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Smoker and feeling stressed. How to cure erectile dysfunction?

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General & Family Physician
Practicing since : 2001
Answered : 8479 Questions
Hello Doctor.
I am 32 years old. My question relates to a sudden lack of erection. 2 weeks ago I noticed a lack of an erection, and I'm scared. Penis is cold, as if asleep, I can not even "inflate". Previously, everything was quite fine. Masturbation also does not work. The penis is half erect even in the climax just before ejaculation. I am 8 months of separation, we are going to get a divorce and that carries a lot of stressing, nervous situation. Currently, I have a new 10 years younger partner. She is sexy, pretty and very attractive. but unfortunately my penis seems to be dead. I smoke cigarettes, not abusing alcohol. There was a time when I masturbated a few times a day to relieve tension. Morning erections happen really rarely. And I still do not know what it is to me. My partner is disappointed my dysfunction. I'm afraid to start foreplay. Please help me.
Posted Sat, 5 Jan 2013 in Erectile Dysfunction
Answered by Dr. Michelle Gibson James 5 hours later
Hi, thanks for using healthcare magic

Erectile function depends on a combination of psychological, vascular, neurological and hormonal factors.Any abnormality in any of these areas whether from medication or from disease can result in problems.

Normally if the problem was purely psychological, there would still be morning erections.

ED (erectile dysfunction) can be associated with anything that affects the (1)blood vessels in the penis such a diabetes, high cholesterol, smoking,high blood pressure,heart disease
(2) nerve supply to the penis
(3) hormonal factors such as abnormal thyroid levels, low testosterone
(4)prostatic problems
(5) medications- some blood pressure medication, medications for stomach ulcers/gerd, medications for prostatic enlargement

Blood investigations can be done, if thought to be necessary by a doctor, to determine the exact cause. Some of the tests may be for thyroid hormone levelsv(if thought abnormal based on your medical history), other hormones such as testosterone.Checking for diabetes, high cholesterol and analysis of the urine should also be done.

In general the main medications that are used are viagra or cialis or levitra.They are all in the same family.
They cannot be used if you are on any medications in the nitrate family.

Generally persons would start on the lower dose and increase only if there is not a good response.
These medications vary according to when they should be taken and how long they last.

You may want to speak to your doctor for an assessment and to obtain a prescription.

Hope this helps, feel free to ask any other questions
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