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Suggest Treatment For Psychological Erectile Dysfunction

Posted on Tue, 29 Apr 2014

Question: Had a brief bout with depression over the last 4 months and have been unable to sexually perform. Depression is gone, anxiety very low level, but still unable to achieve or maintain an erection firm enough for intercourse. Is there anything I can do to help jump start my libido and help get a firmer erection? I have seen a therapist and a urologist. Seen slight improvements in intimacy in general but getting desperate to be able to perform for my girlfriend.

Answered by Dr. Srikanth Reddy (2 hours later)

Brief Answer: Clarifications Detailed Answer: Hello, Thanks for using health care magic for posting your query. I have gone through your question in detail and I can understand what you are going through. However I would require a couple of more details to help you in answering your query in a better justified way. 1. Did you take any medicine for depression? If yes which medicine? 2. What did the urologist and therapist recommend you? 3. Are your depression completely gone? 4. At present are you on any medicine? Hope to hear from you at your earliest convenience. Regards and wish you good health, Dr. Srikanth Reddy MD Neuro-Psychiatrist and Sexologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Srikanth Reddy (5 minutes later)

1) I was in therapy for anxiety for a few months before it changed to depression. I was on trazodone 100mg for a 16 days, then was told to discontinue because it made me feel worse in terms of focus, energy and completely killed whatever urge for sex I had. I was switched to lorazepam 1 mg twice daily and I have been taking it for 4 days. I am also on herbal testoterone booster (Testo-Gain) and a few vitamin supplements. 2) The urologist and therapist have told me to continue what i am doing (no drugs, alcohol, active lifestyle) Urologist found no structural issues. 3) Yes, I am back to enjoying all aspects of my life with no negative thoughts. 4) I am currently on the supplements and lorazepam 1 mg twice daily.

Answered by Dr. Srikanth Reddy (29 hours later)

Brief Answer: Could be due to supplements or lorazepam Detailed Answer: Hello Thanks for the follow-up information and follow-up question. Your urologist is right in stating that your sexual problem is not due to any structural problem. It could be due to the medicine side-effects or due to the psychological issues. Lorazepam can also lead to sexual problems and can be discontinued gradually if your anxiety symptoms have come down. Further the Trazodone which you had used previously can also lead to sexual problems and it may take some time for things to settle down. Many times after a prolonged period of impotence, it becomes difficult to kick start the normal sexual activities. Sensate focus therapy is a very good option. In this therapy sessions for the first 2 weeks, partners take turn to stimulate each other without touching the genitals. Some may use perfumes or creams or oils as well. In the next two weeks genitals can be used for stimulation but the actual sex is still prohibited. This 4 weeks session is done without the pressure for performance on the man and instills lot of confidence in him. then after 4 weeks, regular sex is started and the problem of erection is solved. It can be instructed properly by a sex therapist or a psychologist. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: bit.ly/dr-srikanth-reddy Wish you good health, Kind regards Dr. Srikanth Reddy M.D.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar