Creator: Dr. Kumarshri Shriniwas Saraswat
Published: 2018-08-28T10:18:59-04:00

Patient's Query

Hello doctor,

I am 32 years of age weighing 76 kg and my height is 5 feet 6 inches. I am unable to maintain erection. I have been experiencing this since a year. Prior to that, it was all fine and great.

I have not had any other health issue and my BP, sugar levels, cholesterol are all normal. I exercise three to four times a week. I have attached my test reports for your reference. Please advise whether I can take Tadalafil tablets.

Answer

Dr. Kumarshri Shriniwas Saraswat

Psychiatry Psychologist/ Counsellor Psychotherapy Sexology Sleep Medicine

Hi,

Welcome to icliniq.com.

You can safely take tablet Tadalafil (10 mg or 20 mg) half an hour before sexual activity. It can be taken on alternate days if needed because the effect lasts for two days.

You could also take tablet Tetrafol plus (combination of Levomefolate calcium, Pyridoxal 5-phosphate and Mecobalamin) one tablet daily for three months. It is helpful in erectile dysfunction.

For further queries consult a sexologist online --> https://www.icliniq.com/ask-a-doctor-online/sexologist

Was this answer helpful?

Patient's Query

Hello doctor,

Can I take Radar 20 and Tadafil 20 mg? Will that help?

Answer

Dr. Kumarshri Shriniwas Saraswat

Psychiatry Psychologist/ Counsellor Psychotherapy Sexology Sleep Medicine

Hello,

Welcome back to icliniq.com.

You can safely take tablet Tadalafil (Cialis) 20 mg. It is perfectly fine.

For further queries consult a sexologist online --> https://www.icliniq.com/ask-a-doctor-online/sexologist

Was this answer helpful?

Patient's Query

Hi doctor,

I need further help. Tadalafil tablets helped in maintaining erection for the first time, though subsequently there is no effect at all. I am worried as I use to have good erections and instant ones before.

My sex drive also has dropped. Is there any way of getting it back? Please do let me know whether it is curable. Do you suggest me going through any test to find out the cause? Or is it due to anxiety? Please help.

Answer

Dr. Kumarshri Shriniwas Saraswat

Psychiatry Psychologist/ Counsellor Psychotherapy Sexology Sleep Medicine

Hello,

Welcome back to icliniq.com.

Loss of sexual drive or libido itself can cause erectile dysfunction. The cause of erectile dysfunction could be psychological or physical, but the cause of loss of libido is almost always psychological. Besides psychological problems like depression, anxiety can cause both loss of libido as well as erectile dysfunction. The best way to distinguish between psychological or physical cause of erectile dysfunction is that if you have an erection any time during waking up or while masturbation then it is psychological.

Because if there is something wrong physically, you will never have an erection. Do let me know whether you are feeling sad or have lost interest in activities which you previously enjoyed? Change in sleep, appetite, weight, feeling guilty or pessimistic, excessive and uncontrollable worry are symptoms of depression.

We could start you on a libido enhancing antidepressant like Bupropion and wait for the response. Also, do get your vitamin B12, folic acid levels and your thyroid levels checked. After checking, start on a vitamin B12 or Folic acid supplement like capsule Renerve (Mecobalamin) or capsule Neurobion forte. You have not mentioned your lipid profile results. Lipid levels could be abnormal even if cholesterol is within normal levels.

Revert back with the test results to a sexologist online --> https://www.icliniq.com/ask-a-doctor-online/sexologist

Was this answer helpful?

Patient's Query

Hi doctor,

I feel I have a problem of being impatient and worrying for no reason. Shall I get my vitamin B12, thyroid, folic acid levels and lipid levels checked? Please let me know when can I have them checked?

Answer

Dr. Kumarshri Shriniwas Saraswat

Psychiatry Psychologist/ Counsellor Psychotherapy Sexology Sleep Medicine

Hello,

Welcome back to icliniq.com.

As mentioned in my last answer, I was interested in knowing whether you have any spontaneous or morning erections? I am assuming that you do not smoke or drink.

If we decide to rule out other causes of erectile dysfunction, it is better if you also get a serum testosterone and serum prolactin levels done preferably by taking a morning blood sample.