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Dr. Robert
Dr. Robert, Doctor
Category: Medical
Satisfied Customers: 6680
Experience:  M.B.B.S, Experienced Family Physician
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I am years old but am generally very fit - I go to the gym

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I am 69 years old but am generally very fit - I go to the gym twice a week and work out for about 90 minutes. I am still sexually active but for the last two years I have been unable to climax or ejaculate. I have had two PSA checks in the last four years and both have been negative. I would really appreciate advice.
Dear customer

Welcome to and thank you for your question.
I'm so sorry to hear of your discomfort.I will do whatever I can to help answer your questions .First I need a little more information-

Do you have problem in erection of penis?
Do you have any issues with maintaining erection?
Is there any known medical illness like high blood pressure or diabetes?

I am waiting for your reply..
Kind Regards,
Dr. Robert

Customer: replied 3 years ago.

I use Viagra and with that I have no problem getting an erection. Maintaining an erection varies but generally, I don't see it as a problem. I have no problems with high blood pressure or diabetes.

Dear customer,
Thank you for providing quick additional info.

Although you have good erection & are able to maintain the erection,but the main problem is of orgasm(climax)/ejaculation.

Its most common causes are:suboptimal amounts of testosterone in the body,stress and anxiety,depression,too much alcohol consumption,male andropause(due to elderly age,certain medications.

Stress & anxiety is the most common cause.

You need following tests:

-Dynamic infusion cavernosometry(DIC) and cavernosography (DICC)

-Nocturnal tumescence test

-Testosterone levels

Elderly age-male andropause or low testosterone can be the probable cause.

As you are already using viagra,your treatment may include:Tadalafil (Cialis),Inserting medications into the urethra (intraurethral suppositories), penile prostheses. Testosterone may be prescribed if low levels are detected with tests.

So for confirmation,I advice you to make an appointment with your doctor to have these tests done so as to know the exact underlying cause & then treatment will be done accordingly.

Hope this helped.

My goal is to provide you with excellent service – if you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Thank you XXXXX
Dr. Robert

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