Hello dear
I understand your concern
You do not take viagra and cilais with out the proper evaluation by the uroigist.
It should be used after complete evaluation by the
UROLOGIST.
Treatment of
erectile dysfunction depend on the cause.
It could be due to medical cause and psychiatric issue.
Firstly, I would suggest to go for complete health check up and investigations like blood sugar,
lipid profile, ESR, CRP, serum
testosterone and USG of pelvis and scrotum
If all the investigations come with in normal range then your problem mostly due to psychological problem like stress, anxiety regarding to failure in the bed and partner satisfaction.
Sex
counselling and psychiatric consultation will helpful.
Meanwhile:
spend more time in the fore play and even do fore play during intercourse
Be relax while having sex.
Avoid sex when you feels fatigue and low
Eat healthy diet: rich in protein, lots of fruits and green leafy vegetables
Do kegel's pelvic exercise
Do regular exercise like walking, running followed by yoga, daily in the morning for 45-60 minutes.
At last Viagra and cilais will helpful after Proper clinical evaluation
Tablet paroxentine can be useful too
Hope this may help you
Best regards
Dr. Sagar