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Hi Doctor, Can You Please Help Me Figure Out If
Question: Hi Doctor,
Can you please help me figure out if the erection changes/problems I am dealing with right now are psychological or physical? I am open to answer any questions for this assessment. Thank you.
Can you please help me figure out if the erection changes/problems I am dealing with right now are psychological or physical? I am open to answer any questions for this assessment. Thank you.
Brief Answer:
Please briefly describe your problem
Detailed Answer:
Hello,
Thanks for using Healthcaremagic.
Although it is never possible to conclusively establish the cause for erection problem without physical examination but a simple question answer can establish some important clues.
Before we proceed I request you to briefly describe your problem. This will help me to frame appropriate questions for you?
I look forward to assist you.
Thanks
Please briefly describe your problem
Detailed Answer:
Hello,
Thanks for using Healthcaremagic.
Although it is never possible to conclusively establish the cause for erection problem without physical examination but a simple question answer can establish some important clues.
Before we proceed I request you to briefly describe your problem. This will help me to frame appropriate questions for you?
I look forward to assist you.
Thanks
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
so basically I feel a different sensation when my penis is flaccid. 4 months ago I felt like my flaccid penis felt "dead" and not circulating.
Ever since then my erections kind of come and go. Sometimes I have normal and rigid erections and other times it is difficult to get or keep an erection while I am masturbating. My sex drive has also declined. The only tests my doctors took were a testosterone level test and it came back to be 425 so there wasn't any hormonal issue.
I have been thinking about my erection problem for the past 4 months frequently. Any free time I have to think about anything I always end up thinking about my erection issues. This isn't a case of performance anxiety because in the past 4 months I got an erection every time I had sexual intercourse. During masturbation it is difficult for me and takes longer to get an erection. Also, I used to have nocturnal and morning erections every single day. Now, I only get them about 3 or 4 times a week.
Sometimes I feel my erections and the sensation in my penis going back to normal but I always am afraid in the back of mind that it won't last and it just keeps going back and forth between good and bad.
I do not have any serious medical condition that I am aware of. I don't have vascular or cardiovascular disease. Nor do i have any history of diabetes or multiple sclerosis.
I used to always get erections whenever I wanted to. Now, I am extra cautious and always thinking about if I will get an erection even while I am trying to masturbate.
Ever since then my erections kind of come and go. Sometimes I have normal and rigid erections and other times it is difficult to get or keep an erection while I am masturbating. My sex drive has also declined. The only tests my doctors took were a testosterone level test and it came back to be 425 so there wasn't any hormonal issue.
I have been thinking about my erection problem for the past 4 months frequently. Any free time I have to think about anything I always end up thinking about my erection issues. This isn't a case of performance anxiety because in the past 4 months I got an erection every time I had sexual intercourse. During masturbation it is difficult for me and takes longer to get an erection. Also, I used to have nocturnal and morning erections every single day. Now, I only get them about 3 or 4 times a week.
Sometimes I feel my erections and the sensation in my penis going back to normal but I always am afraid in the back of mind that it won't last and it just keeps going back and forth between good and bad.
I do not have any serious medical condition that I am aware of. I don't have vascular or cardiovascular disease. Nor do i have any history of diabetes or multiple sclerosis.
I used to always get erections whenever I wanted to. Now, I am extra cautious and always thinking about if I will get an erection even while I am trying to masturbate.
Brief Answer:
I feel this is purely psychological
Detailed Answer:
Hello,
Thanks for reverting back to me with details of the problem.
Your description of the problem is self-sufficient to state that the problem is purely psychological. Declining sexual interest and less frequent morning erections can occur in psychological erection problem.
Presence of sudden onset (4 months ago) in a young male with the absence of any risk factors with normal erections during intercourse and nocturnal erections almost rules out the possibility of organic/physical causes.
I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards
I feel this is purely psychological
Detailed Answer:
Hello,
Thanks for reverting back to me with details of the problem.
Your description of the problem is self-sufficient to state that the problem is purely psychological. Declining sexual interest and less frequent morning erections can occur in psychological erection problem.
Presence of sudden onset (4 months ago) in a young male with the absence of any risk factors with normal erections during intercourse and nocturnal erections almost rules out the possibility of organic/physical causes.
I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you Doctor,
So if I seek counseling for anxiety or even sex therapy will my erections go back to normal? I think I just need to correct mind set.
