Brief Answer:
I believe you will FINE- Patience at this time

Detailed Answer:
Good morning. My name is Dr. Dariush Saghafi. I am a neurologist and would like to give share some information and thoughts about your concerns with the recent erectile problems you have been having.

If I understand correctly you are recently married for the past 6 months and sexual intimacy with your wife has been quite satisfactory until for the past few days when you seem to be having difficulty getting and/or maintaining an erection. You are feeling embarrassed and self conscious of this situation. You've taken a medication which is not necessarily by prescription by the name of Gentaplex. You've not referred to me any other physical ailments such as high blood pressure, diabetes, prior stroke, urinary tract infection, or sexually transmitted diseases in the past. You've not said anything about your status as a smoker, a user of alcohol, or of other drug substances which are from the street or otherwise considered illicit. I will assume that you are negative for all these issues. I am also going to assume that you are monogamous with your wife, satisfied with your marriage to her, and that you are not having or wish to be having sexual intimacy with any type of partner. I am also assuming you are truly heterosexual in your sexual preferences. You also have not stated whether or not your wife may be pregnant or if you are practicing safe sex in any way so as to avoid a pregnancy. I will assume that she is not pregnant and that this is by your mutual choice at this time.

If any of the above information needs correction or clarification then, feel free to do so.

As a physician I am inclined to ask all of the usual and standard questions of your physical status, perhaps even recommend that you get tested for some type of chemical or hormonal imbalance to make sure you have enough testosterone levels and suggest that somehow there may be a quick and definitive fix with a pill or injection. But I cannot because that seems highly unlikely in your case. You appear to have no physical ailments and this issue has come about rather suddenly after having had normal interactions over the past 6 months. Therefore, I am saying that from a physical aspect my belief is that you are a normally functioning man and there is no reason to believe that your problems are due to physiological or "equipment" failure as it could be stated in other terms. And so we should not waste time or money trying to look for such causes because I don't believe they exist unless you change the information that you've given to me.

So then, what can this mean. I will give you my thoughts as a man with 4 children and having been married for 23 years to the first and only woman. The fact is I, like you, married in my 30's. It is a fact for all men that our reproductive organs and drive is not always in full gear. This is nothing for a man to be ashamed of and is not reflective upon his feelings or desires for his wife. Nor do I suspect your wife would understand this situation in that way. In fact, it is known through many surveys of women and studies on this subject that they feel must less drive and energy on many more occasions compared to men yet they learn how to be accommodating to their spouses and in many instances make the man believe that they are sensing the same spontaneity and intensity of feelings that he is when in fact they may not...this is a fact of nature and can be shown to be something that exists even outside the human species.

It is always an assumption then, by women (and men), and society in general that MEN are always 100% ON and ready to be lit at the drop of a hat and that almost nothing short of a nuclear explosion outside their bedroom windows could stop them when they are in the act of becoming excited or involved with their wives. BUT THIS IS NOT TRUE and there are many times and many reasons why even the most virile and able bodied men cannot get erections upon command or even erections occur, sometimes ejaculation cannot occur.

In the case of men it is said that the phase of excitement which results in the erection is nearly 50% or more "in the mind" or psychologically driven in its course (assuming of course that the physical apparatus is operational--- and I already said that I believe yours is). The other 50% of the act is then, virtually by physical reflex once a certain point is reached and a climax occurs. However, if anything blocks or impedes the psychological aspect of the arousal phase, no matter how slight or trivial it may be then, things may not progress easily.

There are many reasons and situations where such a thing can happen. Psychological and mental stress (work, school, family related) is likely the most common and obvious of those possibilities followed by physical ailments (i.e. not feeling well with a fever, sore throat, earaches, etc.), and then, by issues of the wife or partner in which the man knows that she is not necessarily as interested in having relations on that occasion. In a way, I can liken this last element of risk factors to a performer who is on a stage trying to tell jokes or perform a musical show but the audience is simply not listening or acting very disinterested. How do you think the performer will feel? How do you think the performer will actually perform compared to when the audience is captivated, excited, and even actively participating to encourage the performer to show what he may have to offer in his show.

So, the sexual act becomes really a 2 way street although again, most women will tell us in surveys and studies that with or without their willing participation men can and do have fully functional and ready systems that stop at nothing. However, on certain occasions this simply is not true.

