Dear doctor, first of all, I would like to say that I appreciate your time for reading and answering my question. My question (problem) is to do with ed. I am 53 years old I have been suffering with ed for long time, at first taking medication helped but now that is not working either. It seems as if I don't have connections between my brain and penis. I want to have sex very much but I don't have desire and my brain seems can not be switched on to concentrate on it. Some times very rarely I feel desire and have very good affection without any medication or being with a woman. For last 6 weeks I am taking listril 100 mg antidepressants but nothing has changed but I strongly believe my problem is in the brain! can you please give me some advise? Ps: all the blood test comes out as normal. Best regards,

Dr. Satyajeet P PattnaikUrologist11yrs exp

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Depending on the cause and severity of your erectile dysfunction and any underlying health conditions, you might have various treatment options. Your doctor can explain the risks and benefits of each treatment and will consider your preferences. Your partner's preferences also might play a role in your treatment choices. Oral medications Oral medications are a successful erectile dysfunction treatment for many men. They include: Sildenafil (Viagra) Tadalafil (Adcirca, Cialis) Vardenafil (Levitra, Staxyn) Avanafil (Stendra) All four medications enhance the effects of nitric oxide ? a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation. Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing some men to function normally. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in men who get normal erections. The medications vary in dosage, how long they work and side effects. Possible side effects include flushing, nasal congestion, headache, visual changes, backache and stomach upset. Your doctor will consider your particular situation to determine which medication might work best. These medications might not treat your erectile dysfunction immediately. You might need to work with your doctor to find the right medication and dosage for you. Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor's OK. Medications for erectile dysfunction do not work in all men and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes.�  

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