Hello Faizan, thank you for sharing your concern. This is a common and treatable problem, and you are not alone.
1. Citanew is known to cause reduced sexual desire in some people. But do not stop the medicine on your own, it’ll do more harm than benefit. Kindly consult your prescribing doctor regarding your sexual issues and this medicine, he/she will modify the treatment.
2. There is NO true reduction in penis size The “contraction” feeling is due to: Reduced blood flow, Muscle tension, Anxiety, Citanew effect. This is reversible.
3. You should get these tests done (morning sample, 8–10 am): • Serum Total Testosterone, Free Testosterone, TSH, Fasting blood sugar, HbA1C, Lipid profile, CBC. Review with reports.
4. Lifestyle measures- Daily brisk walking / strength exercise. Adequate sleep (7–8 hrs). Avoid smoking & alcohol. Reduce pornography and excessive masturbation. Pelvic floor (Kegel) exercises. Stress management.
5. Visit a doctor immediately if you have Sudden severe pain, Curvature or hard plaque, Complete loss of erection, Blood in semen.
Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Medicine
Hello Faizan Thanks for sharing your concerns and medication details. Reduced sexual desire (low libido), shorter timing during sex, and a feeling of contraction in the penis can be caused by several factors, especially as we age. COVID infection, stress, and certain medications can also play a role.
Possible reasons for your symptoms:
1. Medication side effects:
- Escitalopram (Citanew) can reduce sexual desire and performance in some men.
- Blood pressure and cholesterol medicines can also contribute, though less commonly.
2. Post-COVID effects:
- Some men report changes in sexual health after COVID, possibly due to stress, hormonal changes, or general health impact.
3. Age and lifestyle:
- Natural decline in testosterone, stress, poor sleep, or other health issues can affect sexual function.
What you can do: - Don’t stop any medicines on your own. They are important for your health. - Discuss these symptoms with your doctor. They may adjust your antidepressant or check your testosterone and other hormone levels. - Focus on a healthy lifestyle: regular exercise, balanced diet, good sleep, and stress management can help. - If you smoke or drink alcohol, try to cut down. - Open communication with your partner can also reduce anxiety around performance.
Diet Tips: 1. Include Healthy Fats: - Foods rich in omega-3 fatty acids, like fish (salmon, mackerel), walnuts, and flaxseeds, can improve blood flow and heart health. 2. Fruits and Vegetables: - Incorporate a variety of colorful fruits and vegetables. Berries, spinach, and tomatoes are particularly good for circulation and overall health. 3. Lean Proteins: - Opt for lean meats (chicken, turkey), legumes (lentils, chickpeas), and low-fat dairy. These can help maintain energy levels and muscle mass. 4. Whole Grains: - Choose whole grains like brown rice, quinoa, and whole wheat bread. They provide sustained energy and help maintain a healthy weight. 5. Limit Processed Foods: - Reduce intake of sugary snacks, fried foods, and processed meats, as they can negatively impact blood flow and overall health. 6. Stay Hydrated: - Drink plenty of water throughout the day. Proper hydration is essential for overall health and can improve energy levels.
Exercise Tips: 1. Cardiovascular Exercise: - Aim for at least 150 minutes of moderate aerobic activity per week (like brisk walking, cycling, or swimming). This improves blood circulation and heart health. 2. Strength Training: - Include strength training exercises at least twice a week. This can help maintain muscle mass and boost testosterone levels. Focus on major muscle groups. 3. Flexibility and Stretching: - Incorporate stretching or yoga to improve flexibility, reduce stress, and enhance blood flow. This can also help with relaxation and overall well-being. 4. Kegel Exercises: - These exercises strengthen pelvic floor muscles, which can improve sexual function. To do them, tighten the muscles you would use to stop urination, hold for a few seconds, and then relax. 5. Consistency is Key: - Find activities you enjoy to make it easier to stick with a routine. Aim for a mix of cardio, strength, and flexibility exercises.
Thank you
Hello dear See as per history it seems erectile dysfunction Iam suggesting some precautions for improvement Please follow them for atleast 1 months 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 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,
Yes, this is very likely reversible.
Your reduced sex timing, low desire, and “penis shrinkage” feeling are most commonly due to:
Citanew 10 mg (SSRI antidepressant) → lowers libido, delays/weakens erection Blood pressure medicine (Misar AM) → can affect erection quality
Stress, post-COVID effects, and age-related testosterone decline
🛑The penis usually does not actually shrink—reduced blood flow makes it feel smaller.
