###Human: Why do I have loss of libido, premature ejaculation, erectile dysfunction, and fatigue? ###Assistant: Hello. I can understand your problem. Your weight in proportion to height is almost near the normal range. But in lipid profile, the cholesterol levels are high, and HDL levels are low (attachment removed to protect patient identity). Deranged lipid profile is one of the common reasons for reduced libido and sexual dysfunction. You should try to improve your physical activities and try to bring weight and lipids in a normal range. Exercise will help in improving the libido too. For weak erection and reduced libido drugs like PDE-5 (Phosphodiesterase) inhibitors like Tadalafil can be used. Low dose Tadalafil in 5 mg per day after dinner daily will help to make a strong erection. To improve erection at the time of sexual intercourse, you can take an extra 10 mg tablet on SOS basis about half to one hour before sex. Kindly consult your doctor for suggestions and take the treatment with consent. This will improve libido and will make erection hard. Avoid smoking, and alcohol use to stay healthy. Supplements containing L-arginine and Yohimbine have great roles in improving libido. Take Nano-Leo which consists of L-arginine that helps to reduce the fatigue.