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Able To Get Erection But Problem In Maintaining It. Viagra Helped Initially But Now Doesn't Work. Advise?

Posted on Sat, 21 Sep 2013

Question: HI, I am facing the problem of ED where i am able to get the erection but not able to sustain it . Sometimes i am able to sustain and many times not able to sustain which goes down before penetration . I checked my testosterone and got 327 and blood was taken afternoon .
I use generic viagra 50 mg and initially it used to work good but not it works sometimes and sometimes it doesnot work.

Answered by Dr. G.Srinivasan (2 hours later)

Brief Answer:
Exercise, diet, arginine, 75 mg viagra should help

Detailed Answer:
Hi,

Welcome to the forum. Thanks for your query.
Possible reasons are.
1.     Recent illness.
2.     Smoking.
3.     Diabetes.

These things need to be sorted out. Please get your blood sugar checked and get it under control if found to be high. Kindly quit if you happen to be a smoker.
Weight reduction would definitely help. Regular exercise ( Exercise in the form of walking, jogging or swimming for about 45 minutes a day is a must to keep your blood vessels healthy.
Other things that would help are EARLY DINNER, light dinner and prolonged foreplay.
Diet needs to be XXXXXXX in fresh fruits, dried fruits and vegetables.
Medicines that should help are
1. Increase the dose of viagra to 75 mg and can go upto 100 mg per dose.
2. L-Arginine in the form of tablets or XXXXXXX once daily. This will help viagra to work better and can be taken along with the viagra ( But viagra is only on demand!)
Hope this helps, kindly get back for doubts if any.
Regards
Dr GS

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (4 minutes later)

HI,

I checked sugar already but its normal , no diabities .

I started using viagra 50 mg 2 months back and now i have to use 75 mg . Is there any permanent solution of the issue . Is testosterone level low ? .

No recent illness / i dont smoke / no diabities.

Answered by Dr. G.Srinivasan (9 minutes later)

Brief Answer:
should be ok over a period of time

Detailed Answer:
Hi,
Welcome back.
If the testosterone level is within the reference range of THE LAB, there should be no worry.
But if low, testosterone supplement should help. The same can be started if necessary after getting yourself examined for prostate enlargement and doing serum PSA tests.

It is good to know that you do not have the risk factors for a vascular disease.
So, it is only mind set related and you may get erections as before, after using the medicines for a while.
Best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (2 minutes later)

HI,

Thanks for response.

How much of L-Arginine should i take daily (grams )

will it have any side effects ?. will L-Arginine improve my erections . Is it safe to take it with viagra .

How long should i continue taking it .

Answered by Dr. G.Srinivasan (8 minutes later)

Brief Answer:
L- Arginine+viagra -effectively - better erections

Detailed Answer:
Hi,

Welcome back.
L- Arginine - 3 to 5 grams a day as a tablet or powder (in which case to be mixed with 100 ml of water) for a month.
It is not known to have significant side effects, as it is like a supplement.
Viagra acts better if taken along with arginine, as i had already mentioned.

Wish you good sexual health---

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (12 minutes later)

When viagra 50 mg works , i get late night erections for which i have to wake up so that it goes down , whats the best way to avoid it .

Answered by Dr. G.Srinivasan (13 minutes later)

Brief Answer:
It is not in out hands.

Detailed Answer:
Hi,
The best way to look at it - is to have sex when erection occurs, even if it is middle of the night or early am!
Erection is not voluntary. It is involuntary---
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (14 hours later)

HI,

is it ok to take L- Arginine+viagra50g together daily .

Whats the effective number of hrs for L- Arginine.
PLease let me know if there are any risks of blood pressure going too low using the combination as mentioned on below link

WWW.WWWW.WW

Answered by Dr. G.Srinivasan (2 hours later)

Brief Answer:
Very Unlikely at your age.

Detailed Answer:

Thanks for the link and the information.

Arginine is a not a medicine as such. It is only a supplement. There is no mention on the duration of action in the literature.

Patients with cardiac problem taking nitrates SHOULD NOT TAKE THE ABOVE TWO.
The combination of nitrates and PDE5 inhibitor like cialis can cause XXXXXXX drop in blood pressure.

At your age, I do not think of such side effects as compensatory mechanisms are available. If you are on nitrates, please avoid the two.

Best regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. G.Srinivasan (26 minutes later)

I m not on nitrates and no cardia issues / diabities / BP

is it ok to take L- Arginine+viagra50g together daily ?

Whats the effective number of hrs for L- Arginine ?

Should i stop using after one month . Is there any specific hrs gap i need to put b.w the dosage of L-argenine.
Also please let me know if 5 mg capsules come in india and from which comepany u suggest

Or I need to buy granules or powder .i checked from market and i am getting

l-arginine and proanthocyanidin granules ( is that ok ? ).

Answered by Dr. G.Srinivasan (2 hours later)

Brief Answer:
Both cap/tab and XXXXXXX are ok

Detailed Answer:
L- Arginine and proanthrocyanidin combination is better. You can go with it that is available.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (51 minutes later)

Thanks!!

is it ok to take L- Arginine+viagra50g together daily .

Whats the effective number of hrs for L- Arginine.

Answered by Dr. G.Srinivasan (5 hours later)

Brief Answer:
arginine daily, viagra maximum twice weekly

Detailed Answer:
Once a day L- Arginine is good enough, preferably at night.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (2 days later)

HI,

Does my case could be veneous leak issue . I can sometimes to intercourse without penegra , if i give break of a week . but if i increase frequency like daily or once in 3 days i get erection but i loose it before penetration . So i use penera.

Answered by Dr. G.Srinivasan (2 days later)

Brief Answer:
could be., but no guaranteed treatment success

Detailed Answer:
Hi
Welcome back.
Sorry for the delay as i was very busy with no net access as well.
Venous leak is difficult to diagnose and also if diagnosed, the specific treatment offered has no guaranteed success.
o, in my opinion if the erection is not good enough, the simplest way is to go for oral medicines like the ones you are taking now.
Best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (2 minutes later)

In case medicines work is there still possibility of venous leak .

Answered by Dr. G.Srinivasan (12 minutes later)

Brief Answer:
oral medicines should work

Detailed Answer:
Hi,

Venous leak causes early loss of erection. That is all.
But getting erections depending on multiple factors like arterial blood flow in a special pattern and integrity of nerves as well as mind set, but in venous leak it is just that the erection does not last long enough.
So, oral medicines should work.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (2 minutes later)

In my case in the past penegra could give me erection till 45 mins .. could i still have venous leak .

thanks !!

Answered by Dr. G.Srinivasan (2 hours later)

Brief Answer:
difficult to say.

Detailed Answer:
It is very hard to say without performing tests. But since the initial treatment is the same, it is better to use the same working medicines as long as you can and then progress to the next level.
Regards

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar