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ERECTILE DYSFUNCTION QUESTION:

For the last year, my libido and sex life has been literally non-existent. I’m a 38 yr old male weighing 154lbs in relatively good health working out (calisthenics and weights) 3 times a week.

I’ve got my blood tests done and everything looks normal including my testosterone levels. I noticed that the start of this issue coincided with when I started actively working out and losing weight which is odd since it should have had the opposite effect.

The doctor prescribed a short course of Cialis and Viagra, but that did not help.

Please advise.

DOCTOR ALSAYES ANSWER:

First, yes, any physical activity training in your daily routine, such as exercise, or running can help with underlying conditions that play a role in erectile dysfunction in a number of ways, because exercising help to reduce the stress, and help you to lose any extra weight, additionally, it helps to increase your blood flow. All these effects together improve erectile dysfunction.

That being said, you should know that the vast majority of cases of ED problems we see in our clinics are due to psychological problems and what makes them harder to treat is that many of these patients refuse to believe it’s just a psychological issue.

Also, watching too much pornography can lead to ED

The key to dealing with this situation is to identify the cause and to treat it accordingly, in your case, I advise you first to visit your doctor again and make some evaluation tests to exclude any medical/physical causes, and if all tests came up negative then maybe you need to see a psychotherapist to advise you on how to deal with any stress and/or performance anxiety, if any.

Oral ED medications like Viagra and Cialis can correct some of the mechanical reasons for erectile dysfunction, along with a healthy lifestyle of course (healthy diet and exercising), but these medications don’t work well for every case, thus 2nd choice we may try is injections (such as Bi-Mix and Tri-Mix).

If these 2 options didn’t provide much improvement, we consider penile implants.

I hope this answers your question.

The root cause impacts trauma/mechanical damage to my right hip and groin.

This started as a multivehicle car wreck over 10 years ago. Serious damage to my right side pelvis and right side genital muscles and scrotum (seat belt and steering wheel trauma).

Convalescence and home recovery for 7 weeks before I could get back to work. Then, had two corrective surgeries over the years, to repair damages to the groin. Surgeries were only partially successful.

Still, have minor pain and range-of-motion limits. Just have to live with it, adapt to the new circumstances.

Now, I am a 60-year-old white male, 155 pounds, no other medical problems. Other than 81-grain aspirin in the AM, I take no other periodic support meds.

Been using Vardenafil [20 mg] (Prescription on-line order, all I can afford) for over four years as of April. It works like a champ!

I would be happy to share details that I have found that makes Vardenafil work at its best. I have 4+ years of successful use.

And, yes, you have to make some serious changes in your lifestyle to enjoy the best of Vardenafil/Levitra.

My best regards to all. -Sam

Hi all, I have very low libido and it is hard to get visually aroused. This has been going on for about 4 years. I have been checked by a urologist, and all was good there.

My last blood test for testosterone was 810, and free testosterone was good too. I took Zoloft for 6 years, stopping about 4 years ago. I am thinking that this caused the low libido, but I guess it could be my age.

As a result, I am having trouble with ED with my girlfriend. She is 48 and expects me to just get hard without any stimulation. So I have relied on the ED meds, but these are not working so good lately.

I was thinking that it is because I went to Generic in order to save some money, but I hear some guys say that generic Viagra worked just fine.

I can get myself hard, so I know that it does work. I am thinking of trying muse. Oh, I did go to a male clinic about a year and half ago, and they gave me an injection.

Wow, it was hard for 4 hours. They then decreased the amount, and this worked good. But it so inconvenient, and would rather not do this. Any suggestions.

Erectile Dysfunction Question:

I have noticed lately that every time I get an erection,
my penis will go soft almost immediately, what is the reason for that?

Thanks, Dallas

DOCTOR ALSAYES ANSWER:

Hi Dallas,
That’s the typical definition of erectile dysfunction (ED)
First of all, you should know that the vast majority of cases of ED problems we see in our clinics are due to psychological problems and what makes them harder to treat is that many of these patients refuse to believe it’s just a psychological issue.

However, I’d suggest first to check with your doctor for checkup and evaluation, and if all organic causes of ED were excluded then I’d suggest you try some ED oral medications such as Cialis or Viagra.

Usually, we start with oral medications (such as Viagra), but these medications don’t work well for every case, thus 2nd choice we may try is injections (such as Bi-Mix and Tri-Mix).

If these 2 options didn’t provide much improvement, we consider penile implants.

Also, it’s important to have a healthy lifestyle by exercising regularly, eating healthy food (low cholesterol), and stop or avoid alcohol and tobacco as they both contribute to ED.

Finally, try your best to let it go naturally when you are with your partner, don’t overthink it or stress yourself about any of it.

I hope this answers your question.

Injury Trauma and Erectile Dysfunction Question:

Hey there, I was in a head-on crash 18 years ago and was left ED due to trauma. I have tried ED pills, injections and have seen several unhappy women leave my life… it’s been 18 years since my near fatal accident.

I have orgasms but cannot get fully erect. I have pretty much given up unless she likes to play with toys. Is there anything that could be tried that may help?

Thanks, Andy

DOCTOR ALSAYES ANSWER:

Hi Andy,
I’m very sorry to hear that. Yes, there are many options for such a case.

Usually, we start with oral medications (such as Viagra) if the natural erection doesn’t recover on its own, but these medications don’t work well for every case, thus 2nd choice we may try is injections (such as Bi-Mix and Tri-Mix).

If these 2 options didn’t provide much improvement, we consider penile implants. There are 2 main types of these implants; semirigid and inflatable. Each type works differently and has various pros and cons.

In most cases, patients report a satisfaction rate of 80%-90% with penile implants as they have erections suitable for intercourse.

However, you should know; the placement of penile implants requires surgery, and no surgery is totally free of possible complications or risks, and in this case, they may include:
• Uncontrolled bleeding after the surgery possibly leading to re-operation
• Infection
• Scar tissue formation
• Erosion (tissue around the implant may break down)
• Mechanical failure (The implants consist of many parts that could malfunction, however, the 10-year device survival is between 60 and 80 percent)

I’d suggest you speak to your doctor about penile implants and which type would be more suitable for you.

I hope this answers your question.

Cialis Dosage Question:

What would happen if I take 2 Cialis at the same time?

Thanks, James

DOCTOR ALSAYES ANSWER:

Hello James,
First let’s make something very clear, for Cialis, the maximum recommended dosing frequency is once per day, taking Cialis more than once per day or above the recommended dose will increase the risk of having side effects (such as headache, stomach upset, back pain, muscle pain, stuffy nose, flushing, or dizziness).

However, taking 2 tablets of 5mg at the same time is not considered as if you did take it twice a day, it would be the same as if you took 1 tablet of 10mg one time a day.

I suggest you start with 10mg. If you find that the 10mg tablet is too weak, you can ask your doctor if you can take the 20mg dose instead.
Likewise, if you find that you experience side effects when using the 20mg dosage you can switch to the lower 10mg dose to see if you tolerate it better.

I hope this answers your question.

ED Problems and Generic Viagra Question:

I have been having ed problems for a while.. I recently had got a script of generic viagra from my pharmacy. Tried it once, Can’t say it worked well because I was eating at the time. I’ve been wondering the best option to use or the best option in general. I’ve been purging somewhat for a couple of weeks. Next time I want to try it on a completely empty stomach. Do you think it’ll do its job? Also is anything above 125mg safe?

Thanks, James

DOCTOR ALSAYES ANSWER:

Actually, it is recommended to take the Viagra on an empty stomach or at least two hours after eating the last meal, and 1 hour before the intercourse.
It takes around 30-60 minutes for Viagra to make the effect, but this duration can be affected by food or alcohol.

You should know that eating any meal before you take Viagra would cause it to make the effect more slowly. Also, fatty meals are the enemy of Viagra, they can make it harder for the medicine to reach the bloodstream.
So if you take Viagra right before the sexual activity it won’t work very well, also if you had some wine or just had dinner before taking the Viagra that will make it take more time to work so you see the results later on at night.

Yes, in most cases oral ED medications (like Viagra or Cialis) can solve the issue, but you should start with the minimum dose of Viagra (25 mg), if the effect was not noticeable, then you can try Viagra 50 mg the next time.

I hope this answers your question.

Levitra Dosage Question:

Can I take another dose of Levitra 20 mg 12 hours after taking a previous dose?

Thanks, Hazza

DOCTOR ALSAYES ANSWER:

Hello Hazza,
No, Levitra should not be taken more than once daily. Doses should be taken at least 24 hours apart. Taking Levitra more than once per day or above the recommended dose will increase the risk of having side effects.

I hope this answers your question.

Levitra Dosage Question:

Can I take another dose of Levitra 20 mg 12 hours after taking a previous dose?

Thanks, Hazza

DOCTOR ALSAYES ANSWER:

Hello Hazza,
No, Levitra should not be taken more than once daily. Doses should be taken at least 24 hours apart. Taking Levitra more than once per day or above the recommended dose will increase the risk of having side effects.

I hope this answers your question.