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Causes for erectile dysfunction - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Erectile Dysfunction
Answered by

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
User :   Hello, I am twenty five and for some time have been experiencing considerable stress, anxiety, and tension over sexual matters. For quite some time i have been experiencing erectile dysfunction. It has gotten progressively worse and though I have been to a couple of urologists, I cannot get much headway. I think part of the problem is that I have something that is outside their field of expertise. Even before I was having problems in that department, I was aware from a very early age that the thing that turned me on and gave me almost instantaneous erections was imagery or descriptions of women in bondage. I first detected this very early but around 12 or 13 I was able to use the internet to procure the arousing imagery much easier. Around 14 i was aware of the notion that this stuff was not really conventional but continued to use it because a.) it was very pleasurable to masturbate to it and b.) i assumed that it would just naturally progress into regular sexual attraction. Unfortunately, I found that looking at shots of nude women and picturing myself in sexual scenarios with them just did not have the desired effect. It started to tear me up to the point that even the typically arousing stuff would not give me erections. Now i'm a shell of my former self in this department. Basically I want to know if i have resonable chance of success in broadening my sexual arousal patterns or whether what turned me on from the get go is the only thing that can possibly and ever will turn me on like that. I don't want to force relationships and waht not and always have in teh back of my mind that i'm not going to be able to perform. Please give me a sense of where I should go from here and what my prospects are. Obviously this is very vexing and I think about it at some point every day. Thanks so much for taking the time read this.
Doctor :   Hi
User :   Hello
Doctor :   Let me read your query.
User :   Thank you very much, doctor.
Doctor :   May I know if you have had an actual sexual intercourse in the past?
User :   nah never have. never attempted it or have been intimate. i sort of deliberately avoided such situations you could say.
User :   anything sexual for me was all masturbatory
Doctor :   Ok
Doctor :   Do you get early morning erections?
User :   no not really. when i wake up there's some its larger than when flaccid but its not rigid, not an erection.
Doctor :   Ok
Doctor :   May I know if your pubic hair and axillary hair growth is normal.
User :   yep its normal
Doctor :   Ok
Doctor :   Do you have any other medical illness such as diabetes/chronic infections in the past?
User :   nope. id say im overall pretty healthy and have not been diagnosed with any such illnesses
Doctor :   Have you got the testosterone/DHEA levels checked?
User :   i had a testosterone test and they were fairly vague in what they told me after they drew blood. i remember the nurse practitioner said something like i was on the lower end of the spectrum though within normal range.
User :   i couldnt tell you the number though...350 or 380 sounds right though i dont know what unit of measurement is used.
Doctor :   Ok
Doctor :   Let me brief you.
Doctor :   Based on prior research, the most common reason for impotency(erection dysfunctions or inability to sustain erection), in young, sexually inexperienced men are psychological.
Doctor :   This majorly happens due to fear and anxiety.
User :   right. that makes sense.
Doctor :   Hormonal factors are also the cause,
Doctor :   however, if they were to be due to low hormones, you would have other features
Doctor :   such as axillary hair, pubic hair growth problems,
Doctor :   reduction in the musculature and physique.
Doctor :   So, if you are quite healthy, then its unusual that the cause would be hormonal.
User :   right. and i havent seen any such things. in fact ive been working out lately and my musculature is pretty good.
Doctor :   The possibilities of neurological/vascular causes at this young age is also not expected.
User :   the neurological is what worries me. because i have experienced a decrease in sensitivity over time.
User :   and its not like i experienced any kind of damage of trauma to my penis. i masturabted a lot but never felt like I abusing things.
Doctor :   Neurological causes, if at all are, the symptoms would be constant and not varying.
User :   right
Doctor :   They are expected to occur following surgery or following a trauma to the back.
Doctor :   Hence with no such history, its not suggestive of neurological issue.
User :   right
Doctor :   Moreover, masturbation DOESN'T cause erectile dysfunction.
Doctor :   It has no role in the any sexual problems.
User :   right
Doctor :   Hence your thoughts that masturbation may have been the cause isn't entirely right.
Doctor :   Hence my suggestion are
Doctor :   1. Include adequate de-stressing measures.
Doctor :   Regular diet, proper sleep are the most common de stressing measures.
User :   ok that makes sense
Doctor :   2. Improve your nutrition - include plenty of vegetables and fruits with multivitamin in your diet
Doctor :   (vitamins help strengthening nerves system)
Doctor :   3. Recheck your testosterone levels and if they appear to be low, then you will need proper endocrinological evaluation.
Doctor :   4. Symptoms usually settle down, once you become active sexually, hence stop concerning.
User :   is there a means by which to boost testosterone without having to go through something drastic like HRT
Doctor :   This will aid in improving your symptoms.
Doctor :   Very low testosterone levels can be corrected with hormone supplements alone.
Doctor :   I would like to point that levels of the hormones can vary, and as long as they are under normal range, its absolutely normal.
Doctor :   the ranges vary depending on the time of the day and depending on the sexual desires.
User :   i see. i will get re-tested and see from there. this makes sense.
Doctor :   Hence you need not worry.
Doctor :   If you are planning to get a repeat test,
Doctor :   its best that you perform the test at 8 Am in the morning.
Doctor :   Consult an endocrinologist , if the values are really low.
Doctor :   Have you followed what I have suggested?
User :   yes i have doctor and i appreciate the advice very much and will definitely implement it, but can i ask one more question... given what i consistently was able to utilize to arouse myself and how it was more narrow than i would have liked it to be do you think it would be advisable to do some kind of sex therapy. do you think those type of counselors/psychologists might be able to contribute something that would have practical value to come.
Doctor :   Sex therapy sessions in the form of counselling, definitely will help.
Doctor :   Infact that will be the best way to approach the problem
Doctor :   if your hormone levels are normal.
Doctor :   You can consult the sex therapist and in the mean time, you can get the hormone levels checked too.
Doctor :   Have you followed what I have suggested?
Doctor :   Do you have any other query?
User :   yes i have.
User :   no more questions.
User :   thank you, doctor.
Doctor :   Thanks for consulting me. Bye for now.
Doctor :   Have a great day!!
User :   You too. Thank you!
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