Another thing to consider from a physical point of view is that a man's ability to produce sperm and replace it after an ejaculation may make it more difficult for him to have erections and ejaculations on a daily basis for more than 2-3 times before the reserve stores become less and less making it more and more difficult to achieve erections or ejaculations. In other words, sometimes in a situation where there have been consecutive days of sexual activities a man very well may need TIME TO RECHARGE THE BATTERIES. This becomes more apparent with age and though 34 is certainly nowhere near being consdiered old or elderly in that regard it is also a fact of nature that men are at their sexual peaks from a physical perspective in about their early to mid twenties. From that point forward some things may start to wane little by little......not nearly as much or as quickly on average as women when we talk about menopause and those sorts of things but enough so that during one's 30's and 40's a man may notice little hiccups such as what you're experiencing which seem very odd and completely unexpected but it happens....and is destined to happen as time goes on.

Although I'd like to think that as a man I've been at the ready ALL THE TIME....I can tell you that hasn't been the case and both interest levels as well as stamina to perform wanes with time. I'm telling you these now for your education in the future not to imply to you should expect all these changes to be happening to you any time in the near future....certainly not.

However, these past 3 days for example. You should think about what has gone on in your work, your school, among your family, with your wife, or her situation if she works, or situations with her family which may be interfering with HER ABILITY to show or be as interested as you'd like or even need to help yourself initiate activity (remember the performer on stage example). Of course, please do not misinterpret this last commentary as a way to say that it is the wife who is the cause of a man's erectile issues....I couldn't prove that in the least.

However, clearly spontaneous and engaging sexual activity between a couple absolutely should have both party's full willing involvement otherwise, something will be lacking on one partner's part or the other. In the female this may translate into an inability to fully climax or be even able to allow penetration without pain or discomfort. In the male, this could be difficulty initiating or maintaining erections.

So, here are a couple of recommendations which are very simple things which I think have a very good possibility of working for you:

1. Do not waste time and money on products such as Gentaplex. These things generally are very expensive, may contain harmful chemicals, and most of the time DO NOT WORK anything close to what their marketing states. YOU DON'T NEED THAT STUFF.

2. Sit down yourself (or preferably with your wife). Ask her what her feelings are about the difficulties you've been having.....I and my wife do have such converations although I must admit I think at times she prefers not to talk about it and that is understandable....but you make an attempt and if she sees you want to talk about it she may accommodate you. If you don't say anything about it chances are she won't either.

3. See what's been going on in your lives recently and ask if any of the stresses I mentioned apply to you specifically and how you can best deal with those issues first to get them under control whether it be work that needs to get done, money issues, family/friends, etc.

4. DON'T TRY TOO HARD right now....let a little time pass for yourself. Ask your wife to consider alternative ways that she might try and stimulate activities for you...in other words, change your routine habits and ways to try some new ways with each other. I imagine you are either always or nearly always the one to start something. Agree that she may take the lead over the next few days after you've taken a break as I've said....then, let her be the one to suggest or move activities in the bedroom. This should change your emotional environment enough to get things moving in a positive direction.

My feeling is that you will see this as a slight bump in a very long road which is likely to have such bumps now and again, not only for you but likely for your wife (and likely many more times)....do not get frustrated...marriage and companionship with a spouse is much much more than just sexual relationships so on those times when one or the other is having one of these SPEED BUMPS go to alternative means of enjoying each other's company. My wife will tell me to "cuddle more" and think "sex" less.....so it goes. Of course, I don't agree with her and I tell her that I cuddle all the time. But hey, she is the boss in those circumstances and there isn't much I can do except just try and do her bidding and wait until she thinks there's been enough cuddling! LOL!

You will be FINE. You need a little patience. Stay away from a lot of expensive pills, chemicals, injections, or interventions. You do not need a huge battery of tests, imaging studies, ultrasounds, and I certainly don't think you need to go to counselors or psychiatrists either. Just take it easy....relax a little, recharge, talk to your wife and enjoy each other's company for the reasons you got married to one another. The intimacy will come back into play soon enough and you'll be one further ahead in the game of life since now you've seen the unthinkable for a man can and will happen. And you figured out how to cope and deal with it...Good for you.....that's what life is all about....getting your experiences in EVERYTHING so one day people will look at you and know that you've seen it ALL and conquered just about all of it...of course, otherwise, you wouldn't get up every morning, right?

Be well.

If you feel these ideas have helped you in any way I would very much appreciate your written feedback with a STAR RATING so I know if I was helpful or not.

Also, I would greatly appreciate your CLOSING THE QUERY if you have no further questions or comments.

This consult required 120 minutes of physician specific time in order to review, research, and document in final draft form for envoy.

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