Difficulty getting or keeping an erection is common, treatable, and often the first warning sign of a circulation or blood sugar problem. We find the cause before we treat the symptom.
An erection depends on healthy arteries, intact nerves, adequate testosterone and a mind that is not on guard. Any one of those can fail. So the honest first question is not which tablet to write, but which part of the system has stopped doing its job.
That distinction matters more than most men realise. In men past forty, erectile dysfunction is often the earliest visible sign of narrowing arteries, and it can appear several years before any chest symptom. Treating the erection without checking blood pressure, blood sugar and cholesterol is incomplete medicine.
Your first visit at Elegance Clinic is therefore an assessment rather than a prescription. History, examination, a blood panel and, where the picture calls for it, a penile Doppler scan. Once we know what has actually gone wrong, the right treatment usually chooses itself.
Every man has an off night, and one bad experience proves nothing. A pattern that has lasted three months or longer is a different matter and deserves a proper look.
Most men have two or three causes running together, which is exactly why a single tablet so often disappoints.
A confidential history covering the pattern of symptoms, medication, sleep, alcohol, mood and relationship context. This conversation alone usually narrows the cause considerably before any test is ordered.
Blood pressure, genital examination, morning testosterone, thyroid function, fasting sugar, HbA1c, lipids and kidney function. Results are generally available within twenty four to forty eight hours.
An ultrasound of penile blood flow for men with a suspected arterial problem or venous leak, and for anyone considering surgery. It is done in the clinic and takes about thirty minutes.
Your actual numbers are shown and explained, along with what they mean for your heart as well as your erections. Options are set out with their real success rates and their limits.
Dose, timing and technique are taught properly, whether that is a tablet, an injection, a vacuum device or a shockwave course. You leave knowing exactly what to do and what to expect.
A review at four to six weeks with an honest assessment of what has changed. If the current approach is not delivering, we move up the ladder rather than repeating the same prescription.
Tablets work from the first correct dose, but judging them fairly needs four attempts at the right strength, taken the right way, with real arousal present. Many men who believe tablets failed them were simply taking them wrongly, and that is a five minute conversation rather than a treatment failure.
Where the problem is metabolic, the useful gains arrive between six and twelve weeks as blood sugar, blood pressure and sleep improve. Shockwave therapy is judged at three months, not at the end of the sessions. Injection therapy and implant surgery both give immediate, reliable results once the technique or the device is learned.
We review at four to six weeks and change the plan if it is not working. Nobody is asked to keep taking something that is not helping.
Cost depends entirely on what the assessment finds. The first stage is a consultation and a blood panel, and for many men the answer is medication review, metabolic correction and a properly dosed tablet, which is the least expensive route by a wide margin. A penile Doppler scan, a course of shockwave therapy, injection therapy or implant surgery each sit at very different levels, and implant surgery is the highest because of the device itself. You are given a written figure for whichever route you choose before anything is booked, and it will not change afterwards.
We begin with the least invasive option that has a genuine chance of working for your cause, and we tell you plainly what each one can and cannot deliver.
Controlling blood sugar, blood pressure and cholesterol, stopping tobacco, treating sleep apnoea and reviewing any medication that may be causing the problem. Unglamorous, and for a large share of men it is the single change that makes everything else work.
Ask about thisSildenafil and tadalafil relax the penile arteries so blood can enter properly. They need arousal to work and they need correct timing and dose, which is why they are taught rather than simply handed over. Not safe with nitrate heart medication.
Ask about thisA course of painless sessions aimed at improving blood supply within the erectile tissue. The evidence is reasonable in mild to moderate vascular cases and weak in severe or nerve related ones. We will say plainly whether you are a suitable candidate.
Ask about thisA mechanical pump with a constriction ring, useful for men who cannot take tablets and for penile rehabilitation after prostate surgery. It works reliably, has no systemic effect on the body, and feels mechanical, which suits some couples and not others.
Ask about thisA very fine self administered injection that produces an erection independent of nerve signals. It works for most men whose tablets have failed, including many with diabetes. The first dose is always given and taught in person, never learned from a leaflet.
Ask about thisA malleable or inflatable device placed inside the erectile bodies, considered only after other options have genuinely failed. Satisfaction rates are high and the result is permanent, but the surgery cannot be undone, and that is discussed at length beforehand.
Ask about thisHonest answers about this procedure in Surat.
Ask a QuestionErections do change with age, but losing them is not inevitable. Firmness that has fallen away over months usually reflects something treatable, such as narrowed arteries, diabetes, low testosterone or a medication side effect. Age alone is rarely the whole explanation, and men in their seventies commonly respond well once the real cause is corrected.
Because in men over forty this problem is often the first visible sign of narrowing arteries, and it can appear years before any heart symptom. A panel covering blood sugar, cholesterol, thyroid, testosterone and kidney function may uncover a condition that matters far more than the erection itself. It also decides which treatment is safe for you.
For most men they are, and long term use has been studied extensively. They are unsafe alongside nitrate heart medication, and they need caution with certain blood pressure drugs, severe heart disease, recent stroke and some eye conditions. That is why they should be prescribed after a proper history rather than bought over a counter or online.
First the obvious is checked, because many apparent failures are dosing or timing errors rather than true non response. If the tablet genuinely fails at full dose after four fair attempts, injection therapy works for the large majority, including men with diabetes or nerve damage. Vacuum devices and implant surgery remain reliable options beyond that.
Sometimes, honestly. When the cause is a medication, an untreated thyroid problem, low testosterone, heavy alcohol use or anxiety, correcting it can restore normal erections for good. When arteries are already damaged by years of diabetes or smoking, treatment manages the problem well but does not reverse it. You will be told which situation applies to you.
The pattern usually tells us. A sudden onset, good morning erections and firmness during self stimulation point towards a psychological cause. A gradual decline over months, absent morning erections and firmness that is poor in every situation point towards a physical one. Many men have both, and treatment then addresses both together.
It is not required, and plenty of men attend alone. It does help when the difficulty is affecting the relationship, when anxiety is a major driver, or when treatment involves changes you will both notice. You are welcome to attend the first visit alone and bring your partner later, whichever feels easier.
No. Records are confidential, appointments are spaced so that patients do not sit together in a waiting area, and consultations happen in a closed room rather than a shared clinic space. Nothing is shared with family, employers or insurers without your written permission, and reports are handed to you rather than sent elsewhere.
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View detailsSpeak with Dr. Ashutosh Shah at Elegance Clinic, Surat.
