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No improvement with viagra for erectile dysfunction, Is it necessary to go for penile implant?

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Practicing since : 1978
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I am a 35 year old man who has been suffering from erectile dysfunction for some time. I was in a volitile relationship where i had sexual problems though occassionally had sex. I went to therapy and occassionally took viagra which worked. This relationship has now broken up and I have been prescribed Zoloft. I very rarely get erections and when i do they are very weak. I dont smoke, drink very little and am not overweight. I am going back to my doctor to ask to see a urologist. I am very worried as the last 2 times i tried to use viagra it did not work. I have been living with this for about 8 months and it seems to be getting worse. I am now feeling somewhat suicidial. Even considering a penile implant. I am practically a recluse now. No one seems to be taking this seriously now and my parents were very opposed to me seeing a psychiratrist which i then didnt do. I sleep badly, and while i try to put it out of my mind it is always there. I get very weak erections that i cant masterbate with. i have masterbated only when my erection is strong enough and it is very rare and occurrs usually when i am coming out of sleep and drowsy. I tried taking l arginine and hasnt worked. What do i do?
Posted Tue, 21 Jan 2014 in Erectile Dysfunction
 
 
Answered by Dr. Pavan Kumar Gupta 1 hour later
Brief answer....given below Detailed answer.... Hello, Thanks for the query. I understand your problem and going by your history i realise that psychological stress and depression seems to be the cause for your erectile dysfunction ( ED ) . In fact the biggest and major sex organ of the body is brain and once your brain is foggy and stressed,it can make a hell of your sex life and in such situations even medicine like VIAGRA also don't work. Although ED can be caused by physical causes like hypertension,diabetes,hypercholesteremia,obesity and other factors responsible are smoking,alcoholism,lack of exercises etc. Depression,anxiety and stress has a very adverse effect on the erectile functions of he person. A patient whose erectile failure has a clear psychological cause should undergo sex counseling before he pursues any invasive treatments. Sex therapy works best to treat erectile dysfunction if a man is generally healthy and has normal erections during sleep, normal blood tests, and a normal physical exam. Treatment is a short-term form of counseling, generally involving five to 20 sessions.  I advise you to either consult a psychiatrist or a urologist who can investigate you thoroughly and then devise a best treatment plan for you. Till you consult him... Start doing regular aerobic exercises Yoga Meditation Deep breathing exercises etc. I firmly and strongly believe that a proper counselling session along with regular exercises would surely make things perfectly all right for you in next 3 months. I hope it helps,however you may revert to me for any further query. Best of luck Thanks
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Follow-up: No improvement with viagra for erectile dysfunction, Is it necessary to go for penile implant? 59 minutes later
Hi I tried psychosexual councilling I think it made matters worse. what other option is there, could the antidepressant be making things worse?
 
 
Answered by Dr. Pavan Kumar Gupta 3 hours later
Hello, Anti depressants can themselves cause erectile dysfunction and may make matters more worse. For ED ,counselling is supposed to be the best method and it can not make the matter worse.There might be some other reason for it to have failed on earlier occasion. I would advise you to try it again and that too without any bias towards it. It would definitely help you since it helps everybody.The main criteria is that complete your all sessions with the therapist and not leave in between. Along with the therapy start doing regular aerobic exercises since exercises release endorphins which are very great stress busters and induce a sense of  well being. Along with exercises,do yoga,meditation and deep breathing exercises. You must remember that since your problem is psychological and not physical and hence you have to be patient as it is going to take time.Nothing is going to happen fast and suddenly. Thanks
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Follow-up: No improvement with viagra for erectile dysfunction, Is it necessary to go for penile implant? 1 hour later
How do i know it is not physical though?. Why wouldnt Viagra not work it if it has before. Additionally is this the only thing medicine can offer. I have been living with this for months Im near suicidal and im told to wait, I have done meditation and exercise and therapy they didnt help much. you say nothing will happen fast and suddenly does than mean it will take years. Should i then stop taking the antidepressant
 
 
Answered by Dr. Pavan Kumar Gupta 1 hour later
Hello, Although your history suggests that your ED is because of psychological reasons,physical causes must be ruled out by proper and detailed investigations. Viagra normally doesn't help much in people suffering from ED because of psychological reasons. Result of treatment does take time but not years,as you are feeling. I have already written in my earliest reply that a serious effort should make you all right in 3-4 months. Psychological causes have to be and are tackled by psychological approaches only. Thanks
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Follow-up: No improvement with viagra for erectile dysfunction, Is it necessary to go for penile implant? 26 hours later
Quite a while ago my blood was tested and testostorone checked which was ok. Though I have never had an ultrasound or doppler. I think it could be psychological as at times in my previous relationship I was having regular sex. I just though by now time would have helped somewhat
 
 
Answered by Dr. Pavan Kumar Gupta 11 hours later
Hello, For the satisfaction purpose,it would be a good idea to get a penile Doppler done. A normal Doppler result would exclude a physical cause. Psychological causes should be addressed with a professional approach and should never be ignored because of not only bad psychological effects but also physical effects. I would still consider going to a psychiatrist as the best choice and not to leave the problem as such. Thanks
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Follow-up: No improvement with viagra for erectile dysfunction, Is it necessary to go for penile implant? 1 hour later
Actually i took cialis last night as an experiment and it is working. So i guess it must be physcological so it suggests its in my mind. As i said i was in a volitile relationship which has probably left ill effects which i have to address
 
 
Answered by Dr. Pavan Kumar Gupta 1 hour later
Hello, This is what I have been saying.Your ED is due to psychological concerns and not out of any physical drawbacks. Thanks
Above answer was peer-reviewed by
 
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