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Question:

Hi, my name is Saeed I am 69 years old and my wife is 57 years old. I have had a very good sex life but since the last couple of years I am experiencing ED. I have a weak erection which usually does not satisfy my wife. Also since the last 2 years I have had to use Viagra almost all the time, but now since a few months these pills also don’t seem to work, I have a short lived weak erection inspite if taking Viagra. Perhaps I am using counterfeit Viagra ? I have tried Cialis also but to no effect Even at this age my wife is very passionate when aroused, but we are not having any sex as she says she doesn’t get climax with a soft penis I am mildly hypertensive and I take amlodepine / telmisarten combination pill daily, apart from it I don’t take any medicine. What should I do ?

Answer:

Hi Saeed,

High blood pressure over time is one of the most common causes of ED, and to treat erectile dysfunction in such cases, you have to lower high blood pressure. It’s always better to do that through lifestyle changes alone, but since you already on blood pressure medications, I recommend you consult with your doctor to see how’s your blood pressure control is going, and there might be a need to change doses or use other BP drugs (which can help improve your ED).

It’s unlikely that you have been using counterfeit Viagra, since the same problem happened with Cialis as well, but it still very important to make sure you get your medications from a trusted source.
On the other hand, some patients have reported gradual losing the efficacy of Viagra especially after long-term usage (+2 years). However, this loss of Viagra efficacy could be attributed to tachyphylaxis (a form of drug tolerance), or to the progression in organic disease from associated comorbidities and aging.

In the first scenario, stay off oral ED medications for couple of months may help restore the efficacy. Other options may also include increasing the dose (under doctor’s supervision). if we don’t see desired results, then we can use a vacuum erection device (VED) along with ED medications (Viagra or Cialis before sexual activities). However, if that doesn’t work, we then consider adding a daily low-dose of Viagra or Cialis for at least 12 weeks (it shows some benefits in some cases), if it doesn’t work, we then consider alprostadil pellets, injections (intra-urethral and intra cavernosal prostaglandins) or topical alprostadil, and lastly a penile implant.

There are also other options such as Venous constriction devices, shockwave therapy, but again it all depends on your overall health and any medical conditions you may have, and it should be included as part of a systematic treatment program under the supervision of your doctor and not randomly tried.

I hope this answers your question.

Question:

Hi, my name is Chris should you only take your Viagra when you know you are going to have sex? What happens if you take it and sex unfortunately doesn’t happen?

Answer:

Hi Chris,

It is recommended to take Viagra only when needed (before sex), preferably 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.
It’s also important to know that without any type of sexual stimulation (whether visual, physical or psychological), you will not develop an erection after taking Viagra. So, if you’ve taken Viagra and don’t have sex, there is no problem and it is unlikely to have any effect on you.

I hope this answers your question.

Question:

Hi, my name is Troy I’m 36 I did not have sex even once in my life. I can masturbate and take out the cum however I cannot get a feeling for erection.

Answer:

Hi Troy,

Masturbation to pornography frequently and over long time can cause a temporary ED, but once you participate regularly in a normal healthy sexual relationship and avoid self-masturbation especially while watching pornography this issue should gradually fade away.

However, erectile dysfunction could be due to many underlying causes, and for the best treatment option we need to identify the cause erectile dysfunction first. It’s kind of impossible to identify the cause without a full medical history and evaluation. Common causes include:
• Heart disease
• Clogged blood vessels (atherosclerosis)
• High cholesterol
• High blood pressure
• Diabetes
• Obesity
• Metabolic syndrome
• Parkinson’s disease
• Multiple sclerosis
• Certain prescription medications (such as High blood pressure medications)
• Tobacco smoking
• Peyronie’s disease
• Alcoholism and other forms of substance abuse
• Sleep disorders
• Surgeries or injuries that affect the pelvic area or spinal cord
• Low testosterone levels
• Psychological or mental health, issues (depression, anxiety or other mental health conditions)
• Stress
• Relationship problems due to stress, poor communication or other concerns
• Watching pornography and masturbation more frequently can lead also to early climax or erectile dysfunction

As you can see there are a lot of factors that could contribute to ED, that’s why we need a complete assessment of your overall health and other health problems/current medications which may affect sexual function. That being said, please see your urologist to determine if a treatment is required for your current ED.

