Brief Answer:
you seem to have prostate problem

Detailed Answer:
Hello,

Thanks for writing to us.

Low volume of semen and frequent urge to urinate are suggestive of prostate problem. You are already taking tamsulosin for the same likely. Please let me know your prostate specific antigen (PSA) level. If you do not have the same please go for serum PSA level.

In patients with prostate problem ED is common.

Paroxetine can also cause sometime erectile dysfunction issue as well as low volume of semen by delaying ejaculation.Let me know for which purpose you are taking this. If feasible you should stop the same.

Loss of libido may be due to testosterone deficiency. However testosterone on other part can worsen the problem of prostate if on higher side. Serum testosterone level should also be checked.

ED can be treated.

5- PDE inhibitor group of medicines like sildenafil or tadalafil(cialis) 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.

Hope this answers your query.I would like to help you further.

Regards,
Dr.Chintan Solanki.

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