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Dr. Andrew Rynne

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Used anesthesia for dental procedure. Experiencing erectile dysfunction. How to improve the condition?

Answered by
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Dr. Jonas Sundarakumar

Psychiatrist

Practicing since :2003

Answered : 2190 Questions

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Posted on Sat, 15 Dec 2012 in Sexual Problems
Question: I am Single Male,35 years, Height 177cm and weight 84kgs(20% body fat)

I had a third molar extraction done in Aug 2010, wherein the extraction process was very difficult.
I was administered atleast a dozen of local anesthesia during the course of operation.
After that i experineced complete lack of erection for 3 months. Conditions improved but still
Im Expereincing

1. Reduced sex drive
2. Soft erections generally, if hard then weak at base
3. Difficult in self-erection when arosed, only through massage I am getting fullly erect
4. Difficulty maintaining erection
5. Cyclic periods of hard erections( 1month) followed by soft erections ( 1 months)
6. Reduced feeling of sexiness when seeing some sexy lady, movie,etc
I was recently with my Girlfriend for 3 nights in Oct 2012, I was not able to erect even through massage.

Prior to my dental procedure, i was masturbating atleast three times every night. No problems in having and
maintaining hard erections.

Now I have started to exercise and reduced my weight from 84kg to 80 kgs, the condition of my sex drive
including erection has improved, but not like before, i mean before my Dental procedures.

It is possible there might be some nerve damage.

Please help.
doctor
Answered by Dr. Jonas Sundarakumar 2 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

I will certainly advise you regarding your problem. In order to help you better, can you please provide a few more clarifications...

Did you have any other problems, other than the sexual problem, after the dental procedure?

Do you have any sensory loss over the genital area?

Once aroused, how long are you able to sustain your erection?

Are you able to experience normal orgasm and ejaculation?

Do you smoke or consume alcohol or any other drugs?

Do you have any other medical problems or are you on any medication currently?

Do you suffer from anxiety, negative thoughts or low mood? Have you been under any emotional or situational stress lately?

Have you had any investigations or treatment for this problem so far?


Please get back to me with these details and I shall guide you accordingly.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist & Sexologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jonas Sundarakumar 21 hours later
Hi,

Thanks for writing back. pls see pointwise reply below:-

Did you have any other problems, other than the sexual problem, after the dental procedure? No problems

Do you have any sensory loss over the genital area? I cant feel them as i used to when not erect, when seeing something arousing, but when erect its perfectly ok, I can feel as usual.But frequency of erection has come down drastically.

Once aroused, how long are you able to sustain your erection? I am able to mantain an erection thats not an issue once aroused, but becomes sometimes weak at the base. I mean while masturbating, i dont have sex otherwise, baring a case or two in past( 1 year back) when it was 1 on 1.

Are you able to experience normal orgasm and ejaculation? yes mostly, ejaculation may be sometimes little too quick. this is based on masterbation as said earlier.

Do you smoke or consume alcohol or any other drugs? No smoking, drugs, only alcohol 4-8% beverage twice a year, 2-3 bottles only at a time when on vaccaction.

Do you have any other medical problems or are you on any medication currently?I suffer from skin psoriasis from past 8 years but its under control. No problem as such. But im overweight, probably 5-6 kgs higher when i compare my sexual standards( that was 5 years back) when i used to main 74-75 kgs.

Do you suffer from anxiety, negative thoughts or low mood? Have you been under any emotional or situation stress lately? Yes, last 8 months have been a rollercoster of emotions, I started to engage in Stock trading Lessons, my sleep pattern was disturbed because of that. this i was pursuing apart from normal 8-6PM job. Yes, i have to admit, financial stress has been looming around. Im must add I have been involved with this girl more emotionally than sexually. Its based on love, which happened 3 months back. When I look around and see beautiful women I dont feel anything for them as I used to, I mean before meeting her.Im sort of hypnotized.

Have you had any investigations or treatment for this problem so far? She is doctor and recommended I see some expert. I contacted you first for advise.
doctor
Answered by Dr. Jonas Sundarakumar 14 hours later
Hi again and thanks for your clarifications.

You have mentioned that you received only local anaesthesia for the dental procedure and local anaesthetics have effect only on the particular area in which they are injected. Whatever small amount of medication which is absorbed into the system will also be rapidly excreted by the kidneys. So, it is unlikely that this could have resulted in any nerve damage to the penis or had any other sexual effects.

However, to be sure that there are no physical causes for your sudden onset of sexual problems, a proper evaluation is necessary. This will include a detailed medical and sexual history, a thorough physical examination and certain investigations, as per the necessity. Regarding investigations, you may need to undergo a few blood tests since cetain medical conditions like diabetes, high cholesterol, etc. can lead to sexual dysfunction. Sometimes, hormonal imbalances can also lead to low sexual drive and poor sexual functioning. So, certain additional tests like testosterone level, FSH, LH levels, etc. may be required. Similarly, in order to rule out any blood flow problem to the penis, which could be causing poor erections, a doppler study is sometimes advised to check for the blood flow to the penis. Rarely, a due to the local anaesthetic).

Having said this, I would also like to let you know that psychological factors also play a major role in causing or worsening sexual dysfunction. Anxiety, depression, fears or doubts about sexual performance, self-doubts, guilt, etc. can all affect sexual functioning and performance. So, removing the person's anxiety and fears, and improving his self-confidence levels will also definitely help in improving sexual performance. In your case, you have mentioned that you have been going through a significant amount of mental stress and anxiety in the last few months. Plus the relationship with your girl has also happened recently, which would have also altered your emotional state. So, it is possible that these psychological factors could be playing a role in causing or worsening your sexual dysfunction.

Also, since you mention that your sexual function has been improving gradually, this also indicates that there is no major medical or neurological problem which has caused any permanent damage. Therefore, I would advise you not to get too much worried or anxious about this problem. Hopefully, with some more time, you will be able to regain you full level of sexual functioning. To be on the safer side, you can consult a doctor, preferabley a sexologist, to have a proper evaluation, including some basic investigations done. Try to relax and be stress-free. Continue to exercise regularly as this is good for both your body as well as mind. If you feel that you are finding it difficult to handle your stress and anxiety, then you may need counselling or sometimes, a small dose of medication to relax your mind.

Wish you all the best.

Dr. Jonas Sundarakumar
Consultant Psychiatrist & Sexologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jonas Sundarakumar 2 days later
Hello Dr. XXXXXXX

Thank you for the reply. I was actually worried on account of nerve damage but thank you for the clarification.

I have month back taken literally stress free job and i am each day noticing a betterment in my sexual mood and quality of erection.

What I have decided I shall take one or two more months to further reduce my fat and simultaneously take more nutritous food
and see what happens. if I am able to regain 100% of my sexual state then i believe there is no need to visit a doctor. I hope my understanding and approach is
correct. pls confirm.

Also I want to take Ginseng herbal capsule. Pls advise wheter it is safe to take for couple of months.

thanks
doctor
Answered by Dr. Jonas Sundarakumar 16 hours later
Hello again and thanks for writing in.

I'm glad that my advise was useful to you and that your sexual drive and functioning are gradually improving.

Yes, your approach should be just fine and if you continue to be stress-free, have a healthy lifestyle and continue to exercise regularly, your sexual functioning should be back to 100%.

Ginseng supplements have been claimed to treat sexual dysfunction. There's clear scientific evidence for it, but there's no harm trying, since it has not been known to produce any serious side effects. Some people report having insomnia (sleeping difficulty) while taking this herb, so it's better to take it in the mornings.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist & Sexologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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