Question: Hi doctor,

Tis past March I noticed while I was driving to work that my flaccid penis felt weak and kinda "dead". I don't quite know how to describe the feeling but basically I panicked and when I googled causes the first page was just a list of erectile dysfucntion. So I tried to masturbate and couldn't get an erection. I went to a urologist the next day and all he did was physically examine my genitals and told me its anxiety. He did prescribe viagra though. Which I took that day and had an erection.

After that day, I still wasn't convinced that I was treated or examined properly by the urologist and I thought for sure I had a physical problem. I've had inconsistent erections. Sometimes hard, sometimes not. Even while masturbating. Plus, I don't wake up to morning wood every morning anymore. I keep seeing doctors and they keep wanting to say its anxiety but none of them really did any type of confirmatory testing.

They only ask about my medical history and say that since I don't have any illness linked to ED that it isn't possible for someone my age to have organic ED. I got my testosterone test taken and it came back normal including all the other blood test results.

It just feels weird that I wake up often with no morning wood or a weak morning wood. The lack of quality morning erections is my main concern that it means something in my penis is not working well in terms of blood circulation.

Is it possible that I have a vascular issue where decreased amounts of blood is being sent to my penis? Is it also possible that I damaged one of my penile arteries or veins (venous leak)?

Just some relevant background, i was diagnosed with phimosis a week before I had erection issues (my whole life I never knew about foreskin retraction so I thought it was normal up until that point). My doctor gave me a cream to use to retract my foreskin and it worked. On the first night I used the cream I was able to retract the foreskin all the way in a flaccid state but would only pull it just behind the glans when i was erect. That night I masturbated and when I felt like ejaculating I pulled my tight foreskin back behind my glans and it felt super tight rapping around the shaft when I ejaculated my semen basically dripped down instead of shooting. If anything, I am thinking maybe since my foreskin was so tight around my shaft that it may have damaged the artery or a vein. Is any of this making sense? Nothing else is making sense as to why a healthy 27 year old has such a drastic change in erections. I understand the older we get the more our bodily functions decrease in function but I am only in my 20's.....I'm not in my 70's or even 60's. Just wanted to write to you to see if any vascular or cardiological problem may be to blame for my erections these past 8 months.

i'm happy to answer more questions to help you try and find the most likely cause.

not taking any medications

I do not have any chronic illnesses. I have minor psoriasis/eczema on my hands. I have phimosis which i use a steorid cream to correct.

I do not take anything orally.

Is the part about having a tight foreskin while ejaculating causing damage to veins or arteries inaccurate? I admit when i did look at my symptoms on google and all of it led to ED I believed and still beleive that I have some form of physical ED. Is it not possible at all that I have vascular insuffiency in my penis only? I just imagine that men who get kicked in the penis or have a more severe case of penile trauma don't damage their penile veins so I am somewhat reassured that i don't have venous leak due to a tight foreskin around the shaft but again, I do have a history of health anxiety. It's just that this specific phase has been ongoing for 8 months whereas before I would panic that i have a disease i would get a blood test or a catscan and find out nothing was wrong. The reason why this is taking so long for me to realize my penis is healthy is becase none of the doctors are ordering a doppler test to confirm that blodd flow is normal.

yes, all of my doctors seem to agree that this is due to anxiety.

although i have had anxiety for most of my adult life and never had problems with erections. is it likely that since i was so sad and depressed after i found out about my phimosis that i started paying real close attention to my penis and therefore it led me to think that i have ED as well due to a misunderstood penile sensation?

as a cardiologist, id there a liklihood of vascular issues without any other cause? that my eerections are being decreased with no genetic or organic cause?

i know that technically there is a possibility. but is it likely? since i went to the urologist within 24 hours that i had this problem is it most likely due to anxiety?

no doctor has ordered me a doppler yet.

is the lack of morning wood concerning? since i do not get morning wood daily anymore i only get it once or twice a week is that a serious erection problem? it may just be due to me overthinking things. i tend to do that a lot. in 2012 i knew for sure i had apendicties but i ended up not having it, in 2014 i tough i for ure had genital herpes but i ended up not having it, in 2015 i thought i was hiv positive but then i got tested and i wasnt, now since erections are directly linked to my psyche it seems that i am not gonna have proper erections until i 100% reassure myself that i am fine.

is the fact that after i ejaculate it takes like 5-10 minutes for my erectio to go down proof that i dotn have a venous leak?