Brief Answer:
provide more details

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us. You are suffering from erectile dysfunction.

I need more details form your side to guide you further.

- Are you married?
If yes duration of marriage?
If not married, provide details about sex life with girlfriend. Where and in which circumstances you do sex? Also describe what exactly happen when you try for intercourse or masturbation?

- How did problem start? Any specific incidence was there?

- Do you pay more attention to erection while trying for intercourse?

- Do you have any physical illness? Are you taking any medicines?

- How is relationship with your partner? Any emotional or social problem is there?

- Is morning erection present?

- Is there any history of smoking or alcohol?

- Is there any difficulty in urinating?

- When did you do successful intercourse/masturbation last?

- provide details about masturbation if applicable.

I will be happy to help further after your response.
Regards,
Dr.Chintan Solanki.

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Brief Answer:
cardiac check up is required

Detailed Answer:
Hi,

Thanks for information and sorry for delayed response.

At age of 44erection problem should be evaluated by physical examination.

I would recommend proper physical examination with full cardiac check up and serum testosterone level. Diabetes is also one of the causative factors and it should be under control. Alcohol once a week is fine but better if you can stop it.

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

However for fast results drug from 5-PDE inhibitor group is preferred.
5-PDE inhibitor group of medicines includes sildenafil (viagra) or tadalafil (cialis). It is proven drug for male erectile dysfunction. One of them should be used 2 hours prior to sex. They cause 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 you need to consult doctor/psychiatrist/sexologist for the prescription. Cialis has relatively less side effects and well tolerated than viagra in patients with blood pressure.

Feel free to discuss further.

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