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Facing the problem of erectile dysfunction. Cause and cure?

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Practicing since : 2006
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Hi, I am not having regular erections of late. I failed to perform with my girl friend also many times in the recent past. Have the urge but no erection.
Posted Thu, 25 Apr 2013 in Erectile Dysfunction
Answered by Dr. Gourav Monga 18 minutes later

Welcome to health care magic and thanks for your query

Erectile dysfunction is one of the major sexual dysfunction in males. It is caused by various factors like medical illness, most of the times diabetes mellitus which is not so in your case. Other important factors are psychological which are very common such as stress, anxiety related to the sexual act, anger, frustration, depression, alcohol abuse, drugs like SSRIs, past history of surgery, structural defect etc.

If you are getting night time erections, then the cause is probably psychological.

In case of erectile dysfunction following treatment strategies are considered-

1) Nitric oxide enhancers such as sildenafil, tadalafil, verdanafil etc which enhance the blood flow to penis.

2) Prostaglandins like alprostadil can be used transurethrally.

3) Herbal medicines like tentex forte can be used

4) Psychotherapies & Behaviour therapies if cause is psychological

In case above treatment fails, prosthetic implants or vaccum pumps may be used.

But since you have history of surgery for varicocele and hydrocele, you need detailed assessment by a urologist to rule out any physical pathology. You might need some investigations like semen test or testosterone levels to rule out any associated condition which might be leading to ED.

If everything comes out to be normal, then consult a psychiatrist for detailed work up and management.

Don't worry and relax. You will be alright after appropriate diagnosis.

Hope i have answered your query. If you have any clarifications, i will be happy to help.
In case you have no further queries, accept and rate the answer & leave a review.
Wish you good sexual health.
Dr. Gourav Monga
Consultant Psychiatrist

Above answer was peer-reviewed by
Follow-up: Facing the problem of erectile dysfunction. Cause and cure? 1 hour later
I am not getting the night time erections, except in rare occasions. The strange thing is I get an erection when the bladder is full during early morning. Once the bladder is emptied, the penis stops responding. I do feel mild pain in my right testis ever since I had these surgeries years ago. My testis did not return to normal size after the surgeries. Its 3 times normal size, much to my inconvenience. Even If I get an erection as a result of visual/ touch stimulation when I am with the girl, I am unable to hold it more than a minute or two, which is not at all sufficient to have a satisfying intercourse. I do not feel my problem is psychological as I am not stressed or mentally disturbed. What are the possibilities of a problem with my prostate? The secretion of the lubricant from the penis during sexual excitement is normal, but when I masturbate at times, I do not see any semen coming out, except the feel. I appreciate a review of my case by an Urologist or a General Physician. And Thank you for your review and suggestions.
Answered by Dr. Gourav Monga 47 minutes later

You have given nice details about your problem. I appreciate that and I can understand your situation.

As per your details, you are probably having some pathology at testicular level. As production of sperms depends on normal testicular function and absence of semen points towards abnormal functioning of testis.

Your problem is not at all psychological.

Regarding prostate, symptoms like urinary hesitancy, increased frequency of urination etc are necessary to consider prostate pathology. Also prostate problem usually occurs in older ages.

I advise you to get your semen (if it is coming out) test for the presence of spermatozoa (sperms).

Consult a urologist as soon as possible for detailed work up.

Hope i have answered your query.
Kindly accept the answer and leave a review if no further queries are there.
Wish you good sexual health.
Dr. Gourav Monga
Consultant Psychiatrist

Above answer was peer-reviewed by
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