I’ve been facing difficulty in getting or maintaining an erection during sexual activity. I’d like to know the possible causes and treatment options. - #14234

Hello,

Please consult your urologist or diabetologist before starting Sildenafil to confirm it’s safe with your current health and medicines.

They can also screen for hormonal or vascular causes and suggest long-term management.

You can likely use Sildenafil safely at 50 mg as a starting dose, if you’re not on nitrates and your heart health is stable.

Maintain good diabetic control, exercise, and follow up with your doctor for tailored advice.

You can check hormonal profile Due to diabetes,blood flow to the penis also get affected.

Anyway my advice is please consult your physician first ,then start taking medicine

I trust this helps Thank you

This requires personal consultation. Counselling is needed before treatment initiation.

Hello sir See before taking any medication I would like to suggest some curative and preventive measures for better clarity 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 atleast half an hour daily Take shilajeet once a dayfor 1 month once a day . Also take triphala/ ashwagandha onca a day for 1 month In case of no improvement in 1 month, kindly consult gynaecologist for further clarification Regards Hopefully you recover soon Regards

Erectile dysfunction can indeed be related to diabetes, even if it is well controlled. Diabetes can affect blood flow and nerve function, which are crucial in maintaining an erection. You’re right to consider Sildenafil, as it’s a common oral medication used for treating erectile dysfunction by increasing blood flow to the penis. However, before starting Sildenafil, an evaluation of your cardiovascular health is necessary, since the medication can have implications on the heart and blood pressure. Assuming no contraindications such as severe heart disease or concurrent use of nitrates (which can lead to a dangerous drop in blood pressure), Sildenafil can generally be started at a low dose. The initial recommended dose is often 50 mg taken approximately one hour before sexual activity, though doses can range from 25 mg to 100 mg depending on effectiveness and tolerance. This should not be used more than once per day. You should be aware of potential side effects like headaches, flushing, or dizziness. It’s always a good idea to discuss the use of Sildenafil with your healthcare provider first, to ensure it’s safe given your overall health profile and any other medications you may be taking. They might also investigate other potential causes of erectile dysfunction, such as changes in lifestyle, stress levels, or psychological factors, which might be contributing or could be targeted alongside medication to improve outcomes. Make sure to seek professional medical advice if you experience any unusual symptoms or if erections become painful or prolonged, as these can require immediate attention.

Hello Humayun By going through your history and evaluation of your health status i am recommending you following medicine - Rx - 1) Tab Autrin 1 tab daily after food for 2 months 2) Tab ashwagandha 500 1 tab twice daily after food for 2 months 3) Tab tadalafil 10mg 2 times a week

Investigation:

CBC, ESR Thyroid Profile (TSH, T3, T4) Fasting Blood Sugar & HbA1c Vitamin B12 & D3 Testosterone (Total & Free) – for stamina/libido concerns

Thank you

Thank you for opening up about this, Humayun. Erectile issues are quite common, especially among men with diabetes, and the good news is they’re usually treatable once we identify the cause and manage it properly.

Erectile dysfunction in diabetic men often happens because long-term diabetes can affect blood flow and nerve function in the penis. Even with good sugar control, mild changes can persist.

Kindly get done these tests before starting any medications - HbA1c, Lipid profile, Sr. testosterone, RFT and a BP check (as sildenafil can lower BP).

And about starting medications, it’ll be best for you to consult a certified psychiatrist or a Family Physician first, as he/she needs to get a proper history and stress evaluation. You can take an online consult from me as well, as I’m a Family Physician. Sildenafil can cause interactions/reactons with other medicines, so need to get all medicine details from you.

Till then, you can start with these lifestyle changes - Exercise daily, it improves blood flow and testosterone levels. Sleep 7–8 hours nightly. Limit stress.

Feel free to reach out again.

Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Med