Brief Answer: need further clarifications Detailed Answer: Dear XXXXXXX Thanks for contacting Ayurveda with your health concern and following point(s) and causes are worth mentioning for necessary Ayurveda Management of your problem: A. Using the term ED [erectile dysfunction] makes it clear that other problems which interfere with sexual intercourse and reproduction,and problem with ejaculation/orgasm are not involved. B. ED can be a total inability to achieve erection,an inconsistent ability to do so,or a tendency to sustain only brief erection. 3. ED usually is treatable at all ages, thus do let me know about: i. Psychological Factors: such as stress,anxiety, guilt,depression,low self esteem, and fear of sexual failure ii. Anxiety performance [are you in any relation]? iii. fear of rejection by wife [are you married]? iv. feeling of guilt [any childhood impression that sex is bad]? v. any job pressure [over stress], addiction to alcohol, nicotine or opiates? 5. as you have told that cause is psychological, does it imply that it was considered after relevant examination/consultation with a doctor to rule out physical causes of the same? [hormonal profile and endocrinal tests]? 6. start with perineal exercises: while urinating, stop the flow of urine, start again, stop & start again 4-5 times. 7. take: milk and milk products, ghee, makhan, cheese, curd, XXXXXXX black grapes, pears, raisins, dates, almonds, walnut, mango, pomegranate, carrot, banana, apricots, musk melon, amla, coconut, pistachio, turnip, potato, onion, lady finger, radish, old brown rice, peas,garlic, bottle gourd. avoid: sour and cold substances, tobacco [in any form], brinjal, tandori roti, red chilies, heavy and food which require long hours to digest, jaggery and its items, deep fried food. PS. Before prescribing medication for ED, patient should be evaluated for any cardio vascular diseases, thus have an appointment with a Cardiologist for any potential risk of a cardio vascular event, so that Ayurveda medicines/herbs can be incorporated in your daily routine. Dr. Munish Naimittika

---

Brief Answer: Pelvic floor exercise and Management Detailed Answer: Dear XXXXXXX Thanks for reverting back with your concern(s) 1. before starting treatment take . take trifla churan [3 gm] with XXXXXXX warm water before retiring to bed for 15 days PS. if prior to starting the therapy still constipation or hard stools is a problem, go for enema to clear the stools 2. Singly you can use: [after 15 days] . Ashwagandha: best regarded as adaptogen with aphrodisiac properties which may be due to testosterone like effects, thus prescription drug available for same is/are: Ashwagandha churan, Ashwagandha lehyam. . In Compound form: i. Vigomax capsules [Charak]: 1 capsule daily with breakfast or at bed time PS. Recent studies indicate Vigomax was effective in restoring sexual function in men with ED of varied etiologies. ii. Tentex forte tablets [Himalaya]: 2 tablets twice daily for 3-4 weeks. treatment may be prolonged depending upon the response. PS. is a non hormonal and safe sexual stimulant and acts on higher brain centers to improve libido, the antis tress, adaptogen action of tentex forte helps alleviate anxiety associated with sexual desire. 3. take tablet mentat [himalaya] 2 tab twice a day [since ED is a psychosomatic disorder] thus tranquility of mind is important. 4. perineal exercise [pelvic floor programme] is a noninvasive alternative for the treatment of patients with ED by clearing venous occlusion. [will help to achieve full erection afterwards] It also helps to strengthen the muscles and splincters involved in erection and ejaculation. PS. do go for baseline investigations, mainly blood sugar Dr. Munish Naimittika

---