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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suffering From Erectile Dysfunction. On Medication. Very Little Improvement. Suggestions?

sir,
i am vinay.i am suffering with the problem of erectile dysfunction.i have anxiety many years ago.from 2006 i take paxil 10mg-50mg.in 15 feb 2013 i have got married then i relize my doctor drop the dose from 37.5 to 12.5 but i don't got errection.i change doctor in april he switch me to mirtazapine.but i am unable to achieve erection.i have take tobacco since 15 year.can tobacco cause erectile dys.please advise me.my dr suggest me take sildenafil 100 mg and i take it but the errection was only 70 percent.he advise me take the tab many times errection will be back.please advise me
Fri, 16 Aug 2013
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General & Family Physician 's  Response
Hello,
Although erectile dysfunction ( ED ) can be caused by various medical conditions like diabetes,hypertension,hypercholesteremia etc but to have ED at your age is mostly due to anxiety,depression and psychological reasons and this gets further aggravated by facts like obesity,lack of exercises and use of alcohol,tobacco and any other substance of abuse.
Along with medicines,you require quitting of tobacco,doing regular exercises,shedding of weight,regular yoga,doing mental relaxation exercises,deep breathing exercises,meditation and psychiatric counselling from a psychiatrist.
Your problem can definitely be all right if you adopt the right approach.
Thanks
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Sexologist Dr. Dr.Saatiish Jhuntrraa 's  Response
Hello Vinay
You treatment for anxiety was correct with paxil. The doctor might have reduced the dose for fear of reduced libido and delayed ejaculation with paxil ( These are known Side effects) but it seems not to have helped you. You are suffering from ED because of tobacco . It causes spasm of cavernosal artery , thereby reducing the blood flow to penis. Sildenafil may help you to some extent but get a fasting blood sugar and free testosterone level done

GOOD LUCK
DR SAATIISH JHUNTRRAA
SEXOLOGIST
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Suffering From Erectile Dysfunction. On Medication. Very Little Improvement. Suggestions?

Hello, Although erectile dysfunction ( ED ) can be caused by various medical conditions like diabetes,hypertension,hypercholesteremia etc but to have ED at your age is mostly due to anxiety,depression and psychological reasons and this gets further aggravated by facts like obesity,lack of exercises and use of alcohol,tobacco and any other substance of abuse. Along with medicines,you require quitting of tobacco,doing regular exercises,shedding of weight,regular yoga,doing mental relaxation exercises,deep breathing exercises,meditation and psychiatric counselling from a psychiatrist. Your problem can definitely be all right if you adopt the right approach. Thanks