Brief Answer: Mr XXXXXXX follow below steps. Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 35 year old male • Known case of Thyroid, High BP and High cholesterol • Complaints of poor erection What I can understand from your query is that you are not able to sustain hard erection which is required for intercourse, and loose erection before ejaculation. This problem is called erectile dysfunction. In treatment Erectile dysfunction (ED) first step is to identify cause of the problem. Erectile dysfunction can be a result of a psychological or physical problem. Psychological causes: Most common cause in young patients. These include performance anxiety, low mood, feelings of guilt, and the effects of a past sexual and emotional trauma. Physical causes: Include neurological disorders, alcoholism, smoking, hormonal imbalances, diabetes, hypertension, blood vessel disease and chronic diseases. I will describe some measures which you can incorporate and these should help you: 1. Talk to a therapist/Psychiatrist: Make an appointment to rule out anxiety, stress and depression in your case 2. Be open with your partner. Talking with your partner about your anxiety can help ease some of your worries. Trying to reach a solution together might actually bring you closer as a couple and improve your sexual relationship. 3. Get intimate in other ways. There are many ways to be intimate without actually having sex. Give your partner a sensual massage or take a warm bath together. Take turns pleasing each other with masturbation so you don't always have to feel pressured to perform sexually. 4. Exercise. Not only will working out make you feel better about your body, but it will also improve your stamina in bed. Start aerobic exercise (like: Jogging, skipping and cycling) daily for 30 Minutes. It will increase blood flow all over body and will reduce stress. 5. Distract yourself. Try putting on some romantic music or a sexy movie while you make love. Think about something that turns you on. Taking your mind off of your sexual performance can remove the worries that are stopping you from getting excited. 6. Quit smoking and alcohol (if you are taking any). 7. Control and monitor Thyroid (hormonal imbalance), High BP and High cholesterol, as all these conditions affect erection. The commonly prescribed drug for erection problem is sildenafil (Viagra) or Tadalafil (Megalis), which causes erections to be stronger and long lasting, but should be taken after prescription. It is important to rule out medical conditions specially related to cardiovascular system before starting such treatment. Both of these medicines have excellent result in physical causes of erectile dysfunction. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups. Wish you good health. Regards, http://bit.ly/Dr-Ashish-Mittal

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