Brief Answer:
Please provide more details

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

To know what could be the cause for problem I am posting following questions. Please answer them with possible details.

1. How long you are facing problem with erections?

2.Have you ever noticed same problem in past?

3. What were the thoughts while having sex with your partner?

4. How old are you and how the problem started for you?

5. What are the factors that increase the problem according to you ?

6. Factors that relieve the problem- thoughts, situations, place etc, if any.

7. Your partner details- Is she very critical, demands sex more than what can you think, does she feel superior to you or bothers you in some other regards?

8. Effect on your relationship so far due to problem

9. Details of medical illness like duration, any complications, treatment received till date.

10. Medications you are receiving currently, if any including ayurvedic homeopathic or any other.

11. Medication you received in past and their effect?

12. Do you have any psychiatric illness (like anxiety, depression, fear)?

13. Investigations done till date and reports of most latest investigations- serum testosterone, TSH, T3, T4 and any other?


I must assure you that once we identify cause it will be easy to correct it.
I look forward to see more details.

Thanks and regards

---

Brief Answer:
Please provide more details

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

To know what could be the cause for problem I am posting following questions. Please answer them with possible details.

1. How long you are facing problem with erections?

2.Have you ever noticed same problem in past?

3. What were the thoughts while having sex with your partner?

4. How old are you and how the problem started for you?

5. What are the factors that increase the problem according to you ?

6. Factors that relieve the problem- thoughts, situations, place etc, if any.

7. Your partner details- Is she very critical, demands sex more than what can you think, does she feel superior to you or bothers you in some other regards?

8. Effect on your relationship so far due to problem

9. Details of medical illness like duration, any complications, treatment received till date.

10. Medications you are receiving currently, if any including ayurvedic homeopathic or any other.

11. Medication you received in past and their effect?

12. Do you have any psychiatric illness (like anxiety, depression, fear)?

13. Investigations done till date and reports of most latest investigations- serum testosterone, TSH, T3, T4 and any other?


I must assure you that once we identify cause it will be easy to correct it.
I look forward to see more details.

Thanks and regards

---

Brief Answer:
It seems premature ejaculation rather than ED

Detailed Answer:
Hello,
Thanks for follow up and details.

I have gone through the provided details and it is almost clear that the problem is premature ejaculation (PE) rather than erectile dysfunction (ED).

Since the problem is premature ejaculation we need to think for treatment of premature ejaculation rather than ED.

The treatment of PE involves multiple methods of treatment among which medications and behavioral intervention play significant role.
In regard to medications after due testing I often prescribe paroxetine 12.5 mg to be taken at bedtime. This often helps majority of patients as paroxetine and similar medications increase ejaculation latency to significant level. The other options which I often use includes sertraline, fluoxetine and fluoxamine. All of these medications are prescription only medications and you need to have a prescription from local physician after completion of due procedure (physical examination and laboratory tests).

Regarding behavioral interventions I often recommend Kegel exercise with moderate success.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.

---

Brief Answer:
It seems premature ejaculation rather than ED

Detailed Answer:
Hello,
Thanks for follow up and details.

I have gone through the provided details and it is almost clear that the problem is premature ejaculation (PE) rather than erectile dysfunction (ED).

Since the problem is premature ejaculation we need to think for treatment of premature ejaculation rather than ED.

The treatment of PE involves multiple methods of treatment among which medications and behavioral intervention play significant role.
In regard to medications after due testing I often prescribe paroxetine 12.5 mg to be taken at bedtime. This often helps majority of patients as paroxetine and similar medications increase ejaculation latency to significant level. The other options which I often use includes sertraline, fluoxetine and fluoxamine. All of these medications are prescription only medications and you need to have a prescription from local physician after completion of due procedure (physical examination and laboratory tests).

Regarding behavioral interventions I often recommend Kegel exercise with moderate success.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.

---

Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

Yes there are answers to your questions and which is as follows.

First of all I like to inform you that erections like any other functions of body are never consistent and this is natural not to have prolonged erections on some occasions. I mean to say that if the problem is inconsistent and occurs infrequently in regard to erections, it is temporary problem and can revert back to normalcy provided there is proper stress management.

Alike every other medications paroxetine is safe provided taken as per the recommendations of doctor. It is never safe to take it without prescription (read physical examination and laboratory investigations).

The most of side effects associated with paroxetine are temporary and rtevert back to normal once the medication is discontinued.

For premature ejaculation it should not be used for long term and mean for short term intervention. In case it is used for long term there is chance of ED although it reverts back once it is stopped.

It is generally prescribed once a day although in rare cases it can be taken twice a day.

It need to be taken regularly to have proper effect.

Regarding effectiveness every individual is different although my first choice is paroxetine.

I hope this helps you further.
Thanks again.

---

Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

Yes there are answers to your questions and which is as follows.

First of all I like to inform you that erections like any other functions of body are never consistent and this is natural not to have prolonged erections on some occasions. I mean to say that if the problem is inconsistent and occurs infrequently in regard to erections, it is temporary problem and can revert back to normalcy provided there is proper stress management.

Alike every other medications paroxetine is safe provided taken as per the recommendations of doctor. It is never safe to take it without prescription (read physical examination and laboratory investigations).

The most of side effects associated with paroxetine are temporary and rtevert back to normal once the medication is discontinued.

For premature ejaculation it should not be used for long term and mean for short term intervention. In case it is used for long term there is chance of ED although it reverts back once it is stopped.

It is generally prescribed once a day although in rare cases it can be taken twice a day.

It need to be taken regularly to have proper effect.

Regarding effectiveness every individual is different although my first choice is paroxetine.

I hope this helps you further.
Thanks again.

---

Brief Answer:
Vising specialist is recommended

Detailed Answer:
Hello,
Thanks for follow up.

In view of the consistent and frequent problem I feel proper consultation is necessary as no online consultation can cover every aspect of it (it is never possible to conduct physical examination).

I understand that it is never easy to visit a doctor with sexual problems but by avoiding such visits there is chance of progression of problem over the period of time.

I must assure you that in the current era of modern medicine it is largely treatable and there is little to worry about it.

I hope this helps you further.
Thanks again.

---

Brief Answer:
Vising specialist is recommended

Detailed Answer:
Hello,
Thanks for follow up.

In view of the consistent and frequent problem I feel proper consultation is necessary as no online consultation can cover every aspect of it (it is never possible to conduct physical examination).

I understand that it is never easy to visit a doctor with sexual problems but by avoiding such visits there is chance of progression of problem over the period of time.

I must assure you that in the current era of modern medicine it is largely treatable and there is little to worry about it.

I hope this helps you further.
Thanks again.

---