What could cause incomplete erection despite medicine?

Question

Hello doctor,

I have sex with my partner once a month, and we usually use Tadalafil 20 and Propranolol. This has been successful for us in the past. But, this time, I took Tadalafil 20 and Propranolol about 40 minutes before sex, but it did not work. I experienced an incomplete erection for three hours and could not penetrate, only masturbated in front of my partner. Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concerns about your symptoms.

Based on your complaints, you may be experiencing erectile dysfunction (difficulty getting and keeping an erection).

Potential reasons for erectile dysfunction include:

Stress from work, family, or night duties - Regular exercise and yoga can help reduce stress.
Depression.
Varicocele - Ultrasound of the scrotum can help in diagnosing it.
Fear of failure - One episode of ED may lead to fear of future occurrences.
Low self-esteem (due to chronic masturbation).
Homosexuality - Lack of attraction to the same sex.
Religious constraints.
Smoking and alcohol consumption.
Long-term illnesses such as cardiac disease, thyroid disease, kidney disease, or other conditions requiring prolonged medication.
Simple vitamin deficiency - Supplements like Zincovit (multi-vitamin supplement) and Shelcal (calcium) can be beneficial.
Negative attitude towards your partner.
Hormonal issues such as thyroid problems, low testosterone, or increased prolactin levels.
Long-term use of certain medications.
Diabetes and hypertension.

I would suggest you undergo tests such as Doppler penis, USG (ultrasound) pelvis and scrotum, blood pressure measurement, RBS (random blood sugar), Free T3 (triiodothyronine), T4 (tetraiodothyronine), testosterone levels, and TSH (thyroid stimulating hormone).

In terms of treatment, regular exercise and a balanced diet are recommended. Basic exercises like Kegels, squats, yoga, running, or fast walking can be beneficial. Also, specific exercises tailored to different sexual positions can be helpful:

Missionary position: Planks, push-ups, mountain climbers, and glute bridges.
Standing sex position: Bicep curls, pull-ups, and jump squats.
Doggy style: Jump squats and walking lunges.
Cowgirl or girl on top position: Glute bridges and leg raises.

Certain foods like strawberries, apples, avocados, sweet potatoes, sesame seeds, almonds, garlic, and a small amount of chocolate may also have positive effects. Propranolol can also potentially cause erection issues.

I suggest you discuss these options with your doctor for evaluation and personalized treatment.

I hope this information helps you.

Thank you.