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Dr. Andrew Rynne

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Suffering from celiac and erectile dysfunction. What should be done to get cured?

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Dr. Ashish Mittal

Psychiatrist

Practicing since :2004

Answered : 1856 Questions

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Posted on Wed, 16 Jan 2013 in Erectile Dysfunction
Question: Hi, I am XXXXXXX and married for last 8 years having 2 kids. My Problem is that my Penis do not get tight enough to go into vagina and at many a time I got unsuccessful in doing intercourse. Due to this I have never tried different position for sexual intercourse. The problem exist since long. I am frustrated due to this and always feel bad about this. Last year I came to know that I am suffering from Celiac and therby I have started gluten free food but still do not get any improvement with regard to tightness of Penis. Pls advise what should I do any pill without side effects or something else. My weight has got increased from 50-52 KG to 60-62 KG in last 1 year after using Gluten free food and my height is 5 Ft 5 Inches. I do musterbate regularly as my profession do require outstation trips. Moreover this musterbation is result of unsuccessful sex also. Erection is ok but Penis tightness is not upto the XXXXXXX I have never done sex without using my hands on penis for inserting into vagina and getting it completed. I have never used Condom and always erect outside.Pl help me out as I am very fond of doing sex but unsuccessful completion leads to frustration...I would be very thankful to you.
doctor
Answered by Dr. Ashish Mittal 2 hours later
Hello,
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 33 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. I hope you are not taking any alcohol or smoking as sometimes these can also cause erectile dysfunction.
Your main problem is not of erection only, but it is for sustaining erection.

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)
-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. As you will worry, your problem will increase further. You can also plan to some short vacation for honeymoon every year, which will relieve your stress.
-Exercise daily, particularly aerobic exercise (like: Jogging, skipping and cycling).
-The commonly prescribed drug by the doctors is sildenafil (Viagra) or Tadalafil (Megalis), which causes erections to be stronger and long lasting, but should be taken after prescription. 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.

We need to rule out certain medical conditions. These include diabetes, high blood pressure, 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.

Apart from that in person evaluation and examination by psychiatrist may be necessary in your case to identify and treat psychological cause of ED.

Although your problem is chronic, but follow above all steps and get investigated as advised, it will help you greatly.

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.
Regards,



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ashish Mittal 21 hours later
Dear Dr. XXXXXXX

You have explained my problem as erectile dysfunction which may be due to phychological or physical problem.

As far as reasons under psychological causes and physical causes are mentioned, I think it is due to physical cause.

I am not suffering from any disease viz. Diabetes, hypertension, blood vessel disease and chronic diseases and also not taking any alcohal or drug.

I am not aware of neurological disorder or harmonal imbalances. Pls confirm if there are any specific test available for verifying this.

You have mentioned that my problem is of sustaining erection but that is not the case as many a times my penis do not erect and thereby unsuccessful in sex and if it somehow goes into vagina then also it doesnt erect good enough on most of the occassions.

The measures you have mentioned may not be feasible for me as I am non-alcohalic & non-smoker, have healthy gluten free diet, do exercise.

Pls prescibe some Pill and for how long do I have to take this.

I am a vegetarian, so pls prescibe any specific food, oil etc to be used. Also confirm whether so many herbal pills like Musli Power extra etc coming in market are of any use.

Regards
XXXXXXX
doctor
Answered by Dr. Ashish Mittal 2 hours later
Hello again,
Thanks for follow up.

To rule out physical illness like diabetes, high blood pressure, heart or thyroid conditions, poor circulation, penile venous incompetency and neurological causes following tests are needed:
-Fasting blood sugar
-Complete blood count
-Lipid profile
-Hormone test: serum total testosterone, T3/T4/TSH (for thyroid) and prolactine level
-2D ECHO of heart
-Penile doppler study: to evaluate blood flow in penis.

The commonly prescribed drug by the doctors is sildenafil (Viagra) or Tadalafil (Megalis), which causes erections to be stronger and long lasting, but should be taken after prescription. 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. But you will need prescription for it.

Your final treatment will more depend on tests findings, so get tested.

Wish you good health.
Regards.

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