Patient: I have taken viagra and also cialis. I cannot get a erection. What can I do?
Doctor: Erection problems may cause significant emotional disturbance. Erection is a complex combination of psychologic, neurolo gic, hemodynamic, mechanical and hormonal components. Psychologic erectile dysfunction may start suddenly, varies with partner and circumstance, more common in younger men and may have presence of morning erection. Depression and anxiety problems may also manifest as erectile problems. Neurologic (brain and spinal cord) causes may also manifest with erectile problems but usually occurs together with problems in urination and defecation. Conditions that clog the blood vessels (diabetes) may result to this problem as well. You mentioned that you are on Novalog (for diabetes) and Lipitor (for high cholesterol). This is a likely cause in your case. High blood sugar levels and high cholesterol levels can clog the blood vessels supplying the penis, which will prevent erection. Hormonal problems (thyroid hormones and low testosterone) may result to low libido (sexual desire) and erection problems. Trazodone is another drug that may help with erectile dysfunction but you should ask your doctor for a prescription. Another is penile injection therapy: a drug will be injected directly to your penis to help maintain erection. There is also an intraurethral pellet therapy wherein a small suppository will be inserted into the urethra (passageway of semen and urine) to improve erectile dysfunction. Penile implants are the last resort. Ask your doctor or urologist which among these is best for you. I would advise for you to see a doctor and/or urologist so you can be completely evaluated and you may ask what option is the best for you. I do hope I have answered your question. I wish you well always.