Hi XXXXXXX ,

Thanks for your query.

There are many causes for erectile dysfunction. The exact cause can be made out after a history stating when the sexual dysfunction as started the cause and it progress, other relevant medical history. Followed by clinical examination, if necessary the investigations are done to confirm the cause.
The causes for erectile dysfunction are :
• Vascular diseases
• Diabetes
• Drugs
• Hormone imbalances
• Neurologic conditions
• Pelvic trauma, surgery, radiation therapy
• Peyronie's disease
• Psychological conditions

Risk factors for arteriosclerosis(Vascular diseases) include:
•     Diabetes mellitus
•     High blood pressure
•     High cholesterol


Drugs used to treat for high blood pressure, heart medications, antidepressants, tranquilizers, and sedatives are known to cause erectile dysfunction, loss of libido(PAXIL is one among those).

Hormone disorders account for fewer than 5% of cases of impotence. Testosterone deficiency, which occurs rarely, can result in a loss of libido (sexual desire) and loss of erection.

The Neurological disorders, such as erectile tissue. Scarring produces curvature of the penis that can interfere with sexual function and cause painful erections.This is also can be ruled out since there is no history of painful erections.

Depression,guilt, worry, stress, and anxiety all contribute to loss of libido and erectile dysfunction. If a man experiences loss of erection, he may worry that it will happen again. This can produce anxiety associated with performance and may lead to chronic problems during sex. If the cycle is inescapable, it can result in impotence. Psychological factors in impotence are often secondary to physical causes, and they magnify their significance.

After considering the above causes the investigations done to confirm the etiology(cause).

After knowing the etiology the treatment is planned.

So i suggest you to see a consultant(Psychiatrist/sexologist) and undergo a clinical examination, then you can discuss about the treatment which is appropriate to you with doctor.

Don't take medications on your own because these are associated with many sideeffects, after a proper evaluation a treatment will be suggested to you , you can follow that later.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards.

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