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Suffering from performance anxiety erectile dysfunction and depression. How to overcome this?

Dec 2014
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Practicing since : 2007
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I am 29 years old male suffering from performance anixiety erectile dysfunction.i have the following queries:-
1) Since i have been in depression , i am using stablon thrice a day.but can you please suggest any antidepressant that can improve erection as well? Is stablon ok? I have heard that Trazodon and Bupropion are also good. Basically i wasnt an antidepressant that should not cause any sexual side effect and should target both Depression and Erectile Dysfunction?
2) In order to combat with ED,i am using cialis 20 mg and Argipreg(L Arginine + Proanthocyanadin).Can you please suggest me something additional ,that i can combine to improve my Erections? Any medicine? Ayurvedic or any other.I have heard that there are also some centrally acting drugs that improve ED. Any help?
3) Third issue is regarding my penise's foreskin. I am able to pull it back,when its not erect(that too without any pain).But i cant pull my foreskin back and neither it pulls off automatically when my penise becomes erect. Please suggest? and is there any medicine for sensitive gentials?
Posted Thu, 9 May 2013 in Mental Health
Answered by Dr. Seikhoo Bishnoi 41 minutes later
Welcome to Health Care Magic

Performance anxiety is a common problem in youngsters. You are a 29 years old male and you have been in depression also. You are suffering from performance anxiety and erectile dysfunction. Penile doppler and testosterone came normal.
Now coming to your questions-

- Stablon consists of Tianeptin and it is an antidepressant drug. In recent studies it has been observed that this drug is devoid of sexual side effects unlike most of other antidepressants, instead it improves sexual function. Its recommended doses are 12.5mg three times a day because of its short half life. Trazodon is an antidepressant that causes increase in erection so it is commonly used by psychiatrists for erectile dysfunction. It has good hypnotic and anti anxiety action also. Bupropion is mainly used as add on drug to conventional antidepressant drugs. It is very useful in SSRI induced sexual dysfunction. So as per my opinion Stablon is right drug you are taking, just consult your psychiatrist regarding its proper dosing. Second option is trazodon which you can take in consultation of your psychiatrist.

- Cialis (Vardenafil) and Argipreg are sufficient for your problem. These will help in subjective sense of improvement in erection. Other medicine you can try is Tantex Royal 2 tablets about 2 hours before erection. It is an ayurvedic preparation and is commonly prescribed for erectile dysfunction.

Apart from the medicines take Fenugreek seeds or leaves (methi) in meals. In various studies they are found to be useful in increasing libido and erection.

- Regarding the skin of penis, what you have mentioned appears to be milder form of phimosis. Phimosis is common in some adults. Penis foreskin can't be retracted over glans in them. It is of no significance but if it causes pain during intercourse then it should not be ignored. Circumcision is treatment of choice for phimosis. Circumcision is a minor operation, done under local anesthesia by any good Surgeon and it takes only 10-15 minutes and about a week of abstinence from sexual activity. Apart from that it is also beneficial for keeping good hygiene of penis. If the problem is bothersome to you then you can go for it.

Thanks, If you have more questions you can ask again.

Dr. Seikhoo Bishnoi, MD
Above answer was peer-reviewed by
Follow-up: Suffering from performance anxiety erectile dysfunction and depression. How to overcome this? 24 hours later
hi doctor

Thanks for the response.i have following questions. Actually since is my marriagable age so i am under stress due to my psychogenic ED. I know stress and worry is gonna make the things even worse. but i am trying to manage.

I know,i have to rely on these drugs for a while,so that i can atleast save my marriage and can avoid loneliness.Everything was fine for me 2 years back and i never used medicines.I really feel that i have lost self confidence.

so i am open for every medicine now.Hope you understand. I know cialis and arginine alone is enough but just to get the best results i wanna combine it with any good medicine. Hope you understand my situation.

