Brief Answer:
Need to find cause of erectile dysfunction.

Detailed Answer:
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

In treatment Erectile dysfunction (ED) first step is to identify cause of the problem. Erectile dysfunction can be a result of a psychological or physical problem.

Psychological causes: Most common cause in young patients. These include performance anxiety, emotional weakness, inferiority complex and stress. Men with psychological problem usually have normal nocturnal erections and erections upon awakening, whereas men with physical problem often do not.

Physical causes: Include neurological disorders (like disc problem), obesity, alcoholism, smoking, hormonal imbalances, diabetes, hypertension, blood vessel disease and chronic diseases.

I hope you are not obese and not taking any alcohol or smoking as sometimes these can also cause erectile dysfunction.

I will describe some simple measures which you can incorporate and these should help you:
-First of all, quit smoking and alcohol (if you are taking any).
-Exercise, particularly aerobic exercise (like: Jogging, skipping and cycling) daily. It will increase blood flow all over body and will reduce stress.
-Eat a healthy diet rich in vitamins, minerals and antioxidants: fruits, milk and eggs
-Have faith in yourself and do not take any stress. You can talk to your partner openly.
-The commonly prescribed drug by the doctors is sildenafil (Suhagra), which causes erections to be stronger and long lasting, but should be taken after prescription. It is important to rule out medical conditions specially related to cardiovascular system before starting such treatment. But is is only temporary measure and there is need to identify cause of the ED.

There is also need to rule out certain medical conditions which can affect erection. These include diabetes, high blood pressure, heart or thyroid conditions, poor circulation, penile venous incompetency and neurological causes. For that comprehensive evaluation and tests with the help of specialist is needed. You may also need MRI spine to rule out compression of neurons, as it may also cause ED.

Apart from that in person evaluation and examination by psychiatrist may be necessary in your case to identify and treat psychological cause of ED, specially if there is no physical (medical) cause after examination.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,

---

Brief Answer:
Need evaluation.

Detailed Answer:
Hello again,
Thanks for follow up.

It is good that you do not drink and smoke. From further information it is clear that you are not obese. But you have sedentary lifestyle, so start aerobic exercise (like: Jogging, skipping and cycling) daily. It will increase blood flow all over body and will reduce stress.

1) Is there any permanent solution to this? 2 out of 10 times not getting hard is okay but now its 6 out of 10 times.
Answer: There is also need to rule out certain medical conditions which can affect erection. These include diabetes, high blood pressure, heart or thyroid conditions, poor circulation, penile venous incompetency and neurological causes. You may also need MRI spine to rule out compression of neurons, as it may also cause ED.

2) Also if I am able to have sex (without pill), then many times I am not able to do for second time. Whereas my friends are able to do back to back.
Answer: It is normal to have erection without pill atleast once daily.

2) Shall I retake Musli Power capsules because I saw good result with that? Its herbal product so will there be any side effects?
Answer: I do not advice ayurvedic medicine. But if you getting benefit without side effects then you can opt for its use.

3) Can I continue to take Suhagra if needed? Like i mentioned below that i read online that it cause 'sudden loss of vision' and i think i have lost some vision too. So is it still advisable?
Answer: Cardiovescular examination and BP monitoring needed for safe use of Suhagra. So, you can use it 2-3 times in a week (do not use daily or 2 continuous day).

4) I read your reply and I have read the same ans on Public questions where you have replied mostly the same. Here i was expecting some proper medication like take these pills for X no. of days etc etc :)
Answer: You may have read answer in which person might have problem similar to you. For sexual problem it is necessary to treat cause of the problem. For cause you need to investigate case (like before treating fever it is important to know cause of fever). There is no short cut for treatment. There is no pill in allopathy which can given all ED patient in allopathy like in Ayurved (they advise Shilajeet and Musli to all cases). Suhagra is helpful in almost ED cases, but should not be taken for long duration, and cause of the ED should be treated.

In corporate workers stress and faulty life style one of the common cause for ED. These cases improve even with simple aerobic exercise and by fixing sleep-wake up time. If you do not improve in 1 month then medication may be required.

I can understand your concern. But on online platform prescription of medicine is restricted. For that you may need to meet doctor personally.

Please accept my answer and give feedback in case there is no further query and you found reply helpful. In case of doubt, I am here to help you.

Wish you good health.
Regards

---

Brief Answer:
Hi

Detailed Answer:
Hello again,
Thanks for follow up.

Tight foreskin may lead to some erection problem. But you are able to roll it back, so circumcision may not be needed and only stretching exercise may help. But examination by surgeon (plastic surgeon) will confirm need for circumcision.

Reddish curve in pic do not cause ED. Medicine do not cause dry prepuce.

Wish you good health.
Regards

---