Brief Answer:
Want clarification

Detailed Answer:
Hello,

Thanks for writing to us.

I want to know that your erection goes before or after ejaculation. Depending on that further treatment can be done.

Please answer few questions so I can guide you in right direction



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

- Do you pay more attention to erection while trying for intercourse?

- Do you have any physical illness? Any medication?

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

- Is morning erection present when you wake up from sleep ?

- Is smoking or alcohol?

- Is there any difficulty in urinating?

- When did you do successful intercourse last?

- Is there any history of masturbation? If yes, how was pleasure/orgasm during masturbation?

What is frequency of sex or masturbation per week or per month?

How much duration do you last before ejaculation? Do you ejauclate before your partner reaches orgasm?

---

Brief Answer:
refractory period is there

Detailed Answer:
Hi,

Sorry for delayed response.

I think you are talking about second erection after one intercourse. It takes time and particularly in old age.

Late erection second time is due to refractory period.
In males there is called refractory period after ejaculation and orgasm. This is the period during which it is physiologically impossible for a man to have additional orgasms. The penis may be hypersensitive and further sexual stimulation may feel painful during this time frame. While the refractory period varies widely among individuals, ranging from minutes to days, most men cannot achieve or maintain an erection during this time. Many perceive a psychological feeling of satisfaction and are temporarily uninterested in further sexual activity.

There are suggested hormonal, neurotransmitter and muscle fatigue theories to specify refractory period. Average period duration varies from 5 to 45 minutes. But it can be less like 15 minute and more like 1 day also. As age increases refractory period increases in many males. This is likely happening in your case. There is no treatment for it. You need to wait.

If you feel that there is problem in erection, it is erectile dysfunction.

Treatment of ED:
Medical treatment for ED:

5- PDE inhibitor group of medicines are used for this purpose which includes sildenafil or tadalafil. It is proven drug for male erectile dysfunction. One of them should be used 2 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.

Another medicine cum vitamin supplement containing pyridoxal-5-phosphate, mecobalamin and l-methylfolate (trade name tetrafol plus or metanex)is very helpful in my patients. It has shown improvement in 50-60 patients of mine with. You should take it after meal twice a day. If you feel some improvement in 20 days you should continue for at least 2 months. 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. 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.

Let me know if you have nay query.

---