Hello dear I understand your concern Treatment will depend on the cause of the problem. Following are the causes: excessive stress, obesity, diabetes, hypertension, low testosterone, smoking, alcoholism and chronic infections. I advise you to consult the urologist and go for following investigations: Blood: fasting blood sugar, ESR, CBC, CRP, lipid profile, USG pelvis, urine test and semen analysis for better management. Doctor will provide following advises: Avoid: stress, spicy and oily food, smoking and alcohol Do regular exercise like walking and medication daily in the morning for 30-45 minutes. Take high protein diet, fresh fruits , green leafy vegetables, almonds and mutivitamin supplements. Do moderated masturbation 3 times/week. Tablet gondil F and Tablet CO Q. If problem not resolves by above advises then sildenafil and paroxentine should be given after proper evaluation. Hope this may help you Contact HCM for further health query Best regards Dr. Sagar