1) I use to feel anxiety and tension regarding the marriage . can you please prescibe me any ayurvedic product for anxiety? in addition to stablon.
2) Second can i use tenxtex forte as well in addition to tentex royal? i heard that t should be taken one hour prior to intercourse? Kindly validate.
3) how many hours before sexual activity ,can i take Yohimbe(100 mg)? one hour or two hours before?
4) Can i use confido(Himalaya drug company product)? I have heard it helps in ED.
5) I have heard that vagomax forte from Charak Ayurveda is also one the best remedy for psychgenic ED. Can i use it?
6) How is Zandu vigorex sf?since its also an ayurvedic product.
7) As prescribed,I have also bought KY jelly ,since it helps to penetrate penise easily into vagina even though penise is not fully erect due to its lubricating effect.Is it good to use?

Kindly answer and i will close this discussion.

Answered by Dr. Seikhoo Bishnoi 37 minutes later
Hello again

- Tentex royal is an ayurvedic product as I have mentioned already and has proven results in ED. Two tablets should be taken about 2 hours before intercourse.

-Tentex forte is a drug which increases libido and I don't think that theres is need of this drug in your case. You should take tentex royal only.

- You can take Yohimbin along with Tentex. It is available in a lot of supplement medicines.

- You can take Confido also, as it will help in improving confidence and will relieve anxiety. But keep few hours gap between medicines otherwise due to increased stimulation sleep problems may arise. Try to take it just before sleeping.

- See there are a lot of products that are available for sexual dysfunction with varying claims by manufacturers. Vigomax, Zandu vigorex, Musli Power, Manforce etc. But most of these products are not supported by studies and just due to huge marketing they are in use. As per my opinion Tentex and Confido are sufficient for your problem.

- KY jelly is safe lubricant you can use it with consent of your partner. But it doesn't help in boosting erection. Normal human penis in erected and excited state emits lubricating fluid which is sufficient for intercourse. Still in cases of difficult penetration you can use it.

- Try fenugreek seeds as I mentioned earlier.

And last but not least, don't carry away yourself with different products. Try to spend your time in relaxing yourself, as ultimately it is the relaxed mind which help in boosting confidence.

Thanks, wish you a good health.
If you have more questions you can ask again, if satisfied with conversation please rate.

Dr. Seikhoo Bishnoi, MD
Above answer was peer-reviewed by
Follow-up: Suffering from performance anxiety erectile dysfunction and depression. How to overcome this? 19 minutes later

thanks for all your help. I have just two questions:-
1) I use to feel anxiety and tension regarding the marriage . can you please prescibe me any ayurvedic product for anxiety? in addition to stablon.

2) From where i can buy fenugreek seeds? is it availaible in form of tablet as well?

3) My last question is regarding ky jelly. As per my discussion with a urologist. he advised that KY jelly doesnt promotes erection since it doesnt has PDE5 inhibitor properties. But he told me that ,if male is finding difficulty in penetration because the penise is not fully erect. Then use of lubricant like KY jelly allows the penise to glide easily into vagina,even though the penise is 60-70% erect. and once the penise is inside ,the erection naturally becomes stronger. Kindly validate and i will close this discussion.

Answered by Dr. Seikhoo Bishnoi 33 minutes later

- For anxiety and tension regarding marriage you can try omega 3 fatty acid XXXXXXX substances like Flax seeds (alsi seeds), walnuts, fish oils, soybeans etc. Omega 3 fatty acids have proven role in depression and anxiety.

- St johns wort is a herbal medicine for depression and anxiety. It is available in brand names of J-WORT (Lupin pharma). You can take one tablet daily. It is a plant extract.

- Fenugreek seed are nothing but METHI seeds that can be purchased from any grocery shop. Instead of seeds you can add leaves of fenugreek in you diet at least 3 times a week.

- Yes as I have already mentioned KY jelly is a good lubricant. It will definitely help in easy penetration. You can use it without tension.

Above answer was peer-reviewed by
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