Brief Answer:
No chance of impotency at all

Detailed Answer:
Hello XXXX,

Thunks for writing to us. I am sorry for your brother , may his soul rest in piece.

Zolpidem and diazepam do not affect sex life or sperm production at all. They can not cause impotency.So no need to worry fro the same.

As you are currently taking prodep and lorazepam, probably it has been started for depression.

If you are doing masturbation and you can do the same without any problem no need to worry about your sex life after marriage.

Size of penis does not matter much for satisfying partner.
Anterior 3 inches of female vaginal wall is sensitive to sexual stimuli.Normal size of penis in flaccid state is 2 to 4 inches while in erect position 4 to 6 inches. It varies according to body structure and race. Only 3.5 inches of erect penis is sufficient to satisfy female.Hope you are clear about concern of size of penis now.

In first episode of depression if patient is better for 6 months medicines can be stopped gradually. So your medicines can be stopped if you are 100% fine in your psychiatric problem since 6 months. Just discuss the issue with doctor.

Prodep can cause delayed ejaculation and sometime sexual problem which are reversible side effects. If you are facing any sex related problem currently , let me know.However it does not cause impotency at all.

In my opinion you do not need any medicine right now, detail counseling session related to your sex concern may be needed if it persist.
Many young men like you concern about post marital sex life. However most of them need only counseling.

To assure you I want to mention that treatment is there if you find any sex problem after marriage. So just relax and try to come out of these apprehension.

Hope I have answered your query, fell free to discuss further.

Regards,
Dr.Chintan Solanki.

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Brief Answer:
you are welcome

Detailed Answer:
You are welcome XXXX .

If you do not have any query, you can close the discussion and if feasible give your feedback and rating so I can improve my service. In future you can contact me directly on this site if you wish with this link:
http://bit.ly/drchintansolanki
by clicking on 'Ask me a question' on same page.

All the best and wish you good health.

Take care.

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Brief Answer:
healthy diet is the best approach to improve fertility

Detailed Answer:
Hello XXXX,

Thanks for follow up and sorry for delayed response.

There is no routine medicine which can cause sperm generation.You first need to go for semen analysis if low sperm count is found out then one medicine clomiphene citrate can be given under medical supervision. Please note that this is for your information.You are not needed the same at present.If you wish you can go for semen analysis and revert back to me.
Healthy food including fruits, vegetables, milk/egg, sprouts, garlic, avocado are good items which can improve fertility and sex capacity overall.

For your information I am mentioning treatment for erectile dysfunction and premature ejaculation. But remember that first of all diagnosis should be made by a psychiatrist/sexologist to start the treatment.

Treatment of erectile dysfunction:
5- PDE inhibitor group of medicines like sildenafil or tadalafil 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 one needs to consult doctor/psychiatrist/sexologist for the prescription.

Another medicine cum vitamin supplement containing pyridoxal-5-phosphate, mecobalamin and l-methylfolate (trade name tetrafol plus in India)is very helpful in my patients. It has shown improvement in 50-60% patients of mine with ED.One should take it after meal twice a day. If some improvement is there in 20 days one should continue for at least 2 months. You may get this medicine over the counter as it is vitamin product.

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.
One molecule called depoxetine has been used specifically for PME and should be taken before 2 hours of sex when required.
These medicines are prescription medicines and one needs to consult doctor/psychiatrist/sexologist for prescription.


Behavioral approaches are as follows:

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 counselling of your sexual behaviour 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.

In conclusion you should relax. You do not have any significant problem at present. And by chance if problem is there, treatment is there.

All the best.

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