🛑🛑 Do not stop medicines on your own Speak to your doctor about: Changing or reducing Citanew Checking morning testosterone, sugar, thyroid Safe erectile-support options if needed
Improve lifestyle: sleep, exercise, weight control, quit smoking/alcohol
This is medication-related + hormonal, not permanent damage, and can improve with proper adjustment.
I trust this helps Thank you
Hi Faizan,
I hear you loud and clear – this is frustrating and needs fixing NOW! Your symptoms (low desire, poor timing, penis contractions) + your meds = a clear picture. Let’s break it down.
🔥 YOUR MEDS ARE LIKELY THE CULPRIT: - MISAR AM 5/40 (beta-blocker + ACE inhibitor): Beta-blockers kill libido and cause erectile dysfunction in 15-30% of men. - STAT A 10 mg (statin): Can lower testosterone and reduce desire. - Citanew 10 mg (SSRI): Major cause of delayed ejaculation + low desire.
⚠️ YOUR SYMPTOMS SCREAM MEDICATION SIDE EFFECTS: - COVID aftermath + aging (43) = perfect storm for testosterone drop. - “Contraction” feeling = likely poor blood flow (beta-blocker effect).
✅ YOUR ACTION PLAN (START TODAY):
1. URGENT MEDICATION REVIEW
- See your cardiologist TOMORROW.
- Ask: “Can we replace the beta-blocker (MISAR AM) with something ED-friendly like calcium channel blocker?”
- Statins + SSRIs also need discussion.
2. TESTOSTERONE CHECK (MANDATORY)
- Get morning total/free testosterone, SHBG, LH, FSH, prolactin.
- COVID + age + meds = high chance of low T.
3. LIFESTYLE (IMMEDIATE WINS):
- Weight training 3x/week (boosts T naturally).
- Sleep 7-8 hours (testosterone made at night).
- Cut sugar/alcohol (kills desire).
4. TEMPORARY SUPPORT (while fixing root cause):
- Tadalafil 5 mg daily (Cialis) – safe with heart meds, improves blood flow + confidence.
- Discuss with doctor first.
5. DON’T IGNORE THIS
- 43 is NOT old – you can get back to peak performance.
- Act now before it affects your relationship/marriage.
Faizan, this is 100% fixable. Let’s get your fire back!
Dr Nikhil Chauhan
Urologist
Decreases in sexual desire, performance, and changes in size or sensation can be influenced by a range of factors, some of which might be related to lifestyle, psychological, or medical conditions. Your current medications—a combination antihypertensive (MISAR AM), statin (STAT A), and likely an antidepressant (Citanew)—might contribute to your symptoms. Statins and antidepressants are known to potentially impact sexual function, including decreasing libido and affecting erectile abilities. It would be beneficial to review these medications with your healthcare provider to assess if adjustments or alternatives can alleviate your symptoms. Lifestyle factors such as stress, sleep quality, physical activity, and diet also play crucial roles. Regular exercise, a balanced diet rich in fruits, vegetables, and whole grains, reducing alcohol intake, and quitting smoking can improve sexual health. Psychological factors, often influenced by stress or anxiety, could benefit from counseling or therapy. Addressing these can sometimes lead to improvements. Hormonal imbalances, notably low testosterone, can also cause the symptoms you describe. Blood tests to evaluate testosterone and other relevant hormones may be warranted. Importantly, any sudden changes, particularly concerning contraction or severe declines, should be medically assessed. Consult your healthcare provider. They will adjust medication if needed, check for underlying health concerns, and might suggest a specialist consult, like with a urologist or endocrinologist, especially if professionally advised adjustments don’t lead to improvements.
Your symptoms—reduced sexual timing, low sexual desire, and penile contraction—are quite common at your age and are very likely related to a combination of medication effects, post-COVID changes, and hormonal or vascular factors, rather than a permanent problem. Both Citanew (escitalopram) and Stat A (atorvastatin) can significantly reduce libido and delay ejaculation, while Misar AM may contribute indirectly by affecting blood flow; COVID itself is also known to worsen erectile and desire-related issues through vascular and hormonal pathways. You should not stop any medicine on your own, but you should consult an andrologist or urologist, along with an endocrinologist, to evaluate testosterone levels, vascular health, and medication alternatives—many patients improve markedly after proper adjustment and targeted treatment.
