For erectile dysfunction (ED), PDE5 inhibitors like Sildenafil (Viagra) or Tadalafil (Cialis) are highly effective and generally safe with borderline high blood pressure. For premature ejaculation (PE), SSRIs like Dapoxetine or topical anaesthetic sprays are commonly used. Since you have borderline high blood pressure, these medications are typically safe, but PDE5 inhibitors can slightly lower blood pressure and must never be taken with nitrate heart medications. I highly recommend consulting a doctor or urologist to safely evaluate your cardiovascular health and obtain the correct prescription and dosage.

It is excellent that you maintain a healthy lifestyle, but premature ejaculation (PE) can still occur due to anxiety, hypersensitivity, or neurochemical factors. Commonly prescribed treatments include: 1. SSRIs (Selective Serotonin Reuptake Inhibitors) like Dapoxetine (taken on-demand) or daily Paroxetine and Sertraline, which safely delay ejaculation. 2. Topical Anesthetics such as lidocaine or prilocaine sprays and creams are applied shortly before intercourse to reduce sensitivity. Please consult a doctor or urologist for a formal evaluation. They can provide the correct prescription and discuss behavioural techniques (like the squeeze method) that work highly effectively alongside medication.

For premature ejaculation, several medical options can help. First-line treatments include prescription oral medications called SSRIs (such as dapoxetine), which help delay ejaculation. Another option is using over-the-counter topical anaesthetic creams or sprays (like lidocaine) applied to the penis shortly before sex to temporarily reduce sensitivity. Behavioural techniques, such as the 'start-stop' method, are also highly effective. Because prescription medications can have side effects and interact with other drugs, it is crucial to consult a doctor or urologist first. They can safely evaluate your health and recommend the best personalised treatment plan for you.