
Suggest Treatment For Erectile Dysfunction

I am Male 52 years old. Dont smoke,Alchohal ocassionaly,Diabetic since 4 years.Walk , swim,and exercise frequently.No other health problems.Get good sleep .No mentle stress.
Fasting sugar @ 140 and Post 190 and BP 130/94 Cholestral normal,Lipid are normal .
As per Doctors advice,
For Blood pressure I take (Atorvastatin 10 mg and Aspirin IP 75 MG) Combination Tab one a day,
For Diabetic I take (Glimepride 2 MG & METTROMIN HYDROCHLORIDE IP 500 MG) COMBINED tab before break fast one tab a day.Medication since 4 years.
Earlier my penis use to erect within no time and ejaculation was under my control.I use enjoy the intercoarse for @ 30 to 50 mintutes. Since 6 months i am not able to control my erection and the ejaculation.Please do give me the right suggestion
With regards
XXXX
Erectile Dysfunction.
Detailed Answer:
Hi,
Thanks for your question.
After going through your question, there is most likely Erectile Dysfunction in your case.
Patient can achieve erection but cannot sustain it (as in your case) is one of the initial presenting complaint in Erectile Dysfunction.
It is due to-
- Endothelial dysfunction (abnormality of cell lining of blood vessel of penis).
- Diabetic autonomic neuropathy.
Following are the risk factors for developing Erectile Dysfunction-
1) Diabetes.
2) Blood pressure.
3) Cholesterol problem.
4) Hormonal imbalance.
Diabetes-
- Though the Fasting & PP sugar level you have mentioned looks ok, you should check HbA1c level which gives better idea of blood sugar control.
- Accordingly appropriate modification can be done in medicine if required after discussing with your diabetologist.
Hypertension (High blood Pressure)
- For diabetic Diastolic blood pressure of >90 (as in your case) requires medicine for blood pressure control.
- Atorvastatin is for cholesterol control and Aspirin is a antiplatelet (blood thinner) and are not for blood pressure.
- Appropriate medicine need to be selected for you as some anti-hypertensive medicine can aggravate problem of Erectile Dysfunction.
Cholesterol:
- You are already on atorvastatin and also Lipid are normal in your case (as you have mentioned).
- But there may be scope for further control of Lipid profile after discussing with your diabetologist /endocrinologist.
Hormonal imbalance:
- Check your serum testosterone level done.
So it will be better to consult endocrinologist/ diabetologist for detailed clinical examination and further evaluation and appropriate treatment.
Medicine like Sildenafil or Tadalafil can be useful but before using it you should consult endocrinologist/ diabetologist as it requires cardiac evaluation before starting it.
Hope I have answered your question.
Regards,
Dr Abhay Mali.


My Glycated Hb-HbA1c (Whole Blood) is 7.5 on 24.08.2015.I am here by attaching the reports which were carried out on 24 AUGUST 2015.Pl down load and do revert back.
I thought this problem may be due to age factor.But as per u r views seems to be a curable one with right consultant.The Doctor whom i consult was a XXXXXXX specialised in Internal medicine.From a reputed hospital.He is not a diabetologist.
I stay in XXXXXXX I request u to kindly suggest a right consultant for this problem of your repute, endocrinologist/ diabetologist for detailed clinical examination and further evaluation and appropriate treatment.
With regards,
XXXX
Erectile Dysfunction.
Detailed Answer:
* After going through your test reports-
- You have fair blood glucose control with further scope in improvement with appropriate modification in treatment in consultation with endocrinologist.
- TSH, Uricacid, serum creatinine are absolutely within normal range.
- lipid profile is also within target range.
* Definitely age factor is also important but with appropriate evaluation there is possibility of correction of additional risk factors which will definitely help you. As good treatment options are available for every individual case.
* I don't know any endocrinologist from XXXXXXX personally, but you can take help of Healthcare magic and internet for search of endocrinologist in XXXXXXX
Hope this helps you.


Finally some questions,
1)Is this a common problem of all the diabetic patients?
2)Am I in diagnosable stage? If so how much time it may take?
3)Can it be rectified by using Sidenafil /Tadalafil after consultation?
4)Day by day i am having less sensation on my Penis Hood can it be corrected?
5)What additional feed back I must give to a Doctor in this problem!
6) What tests may be proposed by the Diabetologist? What treatment may he
suggest in my case.
Sir, once again i Thank ur sponteneous responses.Since the XXXXXXX Doctors dont give the patients sufficient chair time i wanted to have detailed information.so i got in here. Tks for u r honest suggestion.Will take u r advice.
Wish u good luck in u r career.
Regards,
XXXX
Erectile Dysfunction.
Detailed Answer:
Thank you for your follow up questions.
* Problem of Erectile Dysfunction increases with age. Overall it affect 30 to 35 % of diabetic patients.
* Rather than for diagnosis you need evaluation for treatment option suitable for you. For primary evaluation you may need 1 or 2 settings with endocrinologist.
* Cure of Erectile Dysfunction is essentially not possible in every case, but treatment options are available to satisfy sexual desire of an individual. Tab Sidenafil /Tadalafil are one of the options.
* Decrease in penile sensation may be a part of diabetic neuropathy but it requires clinical examination and depending upon further evaluation.
* Whatever the information you have mentioned in your questions is enough for primary evaluation for endocrinologist.
* Additionally there may be need for ECG, 2DEcho of heart and serum Testosterone level.
Hope this helps you.
You can close the question and rate the answer, if you don't have any further queries.
Regards,
Dr. Abhay Mali.

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