Brief Answer: Rule out the commonest causes of your problem Detailed Answer: Hi there, Thanks for your query. * Firstly, since you are on regular Melatonin and Xanax, I presume that you are suffering from anxiety with/without depression. Lack of libido and erectile dysfunction are commonly seen in anxiety, depression/mental stress. Anti-anxiety and anti-depressant drugs in effective dosages will help greatly. * Diabetes also leads to erectile dysfunction through involvement of nerves responsible for erection. Perhaps, this may explain the initial numbness over the penis head. Have yourself tested for diabetes at the earliest. * High Lipid levels :- lead to deposition of cholesterol within the penile vessels, thereby causing narrowing of these blood vessels (called atherosclerosis). Erection occurs due to increased blood supply --> engorgement of the penile arteries. Hence, narrowing of these blood vessels reduce the blood supply, leading to impaired erection. Incidentally, diabetes is associated with high lipid levels. Hence, get your Lipid levels checked. * Other causes of erectile dysfunction are smoking or excessive drinking; certain medications (particularly for high blood pressure, such as beta-blockers); cocaine abuse. If you do have any of these vices, please give them up. Gradually, your problem will also normalize. Consult your doctor for changing your prescription, if you have high blood pressure. * Finally, psychological problems are the most important cause of erectile dysfunction. If at all, you have personal problems, strained inter-personal relations, any feelings of guilt about your sexual performance, etc.., should be handled with tact, diplomacy and patience. Depending on the presence of either of the above-mentioned problems, please consult a relevant specialist doctor who has the solution/appropriate medical treatment. Hope you find my response helpful and informative. Do revert back to me, if you have further queries. I will be pleased to help you. Fond regards, Dr. Rakesh Karanwal

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Brief Answer: Masturbation does not produce erectile dysfunction Detailed Answer: Hi, Welcome back! NO. Masturbation does not lead to any damage. So, please relax on this aspect. There is however, another possibility of an uncommon genetic condition, called Sickle Cell Disease, which is characterized with abnormal Red Cells in the blood. These abnormal Red Cells lack flexibility and, may occasionally clog small blood vessels, including those of the penis. A Peripheral Blood Picture analysis will reveal this disease. However, since you have not mentioned about any symptoms of this disease, I did not deliberately make any reference to it earlier. It would, nevertheless, be worthwhile to rule out this condition IF the above-mentioned causes have been excluded. Have a good health. Dr. Rakesh Karanwal

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Brief Answer: It is not progressive Detailed Answer: Hi, Nice hearing back from you. I presume that you are referring to Sickle Cell Disease. As I said, it is a genetic condition and can manifest as either milder symptoms, which one usually confuse it as a transient illness. Severe presentation includes recurrent, abrupt severe pains in left side of abdomen (which people consider as intestinal gas or acidity); kidneys (similar pains in flanks) or joints which cannot be attributed to any known cause. There is nothing called 'progression', except for progressive damage to spleen (in the left side of abdomen); kidneys or joints, following each episode of blockage of respective blood vessels. But it does NOT curtail longevity. If you are referring to masturbation, there is nothing to worry about, PROVIDED medical causes are RULED OUT. Regain of self-confidence and curb on anxiety/depression is the TREATMENT OF PSYCHOLOGICAL ERECTILE DYSFUNCTION. Dr. Rakesh Karanwal

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Brief Answer: Bruises/abrasions/ infection can be other causes Detailed Answer: OK. The additional information provided now, simply points towards bruises over the glans (head of penis) and abrasions of the inner lining of the urine passage in the penis. This usually occurs following an intense intercourse or an intense masturbation. It can also be an infection (usually fungal or protozoal) of the urine passage, transmitted during sexual intercourse. Urine analysis or urethral swab will reveal the causative organism. In case you have sexual intercourse, BOTH partners have to be simultaneously treated with 5-7 days of anti-microbials (such as, metronidazole, secnidazole or fluconazole), depending on the organism isolated. In the event of bruises/abrasions as the cause of burning pain, discomfort and numbness, the best treatment is to abstain from masturbation and sexual intercourse for a week or so. Wait for the healing to take place before you resume your sexual activities. Dr. Rakesh Karanwal

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