Brief Answer:
Cause needs to be found

Detailed Answer:
Hi,

Thanks for your question on HCM

I do understand your pain and discomforts

As per your clinical history is concerned you need treatment by an endocrinologist who will treat you from the root. Male sexual arousal is a complex process that involves your brain, hormones, emotions, nerves, muscles, and blood vessels. So any one of it can cause ED. For it you need one physical examination by your doctor and after physical examination he will advise you to follow investigations like-urine [RE/ME], fasting blood sugar, lipid profile, serum testosterone, Thyroid profile, [ECG/ECHO], ultrasound whole abdomen[color duplex Doppler], etc these tests will rule out any underlying pathological disorder present or not.

You also need a psychological exam by a clinical psychologist who will check whether you have depression and other possible psychological causes of erectile dysfunction.

Treatment depends on only underlying pathological conditions only so if any underlying disorders present then no need of ciala or Viagra at all.

Hope you got your answers if you have past reports then you can share here.

Thanks

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Brief Answer:
Impotence

Detailed Answer:
Hi,

Thanks for your follow up reply

As per you request you can do all these investigations and you can send me reports directly. These are as below-:

1)Serum Testosterone,Luteinizing Hormone (LH) , Prolactin level, TSH,
2)Lipid profile, fasting blood sugar,Hemoglobin A1C
3)Urine[RE/ME/], Full blood count
4)Ultrasound examination etc

Please follow me with the reports after that I will tell you what to do,

Hope that helps

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