Can you please explain how anxiety relating directly to the penis works? I have been stressed out other times in my life as well (school,work,family,etc.) but never had these erection issues? Is it because my anxiety this time is directly focusing on my erections making my erection problems worse?
1 week before I had these erection problems I found out what phimosis was and realized I had it. I felt super sad about the fact that I had phimosis for all these years and never knew about it so I started to worry about that quite often during that entire week. Would that have set off my anxiety do you think? My phimosis is treated now. I can fully retracted when my penis is flaccid but I still need to do more streching excersizes to make it loose enough to retract while erect.
Also, during these 4 months I went to several doctors and wrote to a lot of doctors online and even went to the ER 1 day because I felt a lump on my left testicle that I thought might have been the physical cause of my erection issues. Turns out it was a varicoecle. Do you think the varicocele would have caused erection problems? Do you recommend I have it removed? It doesn't hurt at all but I heard that it causes low sperm production and this is making me more worried.
So if I seek counseling for anxiety or even sex therapy will my erections go back to normal? I think I just need to correct mind set.
Can you please explain how anxiety relating directly to the penis works? I have been stressed out other times in my life as well (school,work,family,etc.) but never had these erection issues? Is it because my anxiety this time is directly focusing on my erections making my erection problems worse?
1 week before I had these erection problems I found out what phimosis was and realized I had it. I felt super sad about the fact that I had phimosis for all these years and never knew about it so I started to worry about that quite often during that entire week. Would that have set off my anxiety do you think? My phimosis is treated now. I can fully retracted when my penis is flaccid but I still need to do more streching excersizes to make it loose enough to retract while erect.
Also, during these 4 months I went to several doctors and wrote to a lot of doctors online and even went to the ER 1 day because I felt a lump on my left testicle that I thought might have been the physical cause of my erection issues. Turns out it was a varicoecle. Do you think the varicocele would have caused erection problems? Do you recommend I have it removed? It doesn't hurt at all but I heard that it causes low sperm production and this is making me more worried.
Brief Answer:
Follow up
Detailed Answer:
Hello,
Thanks for follow up.
It is true that in psychogenic erection problems the psychotherapy is mainstay of treatment and quite effective in majority of individuals. It is possible to correct mind set to perfect level.
In regard to your next question I like to inform you that anxiety have often fluctuating course and can jump from one part of body to another part. It is true that erection issues were never the focus of anxieties but it does not mean that same course will be followed. In other words it can be said that the focus of current anxiety is erections. It is also possible that recent encounter with phimosis shifted your brain at the level of penis or erections.
It is very rare for varicocele to cause erection problems unless it is too large (grade 3)
I hope this answers you further.
Thanks again.
Follow up
Detailed Answer:
Hello,
Thanks for follow up.
It is true that in psychogenic erection problems the psychotherapy is mainstay of treatment and quite effective in majority of individuals. It is possible to correct mind set to perfect level.
In regard to your next question I like to inform you that anxiety have often fluctuating course and can jump from one part of body to another part. It is true that erection issues were never the focus of anxieties but it does not mean that same course will be followed. In other words it can be said that the focus of current anxiety is erections. It is also possible that recent encounter with phimosis shifted your brain at the level of penis or erections.
It is very rare for varicocele to cause erection problems unless it is too large (grade 3)
I hope this answers you further.
Thanks again.
Above answer was peer-reviewed by :
Dr. Raju A.T
if varicocele is grade 3 would that mean it is painful?
My varicocele never hurt but I don't know what grade it would fall under.
My varicocele never hurt but I don't know what grade it would fall under.
Brief Answer:
No, It is not essentially painful
Detailed Answer:
Hello,
Thanks for follow up.
Grading of Varicocele depends on the size of abnormality. Although they are not essentially painful as presence of pain indicates toward complication rather than size of varicocele.
The grading can be determined by simple ultrasonography of Scrotum.
I hope this helps you further.
Thanks and regards.
No, It is not essentially painful
Detailed Answer:
Hello,
Thanks for follow up.
Grading of Varicocele depends on the size of abnormality. Although they are not essentially painful as presence of pain indicates toward complication rather than size of varicocele.
The grading can be determined by simple ultrasonography of Scrotum.
I hope this helps you further.
Thanks and regards.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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