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Dr. Andrew Rynne

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Suggest treatment for erectile dysfunction

Answered by
Dr.
Dr. Ashok Kumar

Psychiatrist

Practicing since :2000

Answered : 2683 Questions

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Posted on Wed, 25 Apr 2018 in Sexual Health
Question: Hi j got married one month before and notice something
Surprising.i was not able.to keep erection during intercourse.however erection was.ok but it ckme down suddenly so was not able.to perform perfectly.
Due to.this i feel embarased although i regain myself but again same thing happened again.
After this i notice one.thing i m not able to make myself proper arousal.also
Arousal also.is low from.that.time.i got fear of performance.also now i fear same thing may hapen again so i dont want to do foreplay.also because of fear.
Before one.month everything was ok i was getting good erection and was.having good female fantasies also.
Mastrubation was very good.i dnt know what.happpen in only one.month.
Our relation.is also very good.although wife supported m.a lot so that i shd not feel embarased.
Now i am.observing i did nt get arousal on seeing nude female also.
Please help me
doctor
Answered by Dr. Ashok Kumar 9 hours later
Brief Answer:
It could be performance anxiety

Detailed Answer:
Hello,
Thanks for using Healthcareamgic.

I read your query and understand your concerns.

First of all I like to assure you that there is nothing to worry as all forms of erectile dysfunctions are treatable on this day. Secondly the available description points out that you have the fear of performance otherwise called as performance anxiety. This is evident from the fact that before marriage you have good erections with proper maintenance (during masturbation) but after the marriage (when the performance was requirement) got this problem of suddenly losing erections.

Now regarding problem I like to inform you that performance anxiety can be handled with use of right psycho therapeutic approach. In my own experience around 70% of individuals report dramatic improvement in erections once the psychotherapy is started leading to decrease in performance anxiety.

Below here I am delineating few of the strategies which will help you in the problem.

Firstly get rid of thoughts that you may be sexually inadequate or your doubts that you may not be able to perform properly. This is because performance anxiety, feelings of sexual indequacy, self-doubts, guilt, past negative sexual experiences, poor communication / understanding with the partner, etc. can all affect sexual functioning and performance. Removing such ideas will eliminate the majority of causes for your poor sexual performance. Removing the person's doubts and fears, and improving his self-confidence levels will definitely help in improving sexual performance.

Remember that sex is not just a physical act but also a psychological process involving an expression of emotions, intimacy and love. So, just involve yourself in those feelings and stop focusing on your "performance" alone. Once you do that, then I assure you that your sexual performance will automatically improve.

Most importantly, performance anxiety soon becomes a "vicious cycle" That is, anxiety leads to poor performance and poor performance then leads to further anxiety and this keeps on increasing.

One more problem responsible for performance anxiety is inadequate sexual arousal. When the person is not properly aroused, the blood flow to the penis is not maximal, and so, after a few strokes, the erection weakens and ejaculation occurs. The way to tackle this is not to rush into intercourse quickly, but wait till you get fully aroused. So, increase and spice-up your foreplay. Make sure that you initiate penetration only after both of you are fully turned on. Good foreplay not only arouses you but also sparks off the mood in your partner. So, when she is also aroused and involved, then things keep flowing smoothly and effortlessly, and you don't have to be constantly anxious if you are satisfying your partner or not.

Distract yourself stop "monitoring" your sexual performance. Try putting on some romantic music or mild lighting while you make love. Think about the things that turn you on. Taking your mind off of your sexual performance can remove the worries that are stopping you from getting fully aroused.

Wish you all the best in your sexual health.

