Brief Answer:
Anxiety and stress as a cause of ED

Detailed Answer:
Hi....
Welcome to "Ask a Doctor"service.
I am Dr Ajeet XXXXXXX

I have gone through your query and here is my opinion.

In my opinion,you have performance anxiety.

Your penis is hard during masturbation and prior to an intercourse , which indicates that there is no organic cause of inadequate erection.

Stress,over thinking and anxiety can interrupt the signals from brain to the penis.
These signals are responsible for allowing extra blood flow and engorgement of penis.
Failure of proper erection and inability to do sexual act properly,further augments stress and anxiety thus causing a vicious cycle of ongoing ED.
This may cause behavioral changes that contribute to anxiety and more incidences of ED.

Drugs are not recommended for you as they sometimes complicate the scenario and contribute to ED as their own side effects.

Most important for you is stress management.
Do divert your negative thoughts.
Do yoga and meditation.
Don't rush into sex.
Talk to your partner and win her confidence.This will ease you down.
Get psychological counselling from professionals.
They would help you by CBT (Coagnitive behavioural therapy).
Do belly breathing and have sun exposure to reduce your anxiety.
Get your thyroid profile checked to rule out a superadded hyperthyroidism.

For the time being,you can use Sildenafil 50 mg s.o.s (30 to 40 minutes before starting the sexual act).This would increase the blood inflow to get erection.This drug might cause side effects in the long run hence it would be better if you use it under medical supervision.

If your health problem persists,see a good sexologist for further evaluation and management.

Hope that I have answered your query.

Stay healthy and stay blessed.
Regards.

---

Brief Answer:
Anxiety and stress as a cause of ED

Detailed Answer:
Welcome back...

Use of Panax Ginseng is associated with many side effects like
palpitations, headache, insomnia, dizziness, and changes (rise or fall) in blood pressure.
As per some studies, it's long term use has been associated with liver damage.

Panax Ginseng is said to be useful for increasing sexual desire, arousal and performance but its role is still controversial and it is still not FDA approved.

Studies and clinical trials are still on to establish it's role in ED, clinical use and safety profile.

Take good care of yourself.
Happy living

---

Brief Answer:
Anxiety and stress as a cause of ED

Detailed Answer:
Hello....

Erectile dysfunction (ED) is a general term,used whenever there is an inability to attain or sustain an erection hard enough to do a sexual act.

ED is not very uncommon and every man faces it at some stage of his life.

Frequent and sustained ED can be a sign of health problems which needs evaluation and treatment.

Most common cause of ED is psychogenic which a men experience during the times of stress and extreme anxiety.
This can be managed with control of anxiety,stress management and counseling.

Other variety of ED is pathological in which the primary defect is in venous inflow of penis and pelvic organs(in response to brain stimulus).
It is seen secondary to hypertension,uncontrolled diabetes and heart failure.
This requires specific treatment of primary organic pathology.

Warm regards.

---