### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi I m xxxx from Bd. In last 10 days I have suffering by erectile dysfunction. I m doing foreplay for 10-15 minutes & when my penis are strong enough for erection then i push into vagina. But after pushing 30-40 sec it becomes loose without any ejacul.ation. In last 10 days always have the same condition during intercourse. Please help to find out the problem & give me treatment

### output:

Hello dairy understand your concernTreatment of erectile dysfunction is depended on the cause of it. So first we have to find the causes behind that. Following are the causes of erectile dysfunction: Diabetes, Prostate Enlargement, psychological like Excessive stress and relationship issues, fatigue, alcohol & tobacco consumption (constriction of penile blood vessel), obesity, Problems in low back nerves, Hormone problem like Low testosterone levels. So first consult the best urologist and get the following test done:Blood tests:He, CBC, ESR, blood sugar, lipid profile, urea, creatinine, Vitamin B12, folic acid levels iron, etc. Hormones (total and free testosterone, corticosteroids, RHEAS, Thyroid hormone, seminal fluid analysis, Doppler USG of scrotum and penile area to find out the blood flow problem.Meanwhile, take following advice: Start exercising (60-80 minutes in morning with relaxation and yoga), losing weight, stopping smoking and alcohol, Healthy diet with proteins and vitamin A, C, E. Take anti oxidant like CO Q, More foreplay before sex will lead to more excitement, Do discussion with your partner that help in gaining psychological trust, use more than one condom. Following medicine can be provided by doctor: Tablet Viagra: about one hour before sexual activity, Testosterone Replacement Therapy, paroxetine 30-40 min before sex Hope this may help you Best regards