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Have erectile dysfunction, unable to get aroused. What is going on?

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Practicing since : 2004
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I am a 29 year old man living in Gurgaon. I was dating a girl for 2 years from early 2010 to early 2012. Everything was fine sexually for first 15 months or so but then I started losing sexual arousal with my partner. I must admit that while in relationship, i had few other encounters, none of them reaching intercourse level but even then I could not get a full erection or full arousal. However I would feel very aroused if I wouldn't masturbate for 2-3 days and then I could not wait but masturbate, often with part erection. This made me believe that I had a problem and I visited a doctor in Delhi. He did some tests and told me that I was physically OK. He gave me a medicine called megalis which I had many a times and it would get me an erection but I never felt the pleasure.
After I broke up with my girlfriend, I met another girl with whom as well I couldn't get full arousal initially but in couple of weeks I was back to normalcy. I could get erection anytime, anywhere without a problem. I took no kind of medicine whatsoever. However I didn't love this girl.
Now my ex-girlfriend for 2 years and I are trying to get back but I don't get aroused at all. She tries fore play and massaging me all over but I don't get turned on a bit. It is embarrassing because I love this girl and would want to be with her but I just can't get turned on.
i don't understand what's going on. Initially I thought that I had some problem and saw a doctor but he is said I was ok even though I couldn't get fully aroused with any woman. Then I met this new girl and after a while I was perfectly normal in my sex life. Now I can't get it on when I am trying to get back with my old girlfriend.
Personally I have a fetish for breasts and my girlfriend has very small breasts but I am not sure if that is a reason or so because earlier we had good sex. With other women with big breasts I had problem. I have been with another woman briefly with small breasts but she aroused me. I am really confused what's going on.

I want to marry this girl but I don't think that without sex life I should take such a decision.
Posted Wed, 22 Aug 2012 in Mental Health
Answered by Dr. Ashish Mittal 11 hours later
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Erectile dysfunction can be a result of a psychological or physical problem.

Psychological causes: Most common cause in young patients. These include performance anxiety, emotional weakness, inferiority complex, stress, marital or relationship problems, low mood, feelings of guilt, and the effects of a past sexual and emotional trauma. Men with psychological problem usually have normal nocturnal erections and erections upon awakening, whereas men with physical problem often do not.

Physical causes: Include neurological disorders, alcoholism, drug abuse, hormonal imbalances, diabetes, hypertension, blood vessel disease and chronic diseases.

What I can understand from your query is that you are not able to sustain hard erection which is required for intercourse. You are 29 years of age and at this age, any difficulty in getting or maintain an erection is due to psychological reasons in most of the cases. Liking for big breast may be reason for your problem to minor extent. I hope you are not taking any alcohol or smoking as sometimes these can also cause erectile dysfunction.

The commonly prescribed drug by the doctors is sildenafil (Viagra) or Tadalafil (Megalis), which causes erections to be stronger and long lasting. It is important to rule out medical conditions specially related to cardiovascular system before starting such treatment. Both of these medicines have excellent result in physical causes of erectile dysfunction.

I will describe some simple measures which you can incorporate and these should help you:
-First of all, quit smoking and alcohol (if you are taking any)
-indulge in physical exercise and eat a healthy diet
-Have faith in yourself and do not take any stress. You can talk to your partner openly and indulge in plenty of foreplay before sex.
-Exercise, particularly aerobic exercise is very effective.

We need to rule out certain medical conditions. These include diabetes, high blood pressure, high serum prolactin, heart or thyroid conditions, poor circulation, penile venous incompetency and neurological causes. For that comprehensive evaluation and tests, help of other specialist may also needed.

As you are in Gurgaon, you can visit me personally also after taking my address from XXXXXXX in Columbia Asia Hospital.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
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