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
Given the complexity of your situation, itâs essential to first consider both the physiological and psychological factors that can be contributing to your erectile dysfunction (ED) and premature ejaculation (PE). Letâs 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, itâs 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 youâre 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 hasnât 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 âstop-startâ or âsqueezeâ 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 youâre 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 menâs 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.
This requires personal counselling with you. Please take the personal consultation for better assurance.
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
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
Hello Sharath,I understand this is causing you stress, but please know that these issues are very common and fully treatable.
Iâd 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
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 â 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.
