Brief Answer:
not likely permanent issue, please provide more details

Detailed Answer:
Hi XXXXXXX

Thanks for writing to us.

Erectile dysfunction (ED) is treatable condition. When erection problem is there for at least 6 months most of the time during sex then only we can stamp diagnosis of ED. You have problem since one month only.
ED occasionally can be due to stress, fatigue, work pressure, emotional problem or environmental changes. It is not permanent at all.

Let me know some information:

- What is your age?

- Are you married?

- Do you have any physical illness, specifically diabetes or high blood pressure? If yes describe details with medicines.

- Is there any history of history of smoking or alcohol?

- Is there any difficulty in urinating?

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

- Is there morning erection present?

- Do you able to masturbate?

I will be happy to help further after getting response.

Regards,

Dr.Chintan Solanki

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Brief Answer:
not likely significant problem, metoprolol can cause this side effect

Detailed Answer:
Hello,

Thanks for information.

First of all you need to stop smoking. In long run it causes not only erectile dysfunction but many health hazards.

Morning erection though occasionally present suggests that there is no significant physical problem.

Metoprolol in 8-10% of patients can cause erectile dysfunction.We can confirm it by stopping the drugs for few days.Discuss this aspect with your treating doctor.

I would like to recommend two over the counter product for ED.

You can use medicine cum vitamin supplement containing pyridoxal-5-phosphate, mecobalamin and l-methylfolate (trade name tetrafol plus)is very helpful in my patients.You should take it after meal twice a day. If you feel some improvement in 15 days you should continue for at least 2 months. You may get this medicine over the counter as it is vitamin product.

As you are likely from XXXXXXX I want to mention one ayurvedic product Tentex forte by himalaya which is available over the counter and probably without any side effect for treatment of ED. You can take one tablet daily at night with milk for 2 months.

There are some natural lifestyle measures which help to improve blood flow to penis, increase sperm volume and overall sexual performance.

- The most important factor is healthy heart. Blood is pumped in to body by heart.So regular exercise and avoidance of fatty fast food are important measures to prevent heart disease. Regular walking, swimming or running overall improves blood flow to whole body circulation including penis and keep the mind fresh.

- Good healthy food is also an important aspect. Bananas, Garlic, dry fruits (they contains vitamins), eggs, cow milk, cow butter are good food which may help in erectile dysfunction.

- Avoid smoking and alcohol. Low amount of alcohol can help in increasing blood flow but more amount can cause opposite effects. So better to avoid the same.

Hope this answers your concern.

Feel free to discuss further.

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Brief Answer:
first tetrafol plus then tentex

Detailed Answer:
Hello,

Sorry for delayed response.

I recommend to start tetrafol plus. See the response in 15 days. If no response at all, stop the same. Start tentex forte 2 tablets for a month.
If there is response with tetrafol plus in 15 days add one tablet of tentex forte for one month and continue tetrafol plus for 2 months.

All the best.

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Brief Answer:
diltiazem is better than metoprolol, no drug interaction with tetrafol

Detailed Answer:
Hello,

Thanks for follow up.

Diltiazem is calcium channel blocker and it cause very less and rare sexual side effects than metolprolol. Metoprolol also affects sex drive. Your doctor has stooped metoprolol so your sex drive is likely going to improve.

Diltiazem and tetrafol plus can be taken simultaneously without any safety issue. Tentex forte is an ayurvedic product so no specific data available about its drug interactions but no likely any drug interaction as I have never seen in my patients.

Tetrafol and tentex both will be useful for sex drive. Other routine lifestyle measures to improve sex drive I have already mentioned.

Hoe this answers your query.

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Brief Answer:
you are over concerned

Detailed Answer:
Hello XXXXXXX

Sorry for delayed response.

You are young man. There is no chance of any major sexual problem at this age until there is physical illness. MVP has no relation with sex. You are absolutely fine sexually from physical point of view. However many young men like you are sometime too much concerned about their sex life. This leads to performance anxiety.

For good erection constant exciting erotic feelings must be present in mind. If your mind is diverted to something else apart from sex, erection is going to lose. Many times due to fatigue, stress, physical problem or excessive workload man cannot perform well in sex. This is not permanent failure but only occasional problem. When person becomes apprehensive about such occasional failure and constantly thinks about his ability to do successful sex while he goes for sex his mind diverted from exciting/erotic feelings and penis loses erection. This anxiety might be responsible for failure of intercourse as well as masturbation. This is called performance anxiety.
This is purely psychological problem, no physical/pathological problem at all.

To come out of this man must not think actively about maintaining erection or arousal while doing sex.
To get rid of performance anxiety help of partner/wife is also an important aspect.
Whenever you go for sex, spare enough time in foreplay. You should not think actively about erection, your mind must be occupied with sexual/romantic feelings. During foreplay your wife should try to arouse you and note that your penis gets erection or not. When she feels that penis is sufficiently erect she herself should try to put erect penis in vagina gradually and you should continue your foreplay feelings without being conscious about erection. You must try to enjoy and only enjoy. Once penis is able to enter in vagina and strokes starts it is easy to complete successful sex.

Libido origins from brain. When you are physically and mentally healthy libido would be there. Testosterone is the hormone responsible for the same. Due to any stress testosterone level can fluctuate and affect libido. It comes back to normal on its own after sometime. You already mention that you are thinking too much and consequently searching more about sex problems. I request to keep this aside. Give yourself time of 1 month to relax, take healthy food, regular sleep and do daily exercise. Do masturbation /sex when you feel and while doing the same try to enjoy without thinking about erection/arousal.

Medicines I mentioned would help. Start and see the effects.

If your concern continues no need to worry then also. Consulting psychiatrist/sexologist personally and detail counseling will help.

Hope this answer will help.

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