Dr D. Narayana Reddy.

I am a 37-year-old man with one child. I am not able to enjoy sex with my wife right from the beginning. I have an erection problem. I took medication for the issue, but it was of no use. I am hypertensive and am on medication for that as well as for cholesterol. I also take one medicine for prevention of Diabetes even though I am not a diabetic. Kindly advise.

Some antihypertensive drugs can adversely affect erectile response. This can be overcome by changing the medicines. We must find out why the medicines you took for the erection issue did not work. Either they are not the appropriate medicines or the dose was inadequate. I am wondering why you have been put on diabetes medication when you do not have it.

In general, Erectile Dysfunction can be caused by physical or psychological factors or a combination of both. Some physical factors are: structural abnormalities of the penis; problems of the heart & lungs; consumption of certain medications for the management of other medical problems; misfunctioning of glands which secrete hormones like thyroid, insulin and adrenaline; problems of the penis, urinary bladder, prostate gland, etc.; diseases and disorders of the white and red blood cells; damage caused to the body and the genitals due to infections like tuberculosis, gonorrhea, mumps, etc.; diseases or disorders of the brain and the nervous system; infection, thickening and obstruction of blood vessels, chronic illnesses like kidney failure, liver failure.

Psychological factors include negative influences during childhood; anxieties, guilt, depression; marital discord, lack of trust and poor communication between the couple; belief in myths and ignorance.

I suggest that you consult a Sexual Medicine specialist in person.

I am 19 years old. One of my breasts is bigger than the other one. Whom should I consult? I am very perturbed about this problem?

You have not mentioned your gender. If you are a boy/man, then you may be having Gynecomastia. You need to consult a cosmetic surgeon. If you are a girl/woman, then you need not worry as long as you do not have lumps in the breast. It’s common in many women to have different-sized breasts. Very rarely is a pathological condition associated with it. However, you can consult a surgeon or a gynaecologist.

The writer is a sexologist. Mail him at dr.narayana@deccanmail.com

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