Erection and premature ejaculates

Question #14063

12 days ago

Erection and premature ejaculates - #14063

Sharath

Sarath with age 35 had gone under open heart surgery at age of 7 years 3 years ago I just went to recheck they said mild pulmonary stenosis.. In 2022 I experience low libido andPE Poblem took medicineit was ok then slowly started ed issue used tadalafil 5mg first next 10mg in 2024 my wife got pregnant and dr advice to stop x so we stopped last year Dec now im not getting any Erection even if it gets very little and 20 to30 sec and im losing it i have tried many time from last one month same thing even im not getting morning Erection too .. like in 100%im getting only 25% harder while physical relationship not even able to enter into her .. im not using tadalafil but not getting when I use them it's like 50% harder and once enter im getting out as im having pe .. Please help me to get out of this 🙏 😭 😫

300 INR (~3.53 USD)

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Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

12 days ago

Hello,
Sharath, your ED and PE are treatable, but you need:
1…Blood tests (especially testosterone and sugar levels),
-Hormone profile
-Hba1c,fasting sugar
-LFT/RFT
-Lipid profile
2.Heart-safe clearance before using tadalafil regularly,
3.A urologist or andrologist’s guidance for combined medication and therapy.
With proper evaluation and a few weeks of focused treatment, most men in your situation recover normal erections and control
Stay calm
Stay healthy
You’ve got this!!
Thank you

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Dr. Varunkumar J

I am an ENT specialist with over 6 years of clincial practice and in this time I have tried to balance hospital work with building my own setup. Currently I work as Consultant at Meridian Hospital Kolathur and also as visiting consultant at VIHAA Hospital Anna Nagar. Along with this I started SCOPE ENT CLINIC in Villivakkam, which is my own space to treat patients with more time n focus. Running a clinic teaches you different kind of responsibility, not only treatment but also trust, making sure patient feels heard and safe. My practice covers a wide range of ENT issues, from common ear infections, sinus problems, throat disorders to more complex surgical cases. I try to focus on giving indiviualised treatment plans, because each patient story is differnt even if the diagnosis sounds similar. Working in multiple hospitals also let me collabrate with other specialities which is important when dealing with complicated ENT cases linked to allergy, pediatrics or even neuro. Founding my own clinic was both challenging and rewarding. Some days are hard, managing staff, handling emergencies, ensuring things run smooth.. but it gave me chance to create an environment where patients get continuity of care. For me ENT is not just about procedures but also education, I try to explain conditions in simple words, guide on prevention and lifestyle changes that can reduce recurrnce. Over these years, what matters most to me is not just how many cases I handled but the connections built with patients and their families. I want to keep growing, keep learning new techniques and stay updated with advances in ENT, but at the same time keep the human touch alive in practice.

11 days ago

Hi Dear Sarath,
I can understand your concern
It can be due to stress /drug induced
Kindly donot worry
Kindly visit a nearby Urologist for better understanding and examination and for treatment
take care

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

10 days ago

Given the complexity of your situation, it’s essential to first consider both the physiological and psychological factors that can be contributing to your erectile dysfunction (ED) and premature ejaculation (PE). Let’s start by considering your medical history; having undergone open heart surgery and being told of mild pulmonary stenosis means that cardiovascular issues could be at play here. Since ED can often be related to blood flow issues, it’s crucial to ensure your heart condition is well-managed. Regular follow-ups with your cardiologist are necessary to assess whether your heart and vascular health could be contributing factors.
Regarding the use of medications like tadalafil, these are typically effective for treating ED, but since you’re experiencing reduced effectiveness, it might be worth revisiting this with your healthcare provider. It could involve adjusting the dosage or trying another phosphodiesterase type 5 inhibitor if appropriate and safe. However, the fact that erectile function hasn’t improved with tadalafil usage indicates that there could be more factors at play than just vascular issues.
Low libido and psychological stress, perhaps exacerbated by performance anxiety, can often work together to impact erectile function. This is where counseling or therapy, possibly directed towards sexual health, could be profoundly beneficial. This brings us to the aspect of PE; psychological factors such as stress or anxiety often worsen this issue, and cognitive-behavioral therapy (CBT) can be quite effective. Behavioral techniques aimed at prolonging sexual stamina might also help improve PE symptoms, like the ‘stop-start’ or ‘squeeze’ techniques.
Additionally, lifestyle changes should not be overlooked. Regular exercise, a balanced diet, avoiding smoking and alcohol, and managing stress through relaxation techniques can all contribute positively. Make sure you’re getting sufficient sleep as sleep deprivation can significantly affect sexual health.
Monitoring hormone levels might also be a consideration. Low testosterone, for example, can cause decreased libido and contribute to ED. A simple blood test ordered by your doctor can determine if hormone imbalances are a concern, warranting potential treatment.
Finally, given your detailed surgical history and current symptoms, a full evaluation by a urologist or a specialist in men’s health would be strongly advised. They would provide a deeper understanding of both the physiological and psychological roots of your issues, tailoring a treatment plan suitable to your specific needs and medical history. Always adhere closely to the advice and guidance of your healthcare providers for any medication or therapy, ensuring safety and appropriateness for your condition.

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Dr. Shayeque Reza

I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.

12 days ago

This requires personal counselling with you.
Please take the personal consultation for better assurance.

