Brief Answer:
your problem can be treated, perfomance anxiety should be ruled out

Detailed Answer:
Hi XXXXXXX

Thanks for writing again to HCM.

You have problem in erection. In general when there is problem in erection for at least 6 months during most of the sexual attempts erectile dysfunction (ED) is diagnosed.
Your height and weight are in healthy figures.

Sometime due to fatigue, lack of mood. situational problem or environmental changes erection problem occurs and man can fail in sex. It is normal phenomenon. However when this failure makes person apprehensive about erection, sex life is affected. This is called performance anxiety. After such failure when person actively thinks about erection or success of intercourse during sex his mind is likely diverted to such thoughts. For constant erection continuous exciting/romantic/erotic feelings should be there in mind. If mind diverted to concern about erection, erection would not be possible.

- Let me know if you have performance anxiety or not.

In any case at this age ED can be treated.

Treatment of ED:

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 you need to consult doctor/psychiatrist/sexologist for the prescription.
Tadalafil is preferred in patients with blood pressure.

You can use another medicine cum vitamin supplement containing pyridoxal-5-phosphate, mecobalamin and l-methylfolate (trade name tetrafol plus)is very helpful in my patients. It has shown improvement in 50-60% patients of mine with ED. You should take it after meal twice a day. If you feel some improvement in 15 days you should continue for at least 1 month. You may get this medicine over the counter as it is vitamin product.

There are some natural lifestyle measures which help to improve blood flow to penis 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.

As you are form XXXXXXX I would like to also mention ayurvedic medicine option. Tentex forte is the medicine which is used for ED. No side effects have been reported. Two tablets daily at night with a cup of milk should be taken.

To help you further answer following questions.

- When did you do your last successful intercourse?

- Is morning erection present when you wake up?

- Do you have any physical illness? If yes describe details with medicines.

- Is there any history of smoking or alcohol?

- Is there any difficulty in urinating?(to check for prostate problem)

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

- Do you have any psychological/stress related problem?


I will be happy to help you further after your response.

Regards,
Dr.Chintan Solanki

---

Brief Answer:
go for serum testosterone and thyroid level, Start medicine as below

Detailed Answer:
Hello,

Thanks for information.

Considering your history you should undergo serum testosterone and serum thyroid level.If any of them is abnormal , correction is needed.

In my opinion you should take sildenafil 50 mg before 2 hours of sex.It is prescription medicine and you need to consult doctor for prescription.

Simultaneously you can take tetrafol plus after meal twice a day and one tentex forte at night with a cup of milk for 2 months. They are available without prescription.

Feel free to discuss further.

---

Brief Answer:
for 2 months

Detailed Answer:
Hello,

You should take tetrafol plus after meal twice a day for 2 months maximum. However after 1 month if you have sufficient improvement reduce the dose once daily.

All the best.

---