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Suffering from erectile dysfunction. Could it be related to psychological problem?

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Dr. Ashish Mittal

Psychiatrist

Practicing since :2004

Answered : 1856 Questions

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Posted on Mon, 7 Jan 2013 in Erectile Dysfunction
Question: Hiii,, I am currently facing the issue of erectile dysfunction. I got married five days before and in first two days I was able to get the erection but it was not sustainable for the long enough time to achieve the successful intercourse. Since last three days I am not able to achieve the erection, even the "morning erection" and depressed too much... As of now this seems to be a psychological problem. please help me in coming out of this else this will spoil my married life.
doctor
Answered by Dr. Ashish Mittal 17 minutes 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 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. I hope you are not taking any alcohol or smoking as sometimes these can also cause 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. As you will worry, your problem will increase further. You can also plan to some short vacation for honeymoon, which will relieve your stress.
-Exercise, particularly aerobic exercise (like: Jogging, skipping and cycling) is very effective.
-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. As you are reporting low mood, then you may require treatment for depression also.

If you live near to Gurgaon, you can visit me personally also after taking my address from WWW.WWWW.WW website.

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,
Dr Ashish XXXXXXX Mittal


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ashish Mittal 6 days later
Dear Sir,

Thanks a lot for the information provided. In continuation of my last query i am providing you the following information

1. I dont take alcohal or smoke.
2. as of now i dont have any recent medical history but till last month i was passing through severe stress conditions from two years due to my family circumstances and official work pressure. In my college days(2000 -2002) i also faced the same situation and even took some antidepressants under medical supervision.
3. My Blood pressure is normal but yes in last year it was quite high due to excess stress and family conditions. It has now become normal and i never took any medicine for the same. only follwing the daily excercise has cured this

the same day i wrote to you, I have taken Himalaya Tentex royal on the recommendation of a chemist friend and it worked partially on the same day and i was able to sustain hard erection for few moments and even was successful to penetrate but it seems not to be working after that. I am taking the same medicine from last 5 days but there are no fruitful results except day one. Although my wife is too much cooperative and have a lot of patience but i m filled with guilt and under severe pressure for not being able to make it. Request you to please help me in getting out of it and prescribe some general stimulant which can help me in overcoming this problem
doctor
Answered by Dr. Ashish Mittal 20 minutes later
Hello again,
Thanks for follow up.

From further information it is clear that you had some history of anxiety and depression for which you took treatment. You also reported low mood in primary reply.

In current situation main problem appear to performance anxiety in your case. Using some medicine like tentex give some psychological confidence (like I have received treatment), but it is not working in long run.

So, follow steps mentioned in primary reply like:
-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. As you will worry, your problem will increase further.
-You can also plan to some short vacation for honeymoon, which will relieve your stress and performance anxiety.
-Exercise, particularly aerobic exercise (like: Jogging, skipping and cycling) is very effective.
-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.
-Keep patience as response may take 1-2 month if you will follow all above advice regularly.

Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.

Wish you good health.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ashish Mittal 17 minutes later
Thanks a lot sir for the information. This is very informative...but i am still seeking your advice on taking tentex royal or not. Also, Please advice for any better stimulant if possible. I do understand that doctors don't prescribe medicines before examination but i think ayurvedic/herbal stimulants can be recommended as these dont have any adverse side affects. Please correct my understanding on the same.
doctor
Answered by Dr. Ashish Mittal 27 minutes later
Hello again,
Thanks for follow up.

I do not believe that ayurvedic medicines free from side effects as they are not researched properly and there are recent reports of side effects from some of the ayurvedic medicines.

As I am specialized allopathic doctor, I do not have experience prescribing ayurvedic treatment.

Wish you good health.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ashish Mittal 7 minutes later
ok.. thx doctor... so it means i should only go with the advice given by you (change in the lifestyle) or should i consult a doctor in person for this. Please let me know your schedule in case i need to consult you in person for any prescription or examination.
doctor
Answered by Dr. Ashish Mittal 17 minutes later
Hello again,

First follow lifestyle measures, if do not improve, you can visit doctor.

My details are available on following link:
WWW.WWWW.WW
Wish you good health.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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