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Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

12 days ago

Hello dear
See it seems you are already on medication
I suggest you to please follow below precautions for atleast 1 month
Avoid heavy meals and alcohol
Take ashwagandha or triphala once a day for 2 months
Do meditation
Do physical exercises atleast for half an hour
Especially kegel exercises regularly for atleast half an hour
Take shilajeet for 1 month once a day
In case of no improvement in 1 month, kindly consult gynaecologist for further clarification
Hopefully you recover soon
Regards

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Dr. Prasannajeet Singh Shekhawat

I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.

12 days ago

Hello Sharath
By reading your history and evaluation of your health I must say that -
1. Premature ejaculation is common and often linked to stress anxiety or increased sensitivity of nerves.
2. Since you also have BP and are on medication it is important to rule out drug related effects or associated health issues.
3. Simple techniques like the start stop method using thicker condoms and pelvic floor exercises can improve your control.
4. Certain safe oral medicines and local numbing gels are available but these should be chosen carefully as you are on BP medicines.
5. Lifestyle changes like avoiding alcohol , smoking improving sleep and managing stress are equally important.
6. Please consult a sexologist or urologist for a personalized treatment plan that is safe with your BP medicines.
Thank you

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Dr. Nirav Jain

I am a qualified medical doctor with MBBS and DNB Diploma in Family Medicine from NBEMS, and my work has always been centered on treating patients in a complete, not just symptom based way. During my DNB training I rotated through almost every core department—Internal medicine, Pediatrics, Obstetrics & Gynecology, Surgery, Orthopedics, ENT, Dermatology, Psychiatry, Emergency medicine. That mix gave me the skill to manage acute illness, long term disease and preventive care together, something I find very important in family practice. In psychiatry I worked closely with patients who struggled with depression, anxiety, stress related problems, insomnia or substance use. I learned not just about medication but also about simple psychotherapy tools, psycho education and how to talk openly without judgement. I still use that exp in family medicine, specially when chronic disease patients also face mental health issues. My time in General surgery included assisting in minor and major procedures, managing wounds, abscess, sutures and emergencies. While I am not a surgeon, this gave me confidence to recognize surgical cases early, provide first line care and refer fast when needed, which makes a big difference in online or OPD settings. Now I work as a consultant in General medicine and Family practice, with focus on both in-person and online consultation. I treat conditions like fever, infections, gastrointestinal complaints, respiratory illness, and also manage diabetes, hypertension, thyroid disorders, and lifestyle related chronic diseases. I see women for PCOS, contraception counseling, menstrual health, and children for common pediatric issues. I also dedicate time to preventive health, lifestyle counseling and diet-sleep-exercise advice, since these small changes affect long term wellness more than we often realize. My key skills include holistic diagnosis, evidence based treatment, chronic disease management, mental health support, preventive medicine and telemedicine communiation. At the center of all this is one thing—patients should feel heard, safe, and guided with care that is both professional and personal.

11 days ago

Hello Sharath,I understand this is causing you stress, but please know that these issues are very common and fully treatable.
I’d advise you to get the following tests done first:
• FBS, HbA1c
• Lipid Profile
• Serum Testosterone (Total & Free), Prolactin
• Thyroid Function Test (T3, T4, TSH)
• LH, FSH
• CBC, Serum Creatinine
• ECG / 2D Echo (if not done recently)
Once results are available, treatment can be tailored accordingly. With proper guidance, normal sexual function can usually be restored.
Feel free to reach out again.
Regards,
Dr. Nirav Jain
MBBS, DNB D.Fam.Med

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Dr. Alan Reji

I'm Dr. Alan Reji, a general dentist with a deep-rooted passion for helping people achieve lasting oral health while making dental visits feel less intimidating. I graduated from Pushpagiri College of Dental Sciences (batch of 2018), and ever since, I've been committed to offering high-quality care that balances both advanced clinical knowledge and genuine compassion for my patients. Starting Dent To Smile here in Palakkad wasn’t just about opening a clinic—it was really about creating a space where people feel relaxed the moment they walk in. Dental care can feel cold or overly clinical, and I’ve always wanted to change that. So I focused on making it warm, easygoing, and centered completely around you. I mix new-age tech with some good old-fashioned values—really listening, explaining stuff without jargon, and making sure you feel involved, not just treated. From regular cleanings to fillings or even cosmetic work, I try my best to keep things smooth and stress-free. No hidden steps. No last-minute surprises. I have a strong interest in patient education and preventive dentistry. I genuinely believe most dental issues can be caught early—or even avoided—when patients are given the right information at the right time. That’s why I take time to talk, not just treat. Helping people understand why something’s happening is as important to me as treating what’s happening. At my practice, I’ve made it a point to stay current with the latest innovations—digital diagnostics, minimally invasive techniques, and smart scheduling that respects people’s time. I also try to make my services accessible and affordable, because good dental care shouldn’t be out of reach for anyone.

9 days ago

Your symptoms suggest a combination of erectile dysfunction (ED) and premature ejaculation (PE), which can occur due to reduced blood flow, hormonal imbalance, stress, or psychological causes — especially after heart surgery and long-term medication use. Since you also have a history of congenital heart disease and mild pulmonary stenosis, you should not take erectile medicines like tadalafil without cardiologist approval, as they can affect heart function. Please consult both a cardiologist (to assess heart safety and circulation) and an andrologist or urologist (to evaluate testosterone levels, penile blood flow, and recommend safe ED/PE treatments) so you can regain sexual function under proper supervision.

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Erection and premature ejaculates - #14063

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