Brief Answer: Sildenafil could be a good option for you Detailed Answer: Hello, Thanks for choosing health care magic for posting your query. I have gone through your question in detail as well as the question that you had asked on 11th December and I can understand what you are going through. In the query mentioned on 11th december, you had not stated the blood sugar levels and hence the discussion was not complete. You have mentioned in the current query that the HbA1C levels are 7.2 - 7.5 and anything below 8 is considered as good control of sugars. I would like to congratulate you for your efforts in maintaining the sugars. In diabetics one the most common causes for erectile dysfunction is neuropathy. This causes malfunctioning of the nerve responsible for erection and causes erectile dysfunction. First step in the management of ED in your case would be good sugar control which you have already achieved. The second step would be to supliment you with folate and methylcobalamine. If symptoms persist then the next option would be to take sildenafil 50mg 1 hour before sex along with the vitamin supplements. Sildenafil will act only with the sexual stimulation and will be a mostly natural erection except that it is being assisted by medications. Occasionally depression can as well cause erectile dysfunction. This should be considered if there is sadness of mood, reduced interest in work, reduced pleasure, sleep disturbance, reduced appetite etc. If so then the depression has to be first taken care of by bupropion and then ones depression is fine then the sexual activity will improve. For premature ejaculation, Tab Paroxetine is a good drug which prolongs the ejaculation. I generally prescribe my patients 12.5 mg at night. Paroxetine improves depression as well as it is a primarily antidepressant. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: bit.ly/dr-srikanth-reddy Wish you good health, Kind regards Dr. Srikanth Reddy M.D.

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Brief Answer: Sincere Apologies Detailed Answer: Hello As Health Care Magic is an online forum, legally we are not supposed to prescribe medications without physically examining you. Such regulation are primarily meant for the safety of the patients as well as the Doctor. Further any prescription given in E-mail will not be honored by the pharmacy in your country. Sincere apologies for the same. In my patients I prescribe Paroxetine 12.5 mg at night after food daily for PE For ED i prescribe Tab Tetrafol plus and Cap Eldervit twice a day after food and Tab Sildenafil 50mg SOS one hour before sex. And they do well with these drugs. Thanks and regards Dr. Srikanth Reddy

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Brief Answer: Clarification Detailed Answer: Hello, Sincere apologies for missing out this part of your inquiry. The management for PE with Paroxetine need to be continued for around 6-8 months and the medication is generally withdrawn and seen if the effects are persisting. Sildenafil is generally continued for years without much side-effect. This can also be stopped after 8 months to see if the illness has resolved or not. Yes, they are safe with the diabetic medications and will not disturb your sugar profile. Hope I was clear in discussing your doubts. In case in future if you need any further help, I wil be more than glad to help you on the same link: bit.ly/dr-srikanth-reddy Regards Dr. Srikanth Reddy MD Sexologist

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