instruction: hello doctor I am 56 years old diabetic with high blood pressure in the last four years when I am sleeping I have multiples erections dreams and not a calm night of sleep my wife always complains and we argue because during day time I have no desires and it is very hard to have an erection and this makes more friction between us sometimes we take a month to have intercourse we have been together for almost years the problem of erection during sleep time started with fewer times and now it is getting worse sometimes six times during a night I really need some help to have a calm night what do you suggest I am currently taking medications for diabetes and high blood pressure along with insulin and baby aspirin
output: hi firstly you will need good control of your sugar levels it will help with the erection problem and sleep start a good exercise regimen and lose some weight also search on the internet for kegel exercises and do them daily it will help strengthen the muscles at the base of the penis and help with good erections also start a good multivitamin with a lot of complex group of vitamins finally for a few times you can try taking sildenafil or tadalafil to help with getting erections for sleeping you should try taking something harmless initially like melatonin supplements or you can try to take something which will give you sleep and also help with your stress such as mirtazapine 5 or vilazodone 20 my which do not have any sexual side effects