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Erectile dysfunction, Psychological impotence - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Men's Health
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2379 Questions
Doctor :   Hi
User :   hi..
Doctor :  
How can i help you?
User :   I have a problem related with intercourse...
Doctor :  
ok
User :   Im 28 yrs...got married 4 mnths back...
User :   unable to have sex with my wife...
Doctor :  
ok
User :   each time I try to penetrate, either I lose erection or am not able cum inside...
Doctor :  
ok
User :   we have tried both ways, with her or me on top...
User :   in the end, have to use my hand to mastrubate...
Doctor :  
ok
User :   we enjoy oral, but unable to do intercourse.. also, i feel, unless i jerk myself with my hand, i am not able to climax...
User :   pls advise..
Doctor :  
yes i shall help you in this
Doctor :   may i know some more details

User :   sure.. pls ask..
Doctor :  
do you have the habit of smoking or consuming alcohol
User :   i take alcohol... once/twice in a week.. no smoking..
Doctor :   were you masturbating regularly
User :   yes... pretty much..
User :   once in 2 days.. sometime everyday..
Doctor :   ok
Doctor :   what is the problem u are finding while penetrating?
User :   at times i just lose my erection.. its easier if my wife's on top...else i can't...
Doctor :  
ok
Doctor :   do u feel ur wife vagina is tight?
User :   it is... but we used lubricants, then it was ok.. but after being there for sometime, i would again lose erection
Doctor :  
ok
Doctor :  
did u have sex prior to this with any other girl?
User :   no ...
Doctor :  
ok
Doctor :  
how much time u will spend on foreplay?
User :   quite alot of time.. about 20-30 mins normally... even more at times...
Doctor :  
ok
User :   wat seems to be the problem??
Doctor :  
once u answer my questions i will tell u
User :   ok..
Doctor :  
how much time u are holding erection while masturbating?
Doctor :  
are u finding any difficulty while masturbating also?
User :   depends... upto 10/15 mins also sometimes... no problems while mastrubating at all...
User :   i have erection thorughout the foreplay also..
Doctor :  
ok
Doctor :  
Psychological impotence tends to be abrupt and related to a recent situation. The individual may be able to have an erection in some circumstances but not in others.
User :   ok..
User :   and how can this be treated...
User :   also... one thing more...
Doctor :   The inability to experience or maintain an erection upon waking up in the morning suggests that the problem is physical rather than psychological.
Doctor :   ok please proceed
User :   i can't pull the skin of penis completely....
User :   n the inner area is very sensitive...
Doctor :  
while in erection?
User :   ya... it doesn't get pulled completely.. only half the head shows...and its very sensitive...
Doctor :  
ok
User :   but as u mentioned earlier... i do maintain erection upon waking up in the morning...
Doctor :  
then most probably this is psychological
Doctor :  
do u have penile discharge?pain on urination?
User :   no.. nothing like that...
Doctor :  
good
Doctor :  
then ur problem must be psychological
Doctor :  
Anxiety has both emotional and physical consequences that can affect erectile function. It is among the most frequently cited contributors to psychological impotence. Anxiety over sexual performance is often referred to as performance anxiety and may provoke an intense fear of failure and self-doubt. It can sometimes set off a cycle of chronic impotence
Doctor :   In response to anxiety, the brain releases chemicals known as neurotransmitters that constrict the smooth muscles of the penis and its arteries. This constriction reduces the blood flow into and increases the blood flow out of the penis.
User :   ok..
Doctor :   Depression also is strongly associated with erectile dysfunction.
User :   is there any way to overcome all this??
Doctor :   i feel its better u see apsychiatrist
Doctor :  
he will give u counselling
Doctor :   and help u overcome this problem
User :   ok.. so there's no physical issue??
Doctor :  
and also Alcohol has also been implicated in causing impotence. In small doses, alcohol releases inhibitions, but in doses larger than one drink, it can depress the central nervous system and impair sexual function.
User :   I had read somewhere, that if the skin of the penis can't be pulled back properly, that is also a problem... can that be a problem..??
User :   but i dont drink as much alcoho..
Doctor :  
according to the history given by u i feel it might not be physical
Doctor :  
Phimosis is tightness of the prepuce (foreskin) of the penis that prevents the retraction of the foreskin over the glans.
Doctor :  
but in phimosis The foreskin may be red, swollen, and tender
Doctor :   along with discharge

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