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Difficulty in EJACULATION, IMPOTENCE at 70 years old patientof age.

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I am 70 years old patientold. I have had a very general decline in sexual impotence over 15 years.
For the last 10 years old patientI have used a generic viagra product which works fine and shows no side affects. However in the last 12 months I have had increased difficulty to ejaculate ( if at all) and can now only do so after lengthy stimulation by hand.

Can anything be done to improve this.

I have regular bloodtest and medical checkup and all is OK. I have had no previous surgery.
I take daily 10 mg of synvistatin and 10 mg Ixia for slight hypertension

Category: Sexologist

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Hello
Thanks for posting your query at DoctorSpring.com
I understand your concern.

I have gone through your question in detail however i would require a few clarification.
1. How is your current blood pressure and blood sugars?
2. Have you ever skipped your evening alcohol and tried sex? Does that help?
3. The ejaculation is delayed...how does the erection stay? Is it good through out?

Hope to hear from you.
Regards
Dr . Srikanth Reddy


Patient replied :

1. Blood Pressure is usually OK. about 130/65. I check regularly - 3 times per day. The top sometimes goes over 140 and rarely over 150. The lower rarely goes above 80 but sometimes goes quite low (47-57). 3 months ago I reduced the 10 mg of Ixia to 5 mg.
Blood Sugars - readings from last analysis in Oct 13 are attached.
2. I do not drink every day. I try to have atleast 1 or 2 days pw without any alcohol. I drink say 32 units pw - say 8, 3, 2, 0, 8, 7, 4 units per day.
I would not attempt sex after drinking - it wouldnt work. These days I really need the viagra for an erection. I think sex is better after no alcohol for a day or 2 but ejaculation is still difficult.
3. I usually have sex about 3 times pw. Only over the last year it has become increasingly difficult to ejaculate. With Viagra the erection lasts OK - maybe starts to wain abit after 30 -45 mins.


Hello.
The two most common causes for such a presentation of delayed ejaculation with some erectile dysfunction are adverse drug effects of medications and organic causes. The medicines mosg commonly implicated are antihypertensives. It would be wise to switch to a different group of anti hypertensives for a trial and look for the improvement.
For the other possibility, it would be wise to get a penile doppler test done. There may be a problem in the circulation of the penis leading to the stated problem.
The third possibility is a peripheral neuropathy due to the diabetes. The first step is proper control of sugars which you are already taking care of. The next step should be to take a course of multivitamins and trace elements like zinc.
Hope this helps
If you have anu further query,let me know.
Kind regards
Dr. Srikanth Reddy


Patient replied :

Hi,
Many thanks for your advice.
I will start the zinc and multivitamins course. I do not think I have diabetes.
I will also ask my doctor to prescribe an alternative to Ixia.
Could it be caused by low testosterone due to age. Would it be worth trying tablets of testosterone supplement. Something gentle to see if it makes a difference.
What about something like Pro-Viron (Mesterolene) - I saw this offered on the internet. Would this be safe to try..


Hello
It would be even better to get a serum testosterone levels checked. Testosterone levels do drop with age but it will not cause delayed ejaculation.
I would suggest that instead of starting hormonal medications, it would be better to check yourself and then start if required.
Kind regards,
Dr. Srikanth Reddy


Patient replied :

Hi,
Many thanks for your advice.
I am now taking Multivitamins and Zinc supplements which I understand could help ED.
Although the ED is not such a problem as it is solved by use of the generic viagra.
The difficulty in ejaculation is more prblematic which you say is most likely caused by IXIA.
I have stopped taking the 5mg per day (half a tablet) of IXIA as I dont seem to need it as my blood pressure is if anything too low. In the evenings when relaxing the lower reading is. regularly 47-57. However I will monitor it 4 times per day.
Is the Testosterone test a simple blood test? Is there any harm in buying a gel and simply giving it a try to see if it improves the ED. Would there be any problem if I later stopped it.
I dont fancy the Penile Doppler test - sounds invasive. If such a problem is found how can it be treated.


Hello.
Blood testosterone level is a simple blood test. It would be better to defer using testosterone preparations until the blood tests demonstrate the deficiency. Regarding the Penile Doppler Test, its not that invasive except for one single injection. If the test comes negative then the cause of your problem needs to be traced to psychological reasons.
Hope this helps.
Kind regards, Dr. Srikanth Reddy MD.


Dr. Srikanth Reddy
Category: Sexologist
Experience: 
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
Dr. Srikanth Reddy and 4 other Medical Specialists are ready to help you

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