I hope this helps.

Question:

Hi, my name is Rodney is there any truth to the claim that there is permanent fix to ED and that it was formulated to restore sexual youth and performance helping a man experience intense, blissful and powerful sex life?

Answer:

Hi Rodney,

This claim can be accurate in some cases and can be misleading in other cases. It simply depends on the cause of erectile dysfunction.

Erectile dysfunction could be due to many underlying causes. For the best treatment option, we need to identify the cause first. It could be due to causes, such as; anxiety, diabetes, high blood pressure, alcoholism and smoking tobacco, acute stress disorder,…etc

Some causes can be permanently resolved (e.g. in cases of stress or anxiety) and in such cases, the ED will be fixed. While in other cases the main cause behind the ED can’t be cured (e.g. in cases of diabetes), however, it can be controlled so the ED will be also under control (improved) but not totally fixed.

I hope this answers your question.

Question:

Hi, my name is Tom I have ED and am taking Viagra, it works well and my wife is happy. Recently I have been curious about using a penis ring in conjunction with Viagra to make my orgasms more intense, however I am slightly worried that this could be dangerous given how Viagra increases blood flow and a ring cuts it off. Is it safe? Or should I just not even bother?

Answer:

Hi Tom,
ED rings don’t work for everyone, some ED patients see some real benefits while others don’t – the main advantage of penis rings is they can be used with other erectile dysfunction treatments (such as oral medications) to improve the effects.

A penis ring fits around the base of the penis, or the penis, and applies pressure to the surrounding area to slow the flow of blood back from your penis to help maintain an erection. So it doesn’t interfere with Viagra work. ED rings work best when you can achieve a partial or full erection but has difficulty maintaining it.
However, I wouldn’t recommend using the ring if you already having good results with Viagra alone, because there are risks to using penis rings. You might be at risk of damaging your penis, feelings numbness or a feeling of pins and needles, or bruising of the penis, or unusual swelling or bulging.
A better combination would be using Viagra with vacuum pumps.

I hope this answers your question.

Question:

Hi, I’m Darren and I’m 24 years young man except the diseases I will mention below I m perfectly healthy with body mass index of 19 I am suffering from Ed since past two months I also have left sided varicocele of size 4.00 mm and my doctor told me its third grade varicocele and I am also suffering from low sex drive my question to you whether there is any link between varicocele and Ed or low libido? And if yes then get it repaired my varicocele will solve my problems?

Answer:

Hi Darren,
Yes, there is an association between both varicocele and ED.
Because varicocele (grade 3) is associated with a significant reduction in testicular function with a significant increase in serum levels of FSH and LH, which may cause erectile dysfunction and male infertility.
However, a complete medical assessment and exclusion of any other causes/factors that contribute to ED are needed. The good news is that patients with varicoceles may opt for surgical repair to improve testosterone levels and ejaculate quality. This surgery is called varicocelectomy. Microsurgical varicocelectomy provides a safe and effective approach to varicocele repair with preservation of testicular function, and many patients reported improvements in semen quality and erectile functions as well.

I hope this answers your question.

Question:

Hi, my name is Doug I was recently prescribed a penile injection drug by my doctor, it’s Papaverine/Phenolamine 30mg and I’ve tried it four times injecting 1Mg. per time and it has absolutely no effect. Not even a small erection. What would you think the problem might be? Thank you

Answer:

Hi Doug,

Papaverine belongs to the group of medicines called vasodilators, which when used cause the blood vessels to expand, thereby increasing blood flow and erection.

