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Suggest Treatment For Psychogenic Erectile Dysfunction

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Posted on Fri, 8 Jul 2016
Question: Hi

I am 32 years old married male without any BP/Cardiac issues. I have been married since last 3 years now and have 1 year old baby.

I had been diagnosed with psychogenic ED in 2011and doctor prescribed me tadalafil 10mg. After using pill for 25 times, I was even able to do intercourse with my wife without pill.but now i am again facing the ED problem.

1) Cialis 10mg worked again perfectly once for me 14 days back. But after that It didnt worked as expected. I got an erection initially using cialis 10 mg. But couldn't maintain the same to complete the intercourse. So next time , I took Cialis 20 mg, Tentex royale 2 capsules and Argipreg ( L Arginine ) .This time also i got the complete erection for 10 minutes but couldnt maintain the erection while trying the other sex pose. Same issue like with cialis 10 mg.My problem is maintaining the erections even after using cialis 20 mg. Can I give a try to levitra or viagra or avanafil?Which one will you suggest?Is there any possibility for them to help me with this since cialis also works the same way.
2) Can I combine the pill (that you will suggest) with L Arginine,Tentex royale and confido? Is it advisable?
3) Can you prescribe me any other additional gel/product ,that can help me with ED problem?
4) Can you prescribe me any other gel/cream that can help me to insert penise into vagina, even though penise is not completely erect?KY jelly doesn't helps me.
doctor
Answered by Dr. Dr. P. T. Patil (1 hour later)
Brief Answer:
You can take Dapoxetine along with Cialis

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you are facing problem of Psychogenic Erectile Dysfunction and getting satisfactory erection with 10 mg Cialis hard enough to penetrate vagina but unable to sustain erection for longer time .

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Do you ejaculate fast within a minute after penetration ?
2) Do you spend adequate time in fore play so as to get hard erection for penetration at ease ?

Basically your problem of ED is psychogenic in origin which responds well to Cialis and inability to sustain it longer is also due to psychological factor (Performance Anxiety)

If you have problem in penetration use of K.Y jelly it may be mostly due to inadequate lubrication of vagina due to inadequate vaginal secretion .Spending more time in fore play should help to resolve this problem .

All the gels act as a lubricant and have no role to play to achieve erection ..There is no gelly that has specific action to increase vaginal secretions and easy penetration.

The other drugs like Ciagra XXXXXXX that have been used in ED have the similar mode of action except slight difference in duration and time of onset for action .

You can take combination of Cialis and Dapoxetine one hour before sex .This will help to achieve hard sustainable erection and to delay ejaculation and to have enjoyable sex.

Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (42 minutes later)
Hi Doctor

Just to keep it simple.

The problem here is of not being able to maintain the erection , even after using Cialis 20 mg.

1) I am not at all suffered from premature ejaculation.
2) The problem is that I am not able to maintain hard erections ,so that I am not able to penetrate easily. I am facing the same problem ,even after using Cialis 10mg and Cialis 20 mg. So I am not satisfied with the Cialis effect. And there is no issue with vaginal lubrication . I do enough foreplay so I am able to get the erection but I am not able to maintain it. Seems like ,even Cialis 20 mg is not
working for me.

Kindly answer the below questions:-
1) Can I use verdanafil/sidenafil/avanafil instead of Cialis 20 mg? Can I give a try? Kindly suggest the correct medicine and dosage.

2) Can I combine the Tentex Royale,Confido & L Ariginine with the pill, that you will suggest?

3) Can you suggest me any tropical cream/gel that can boost the erection? Does Himcolin gel works? Can I use it?

4) Please suggest me any gel/cream that can be applied on the penise and can be used to glide the penise into the vagina, in case of partial erection.
doctor
Answered by Dr. Dr. P. T. Patil (1 hour later)
Brief Answer:
You can use Xylocaine Gelly as a lubricant .

Detailed Answer:
Hello
Thanks for follow up .Your basic problem is not to get hard erection adequate enough to penetrate vagina.
I would address your queries as detailed below .

1) All the drugs that you have mentioned belong to same family and have similar mode of action with slight difference in onset and duration of action .So switching over other drug may not help to your satisfaction .However you can try Avanofil Optimum dose is 100 mg as on demand .

2) There is no harm in taking pills that you have mentioned along with Avanfil.

3) Himcolin is an topical cream containing Ayurvedic medications from Himalaya.It is used to apply over shaft of the penis and the manufacturer claims it to help in getting strong erection .There is no harm in trying it .

4) You can use Xylocaine gelly as a lubricant .It is a local anesthetic and does help to prolong ejaculation .

Thanks and Regards.
Dr.Patil.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (3 hours later)
Thanks for your reply. Just to confirm. :-
1) Does avanafil has better results than Cialis? I mean ,does it gives harder erecations as compared to Cialis?
2) please let me know, under which name is this medicine available in India?
doctor
Answered by Dr. Dr. P. T. Patil (4 hours later)
Brief Answer:
Avanafil is a new drug used in ED

Detailed Answer:
Hello
Thanks for follow up .

Avanafil is a new drug in this category and is more potent than Cialis .It is available as Stendra and is manufactured by Sunrise Remedies .Optimum dose is 100 m as on demand .

Thanks and Regards.
Dr.Patil.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10583 Questions

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Suggest Treatment For Psychogenic Erectile Dysfunction

Brief Answer: You can take Dapoxetine along with Cialis Detailed Answer: Hello Thanks for your query ,based on the facts that you have posted it appears that you are facing problem of Psychogenic Erectile Dysfunction and getting satisfactory erection with 10 mg Cialis hard enough to penetrate vagina but unable to sustain erection for longer time . I shall be happy if you can post me few more details to help me in making comments on your problem. 1) Do you ejaculate fast within a minute after penetration ? 2) Do you spend adequate time in fore play so as to get hard erection for penetration at ease ? Basically your problem of ED is psychogenic in origin which responds well to Cialis and inability to sustain it longer is also due to psychological factor (Performance Anxiety) If you have problem in penetration use of K.Y jelly it may be mostly due to inadequate lubrication of vagina due to inadequate vaginal secretion .Spending more time in fore play should help to resolve this problem . All the gels act as a lubricant and have no role to play to achieve erection ..There is no gelly that has specific action to increase vaginal secretions and easy penetration. The other drugs like Ciagra XXXXXXX that have been used in ED have the similar mode of action except slight difference in duration and time of onset for action . You can take combination of Cialis and Dapoxetine one hour before sex .This will help to achieve hard sustainable erection and to delay ejaculation and to have enjoyable sex. Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you . Thanks and Regards. Dr.Patil.