ED PME - #9773

Hello Vyom, Thanks for sharing openly — that's a lot you're dealing with, and it's important to take a full view of your health. Let's break things down step by step to help you understand what's going on and what can be done. I’ll keep it clear and respectful Your Current Health Overview** -Age**: 40 -Height/Weight**: 162.5 cm / 79 kg (BMI: around 30 — borderline obese) - **Conditions**: - **Diabetes** (can affect nerves, blood flow, hormones) - **Hepatitis C treatment ongoing** (can affect testosterone levels and energy) - **Leg treatment ongoing** - **Sexual Health Issues**: - Weak or inconsistent erections - Ejaculation within 1 minute (likely premature ejaculation) - Penis size: 4 inches length / 4 inches girth (within average range when erect) - Concerns about semen/sperm quality and fertility Why These Problems Might Be Happening** 1. **Erection & Hardness Problems** Caused by: - **Diabetes** damaging blood vessels and nerves (diabetic neuropathy) - **Hepatitis C or its treatment** lowering testosterone - **Stress/anxiety or performance pressure** - **Obesity** (impacts testosterone, blood flow) - **Poor sleep, smoking, alcohol, or lack of exercise** # 2. **Premature Ejaculation** - Very common in men with anxiety, diabetes, or low testosterone. - Can also happen when there's infrequent sex or oversensitivity. ### 3. **Penis Losing Erection Before or During Sex** - Blood flow issue, weak pelvic floor muscles, or nerve damage from diabetes. - Can also be psychological. ### 4. **Semen/Sperm Quality (Fertility)** - Hepatitis C, diabetes, obesity, age, and medications can reduce sperm count and quality. - The only way to know accurately is through a **semen analysis** (done in fertility clinics/labs). **What You Can Do** **1. Get Medical Tests** **Blood sugar (HbA1c)** — check diabetes control **Testosterone level** — low T causes erection/fertility problems *Semen analysis** — to check fertility *Liver function tests** — since you're on Hep C treatment - **Penile Doppler test** (if erection issues continue) **2. Lifestyle Steps** **Lose weight slowly** (aim for 70–72kg) — even 5-7kg down can help erections and hormones - **Walk daily** or light exercise if allowed with your leg condition - **Avoid smoking, alcohol**, or junk food - **Sleep 7-8 hrs** — helps testosterone and performance **3. Sex-Related Help** - Try pelvic floor exercises (Kegels) for better control and hardness Thank You Dr Shayeque Reza MD 9800280276