Brief Answer:
provide more details

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us.

To help you further I need more information from your side.

At age of 52 erection problem should be evaluated by physical examination.

I would recommend proper physical examination with full cardiac check up and serum testosterone level.

To guide you further let me know following details.

- Since when problem is there?

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

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

- Do you have any habit of tobacco use, smoking and alcohol? If yes, provide details.

- When did you do your last successful sex?

- Is there any difficulty in urinating?

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

- Is morning erection present?

- What is your wife's opinion about this problem?

- How was the response with Nano leo?

I will be happy to help further after your response.

Regards,
Dr.Chintan Solanki.

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Brief Answer:
you can go for other supplements and at last for tadalafil

Detailed Answer:
Hi,

Thanks for information. Blood pressure is common cause of erection problem.

I need to know unit of your free testosterone level - 23.4??

I recommend following treatment if I were your treating doctor.

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. It has shown improvement in 50-60 patients of mine with ED. You may get this medicine over the counter as it is vitamin product.

As you are likely form XXXXXXX I would like to also mention ayurvedic medicine option. Tentex forte is the medicine which is used for sex related problem. No side effects have been reported.

If I were your treating doctor I suggest one tablet of tetrafol plus after meal twice daily for two months and one tablet tentex forte daily at night with a cup of milk for 4 weeks.

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.

If above approach fails other medicines are there.

5- PDE inhibitor group of medicines like sildenafil or tadalafil are used for ED. One of them should be used 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.

Hope this answer is helpful.

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