I hope this helps you further.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ashok Kumar 35 hours later
Sir
Thanks for your response.
Observation is also since then i m seeing something unusual also.earlier on seeing any of any model or anh attractive women used to .get aroused which s normal in every male.
Now even i try to focus on arousal i didng get that mjch of synergy. Also if somtime get aroused but erection is not proper.penis is not getting erect to that extent which is used to be during mastrubation.
Some one two year back i got pain in testicle i wnet to urologist he refred for ultrasound of scrotum
There was some mild varicoecele in right testicle at that time however he advised to wear tight jnderwear and gjven some medicine.after 4 mknths again done scrotum ultrasound that was normal then.
It was ok everything was ok erection was proper.i have done blood test in that cholestrol was high 260.is tgere anh affect of cholestrol on less libido and erection.
Testasterone was 540 mg bfr 4 months back.i have given blood sample for thyroid lipid testasrerone blood glucose day bfr yesterday report will come tommorow .
Shall share report.
Also bfr mknths i have done hb test at that time it was 15.4 one month bfr dkne again at that time it came 12.4 report for hb also be given tommorow.
Got operated in year 2011 for gall baladder also.
There is no other medical condition preaent.
doctor
Answered by Dr. Ashok Kumar 1 hour later
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

It is common for any male to observe decreased libido and poor erection when stressed. In other words stress is biggest killer of your sexual life and any amount of stress emanating from poor sexual relationship affecting your erections quantity and quality.

Regarding cholesterol it is well established fact that increased cholesterol associated with obesity decreases sexual libido in long run although this is reversible with correction of high cholesterol.

I hope this helps you further.
Thanks again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ashok Kumar 15 minutes later
Thanks a lot.
What is your suggestion.yea there was stress regarding finance issue regafding marraige expenditure to lot of exgent.
Now it is ok getting released day by day stress and try to be happy.
What are suggestion and precautions regarding eating id any.
Any special advice
doctor
Answered by Dr. Ashok Kumar 1 hour later
Brief Answer:
Follow up

Detailed Answer:
Hello
Welcome back to health care magic.

I am writing down few of the strategies that will help you in management of stress leading to reduction of your stress level.
1. Diet: Ensure intake of adequate quantity of fiber. 2 servings of vegetable salad and 2 servings of fruits( One preferable citrus fruit). Avoid junk food and fast food especially pizza, burgers and excessive sweets

2. Ensure adequate water intake: Recommended intake of water is 2 to 3 liter a day.

3. Early morning Exercise: Brisk walking for 30 minutes at a stretch preferably in garden will be very helpful. Make it a daily habit and incorporate in your lifestyle. Believe me it makes wonders. There is no need to go to gym or use any expensive workout instruments.

4. Avoid tea/coffee/ nicotine and alcoholic beverages: If at all you want to drink something, drink fresh lime water.

5. Start your day with a glass of Lemon water with 2 spoons of honey added. have a good breakfast.

6. Don't take work so seriously: We all have the feeling to excel in our respective fields and don't spend adequate time with our own self trying to understand our own needs.
Spend time with your family and friends.

7. While working take frequent regular breaks: Take break for 5 minutes every 30 minutes.
Close your eyes and rotate the eye balls for couple of minutes

8. Avoid late night socialization

9. Avoid starring for longer time at the computer screen or TV for longer time

10. Steam inhalation before going to sleep will be very refreshing.

11. Multivitamin and Calcium supplement.


I hope this helps you further.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ashok Kumar 19 hours later
Got reports today cholestrol is ok only 145 ldl but testasterone level.has gone down to 223 ng only it was 3 months before 545.
I suspect this might be the reason.
But why it has gone down.i dont understand.
doctor
Answered by Dr. Ashok Kumar 2 hours later
Brief Answer:
It could be lab error

Detailed Answer:
Hello,
Thanks for follow up.

First of all I like to inform you that lipid profile is still abnormal as evidenced by high cholesterol, high LDL cholesterol and low HDL (minimum 50 for male). Both are beyond normal range and there is need to make consistent efforts to make them normal by increased exercise and decreased use of fats in diet. In case this does not help option of medication can be explored.

Regarding the testosterone level I think there is need to get free testosterone (unbound) level as increased protein can be responsible for decreased level of testosterone. In addition the possibility of lab error can not be ruled out so I request you to get testosterone level from different but reputed laboratory in your city.

I hope this helps you further.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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