I’m not aware of your overall health condition and medical history to know why your doctor prescribed the injection, therefore I can’t tell why it didn’t work and what’s the main cause of your ED.
As you might already know, Erectile dysfunction could be due to many underlying causes. For the best treatment option, we need to identify the cause first. It could be due to causes, such as; Anxiety, diabetes, high blood pressure, alcoholism and smoking tobacco, acute stress disorder,…etc
Making good lifestyle choices is a very important factor along with the medical treatment, which usually started with the use of oral ED medications when needed, if we don’t see desired results, then we can use a vacuum erection device (VED) along with ED medications (Viagra or Cialis before sexual activities). However, if that doesn’t work, we then consider adding a daily low-dose of Viagra or Cialis for at least 12 weeks (it shows some benefits in some cases), if it doesn’t work, we then consider alprostadil pellets, injections (intra-urethral and intra cavernosal prostaglandins) or topical alprostadil, and lastly a penile implant.
There are also other options such as Venous constriction devices, shockwave therapy, but again it all depends on your overall health and any medical conditions you may have, and it should be included as part of a systematic treatment program under the supervision of your doctor and not randomly tried.

Question:

Hi, my name is Jose I’m 18 and I can’t get a strong erection like I used too, what can be the problem?

Answer:

Hi Jose,

It’s kind of impossible to identify the cause without a full medical history and evaluation.
Erectile dysfunction could be due to many underlying causes, and for the best treatment option we need to identify the cause erectile dysfunction first. Common causes include:

• Heart disease
• Clogged blood vessels (atherosclerosis)
• High cholesterol
• High blood pressure
• Diabetes
• Obesity
• Metabolic syndrome
• Parkinson’s disease
• Multiple sclerosis
• Certain prescription medications (such as High blood pressure medications)
• Tobacco smoking
• Peyronie’s disease
• Alcoholism and other forms of substance abuse
• Sleep disorders
• Surgeries or injuries that affect the pelvic area or spinal cord
• Low testosterone levels
• Psychological or mental health, issues (depression, anxiety or other mental health conditions)
• Stress
• Relationship problems due to stress, poor communication or other concerns
• Watching pornography and masturbation more frequently can lead also to early climax or erectile dysfunction during actual sex relation

As you can see there are a lot of factors that could contribute to ED, that’s why we need a complete assessment of your overall health and other health problems/current medications which may affect sexual function. That being said, please see your urologist to determine the best treatment for your current erectile dysfunction after evaluation.

I hope this answers your question.

Question:

Hi, My name is Matthew I know we’re all different and I’m not asking for any medical advice it’s just a basic question please don’t tell me to contact my doctor. It’s just a question. I’m having premature ejaculation during masturbation because I haven’t been sexually active for a while, Does that mean I will probably have premature ejaculation when I am sexually active again? Thank you

Answer:

Hi Mathew,
Simple answer is maybe (and maybe not).
Though the exact cause of premature ejaculation is not known, however, some underlying causes could be behind this issue:
• Serotonin levels might be the cause.
• Sometimes premature ejaculation could be a problem for men who have erection problems (erectile dysfunction).
• Psychological or mental issues can be the cause, such as; depression, stress, unrealistic expectations about sexual performance, history of sexual repression, lack of confidence.
• Some medications can lead to a temporary premature ejaculation.
• Masturbation to pornography frequently

Now, if you have any of these causes, then yes, your current premature ejaculation will continue until you fix the problem.
But if you don’t have any of the aforementioned causes, then it is most likely that your premature ejaculation will resolve on its own once you participate regularly in a normal healthy sexual relationship and avoid self-masturbation especially while watching pornography.

Exercises, such as the squeeze technique, may be helpful to prolong an erection, but the most important point is you should learn ways to relax and avoid worries (such as performance anxiety) because it simply can make the problem worse.
I hope this answers your question.