Sexual Health & Disorders Online Doctors Consultation — page 10

Hello Ashish. As per your history, I assume that erectile dysfunction started only after the procedure. If so, it could be due to the procedure itself, by causing trauma to the perineal structures or vascular injury to the perineal blood vessels. If it's the spinal anesthesia that you have been given, there are few case reports citing that spinal anesthesia can cause erectile dysfunction due to alteration of autonomic nervous system and it is temporary condition. Kindly consult nearest sexologist / neurologist for further evaluation and assessment. Regards, Dr. Charan Kumar, MD Psychiatry (NIMHANS).

Hello Sai. First of all, there are lot of questions to be answered before coming to the diagnosis and concluding cause for the same. Erectile dysfunction occurs when sufficient erection fails to happen either in terms of time duration or turgidity (hardness). Broadly speaking, it can be of 2 types - Lifelong (when ED is occuring since the first sexual encounter) or Acquired (ED occuring after an initial period of normal functioning). Lifelong ED can be due to mainly (but not always) medical causes like increased cholesterol levels, vascular insufficiency, hormonal causes like low testosterone, diabetes, etc. Acquired ED could be mainly (again not always) due to psychological reasons like stress, depression, anxiety, marital issues, inadequate foreplay and few other reasons. One more indicator of psychological causes is when ED does not occur with masturbation and occurs only with the partner. Most often than not, ED is also associated with Premature ejaculation which needs to be answered. Management includes 1) Hormonal assays and basic investigations like CBC, Lipid profile, blood glucose levels and thyroid tests to rule out medical causes 2) Drugs like Sildenafil (Viagra) / Tadalafil along with SSRI like Dapoxetine if PE co-exist. 3) Sex therapy 4) Lifestyle modifications 5) Testosterone supplementation in case of low testosterone Kindly consult nearest psychiatrist/ sexologist for further assessment and management. Regards, Dr. Charan Kumar, MD Psychiatry (NIMHANS).

Hey Sam , as you have given history,gabapentin doesn't have this long effect and for your medication I would say start again your old vitamin which u were taking as well as get your testosterone levels check .as you are getting erection after taking pde5 tablet there no issue with your vessels.its is eithera hormonal issue or psychotic issue which got flared due to stress and over thinking

Premature ejaculation (PE) is a common concern for many men and can be caused by a variety of factors, including psychological and physical factors. Since you've already tried techniques like "stop and start" and some Ayurvedic products without success, here are a few steps and suggestions you can take to address the issue: ### 1. **Psychological Factors** - **Stress and Anxiety**: Psychological issues such as stress, anxiety, performance pressure, or relationship issues can contribute to PE. Even though many people may say it’s psychological, these factors can have a significant impact. - **Therapy**: It might be helpful to see a therapist or a sexologist who can help you address any underlying psychological causes. Cognitive Behavioral Therapy (CBT) and other forms of sex therapy have been shown to be effective in treating PE. ### 2. **Physical Health Factors** - **Pelvic Floor Muscles**: Weak pelvic floor muscles may contribute to PE. Regular pelvic floor exercises (such as Kegel exercises) can help improve control over ejaculation. - **Medication**: There are medications like selective serotonin reuptake inhibitors (SSRIs) or topical anesthetics (like lidocaine) that can be prescribed to help delay ejaculation. These medications need to be prescribed by a doctor or a sexologist, so consult a specialist for proper evaluation and advice. ### 3. **Communication with Your Partner** - **Relax and Communicate**: Sometimes, the pressure to perform can make things worse. Open communication with your partner about the issue can help reduce stress and build a stronger emotional connection. It's important to approach this issue together. ### 4. **Lifestyle Factors** - **Healthy Diet and Exercise**: Regular physical exercise, maintaining a healthy weight, and avoiding excessive alcohol or smoking can improve your overall health, which may help in managing PE. - **Avoiding Pornography**: If you engage in excessive viewing of pornography, it can sometimes exacerbate premature ejaculation. Reducing or eliminating pornography consumption may help. ### 5. **Consulting a Sexologist or Urologist** - Since PE has persisted for some time, it would be beneficial to seek professional help from a sexologist or urologist. They will perform a thorough assessment to determine the cause and suggest the best treatment options for you. They may perform tests to rule out underlying medical conditions like hormonal imbalances, infections, or other physiological issues. ### 6. **Explore Behavioral Techniques** - **Squeeze Technique**: This involves applying pressure to the penis when you feel you are about to ejaculate, which can help delay it. - **Mindfulness and Relaxation**: Focusing on the sensations and not rushing can sometimes help reduce anxiety and premature ejaculation. ### Conclusion: PE is a treatable condition, and seeking professional help is important. Consider seeing a specialist like a sexologist or urologist who can help you with tailored advice and medical treatment. With the right combination of psychological therapy, physical exercises, and potentially medication, you can improve your condition. It’s important to be patient with yourself as progress may take time.

Hello It is a common problem There will be latency period for erection of penis after ejaculation. No necessity of medications If it still persist kindly consult.