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Suggest treatment for erectile dysfunction

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Posted on Sat, 30 May 2015
Question: Hello doctor i am XXXXXXX here and I am 47 years old. doctor for last 3 4 months I have a feeling that I am not achieving a proper erection. Sometimes it happens that I have a feeling of doing sex but due to not having an proper erection I feel guilty. It takes time for the erection and sometimes too long.

Please advise on this
Thanks

doctor
Answered by Dr. Chintan Solanki (1 hour later)
Brief Answer:
treatment for erectile dysfunction is there

Detailed Answer:
Hello Mr. XXXXXXX

Thanks for writing to us.

I can understand your concern.

You seem to have erectile dysfunction (ED).

First of all you should check for your blood pressure as well as diabetes as these are common causes of erectile dysfunction after age of 40. If you have already check up done, please revert back to me with details.

If you have any intake/habit of tobacco chewing/smoking, alcohol or something else please let me know details abut the same. These are also related to erectile dysfunction.

Treatment of erectile dysfunction is there.

5- PDE inhibitor group of medicines like sildenafil or tadalafil(cialis) are used. One of them should be used 2 hours prior to sex. They causes headache,stuffy nose nausea and gastric discomfort like common side effects. Proper physical check up of cardiac system should be done by a doctor before starting the same.These are prescription medicines and you need to consult doctor/psychiatrist/sexologist for the prescription.
Tadalafil is preferred in patients with blood pressure.

You can use 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 ED.You should take it after meal twice a day. If you feel some improvement in 15 days you should continue for at least 1 month. 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.So 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 form XXXXXXX I would like to also mention ayurvedic medicine option.Tentax forte is the medicine which is used for ED.No side effects has been reported. I use it infrequently and no specific studies are there of its efficacy. Two tablets daily at night with a cup of milk should be taken.

Hope this answers your query.I would like to help you further.

Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (1 hour later)
Thank you doctor for a prompt reply.
Yes I do have blood pressure and I am taking medicine Telma H 1 tablet daily. I am not a diabetic.
Yes I do smoke bit an occasional drinker. May be 1 or 2 small ones.
You had recommend tentax forte. Is there any course for this or I have to take every day. I dont want ro become a habitual.
Or it is used before sex only.
Thanks
XXXX
doctor
Answered by Dr. Chintan Solanki (2 hours later)
Brief Answer:
quit smoking, tentax forte initially daily then on required basis

Detailed Answer:
Hello,

Thanks for follow up and information.

Telma H does not affect sexual function so it is ok. Just note that your blood pressure should be under control.

Stop smoking as it has many hazardous effects on body apart from sexual dysfunction.If you cannot quit yourself psychiatrist can help in this aspect also.

If I were your treating doctor I would recommend tetrafol plus.If it does not work in one 3 weeks, I would suggest tentax forte then. It should be taken initially for a month then as an when required before sex.

None of the above drugs are habitual, one is vitamin product and second one is ayurvedic.
In any case if you need 5 PDE inhibitor it is also not habitual.Just use the same under doctor's guidance.

Feel free to ask further if need.

Take care.


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Chintan Solanki (11 hours later)
One last question doctor. Medicine Confido how much is effective in my case.
Thanks
doctor
Answered by Dr. Chintan Solanki (13 minutes later)
Brief Answer:
no scientific evidence of its effectiveness

Detailed Answer:
Hello Mr. XXXXXXX

Thanks for question.

There are no scientific studies suggesting efficacy of confido.It is ayurvedic medicine without any side effects. Frankly speaking I use it very less and for premature ejaculation. I am not using for erectile dysfunction. So I do not want to give any confirm answer of your question.But you can use and check the effectiveness without any problem.

Hope I have answered your query. If still any query there, I will be happy to answer. If not, you can close the discussion and if feasible give your feedback so I can improve service. In future you can contact me directly on this site if you wish with this link: http://bit.ly/drchintansolanki
Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Chintan Solanki (49 minutes later)
No I will not take any medicine unless guided by the expertise.
I will first try tetrafol plus as suggested by you. One confusion I have please clear that. If this medicine is effective then I dont have to take on regular basis correct. And then for future my problem will be corrected.
Why I am asking this is because I like to have sex whenever it comes to me. And as per you I have to plan when I have to do sex and before that I have to take medicine. Hope these medicine will improve the time period of duing sex also
Thanks
doctor
Answered by Dr. Chintan Solanki (1 hour later)
Brief Answer:
tetrafol plus should be taken for 2 months

Detailed Answer:
Hello,

Tetrafol plus if effective should be taken for 2 months. It solves problem by improvement in mechanism of dilatation of penile vessels. Its effect last for roughly 1 year. If problem recurs, second dose schedule should be taken.
As this medicine is in market since 15 to 18 months, I have not seen patients follow up for effectiveness so long.But yes I get results in almost 50-60% of my patients with blood pressure.
This medicine will not be needed later on if improvement is there.You can do sex without medicine without any plan.

This medicine will not effect on time period. But if you do not have any problem of premature ejaculation you would have enough time period during sex.Medicines for premature ejaculation(PME) are different.

For your information I would like to mention about PME here.

Premature Ejaculation (PME) or early discharge defined when male partner ejaculates early before the female partner reaches to orgasm. There is no absolute time by which we can diagnose PME. It is relative term and female partner is the best judge.

There are medicinal and non medicinal approaches to treat 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 (duralast)has been used specifically for PME and should be taken before 2 hours of sex when required.Yes you can take duralast without much discomfort.No issue with blood pressure.I have used in many patients but due to unavailability of the same its use is limited.
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 counseling 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 using condom while sex helps in delaying ejaculation by reducing sensitivity of glans penis.

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

All the best and take care.
Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Suggest treatment for erectile dysfunction

Brief Answer: treatment for erectile dysfunction is there Detailed Answer: Hello Mr. XXXXXXX Thanks for writing to us. I can understand your concern. You seem to have erectile dysfunction (ED). First of all you should check for your blood pressure as well as diabetes as these are common causes of erectile dysfunction after age of 40. If you have already check up done, please revert back to me with details. If you have any intake/habit of tobacco chewing/smoking, alcohol or something else please let me know details abut the same. These are also related to erectile dysfunction. Treatment of erectile dysfunction is there. 5- PDE inhibitor group of medicines like sildenafil or tadalafil(cialis) are used. One of them should be used 2 hours prior to sex. They causes headache,stuffy nose nausea and gastric discomfort like common side effects. Proper physical check up of cardiac system should be done by a doctor before starting the same.These are prescription medicines and you need to consult doctor/psychiatrist/sexologist for the prescription. Tadalafil is preferred in patients with blood pressure. You can use 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 ED.You should take it after meal twice a day. If you feel some improvement in 15 days you should continue for at least 1 month. 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.So 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 form XXXXXXX I would like to also mention ayurvedic medicine option.Tentax forte is the medicine which is used for ED.No side effects has been reported. I use it infrequently and no specific studies are there of its efficacy. Two tablets daily at night with a cup of milk should be taken. Hope this answers your query.I would like to help you further. Regards, Dr.Chintan Solanki.