in more amount and erection cannot be achieved.

Hope this answer will help.

take care.

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Brief Answer:
start 3 tablets simultaneously

Detailed Answer:
Hi,

Sorry if you cannot understand my message.

You understood for tetrafol plus correctly twice a day for 2 months then once a day.

However with tetraol plus you should start tentex forte and confido simultaneously from beginning only, not after 2 months.

Feel free to ask further if you have any doubt.

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