What Is The Cause And Treatment For Erectile Dysfunction?

Posted on Wed, 25 Feb 2015

Question: Suffer from erectile dysfunction. GP has described Sildenafil but this works only intermittently, although I think "performance anxiety" may be part of the problem. I am aged 64, in general good health and have been told my blood pressure is excellent for my age. I exercise regularly (weights and aerobics); however part of this exercise includes intense workouts on an exercise bike and I wonder if this may be part of the problem (i.e. constant rubbing on an uncomfortable seat). I also feel a general lack of libido but I still fancy my wife (only three years my junior) so obviously this is something I'd like sorted.

Answered by Dr. V. Sasanka (1 hour later)

Brief Answer:
can continue Viagra

Detailed Answer:
Hi,
At your stage, I doubt if you could be having performance anxiety. Advancing age is the commonest cause of erectile dysfunction, and your exercise cycling is certainly going to affect your pudendal nerves and make a small problem worse.
I see no reason why you cannot continue drugs like sildenafil, but a better choice might be Tadalafil, which is generic Cialis, especially as you have no heart issues. You can take it at about 10 mg on alternate days and see if things are better but if you need a consistent response, 5 mg daily at bedtime and 10 mg on demand might make a better choice at a later stage.
Hope I have been if help.
Best wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. V. Sasanka (6 hours later)

Hi

Thanks for your reply. Some time ago I did try Cialis 5mg per day for 14 days but found the side effects uncomfortable in terms of indigestion. What about Leitriva?

Answered by Dr. V. Sasanka (5 minutes later)

Brief Answer:
Never prescribed, but Cialis apparently better

Detailed Answer:
Hi,
I would probably not worry too much about indigestion problems if the drug has been of help at that dosage, which does not happen to everyone.
There are other effects like backache which could be more disabling and would necessitate drug discontinuation.
I have never prescribed any PDE5 inhibitors other than Viagra and generic Viagra or cialis, and of the three, my patients have been relatively more comfortable with Cialis.
Best wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. V. Sasanka (23 hours later)

Dear Dr Sasanka

Thanks for your most recent reply.

I believe I am allowed one more follow up question as part of the deal.

In my first message I referred to a lack of libido. Because of this I went to my GP last year and a blood sample was taken to test my testosterone levels. This came back as "normal" yet I definately don't have the same periodic desires as I did even a couple of years ago.

I notice there are various supplements (for example zinc) which are claimed to improve libido and some are available from respectable High Street retailers. Do you think these do any good or are they just a money-making rip-off?

Thanks

Answered by Dr. V. Sasanka (50 minutes later)

Brief Answer:
really doubtful

Detailed Answer:
Hi again,
I would have also gotten your serum testosterone checked if pde5inhibitors dd not work, but in a way, I would have expected it to be normal. There are other hormones too which should be assessed, as a matter of fact, such as prolactin.
There are multiple other causes of low libido, such as stress, work pressure, interpersonal strain, lack of sleep. Maybe you should ensure these are not relevant in your case.
I have found Sildenafil and Tadalafil pretty useful in my patients, and all other drugs including zinc are what we term nutraceuticals meaning they could help but with unproven benefit. I would never give them in isolation and expect to work, except as a placebo.
Hope you do well. I particularly have not been aware of a ceiling on number of questions, but I do hope you have found some benefit in this forum. You can let me know how you are doing in about three months time.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar