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What Causes Erectile Dysfunction?
Question: Hi Doctor,
I'm having ED problem started 3 to 4 months back.
with out knowing details of the product, I applied mint oil (Navartna) only once to penile does this cause any damage to it and can cause ED(erectile dysfunction).
I went to urologist he prescribed for blood test for estrodil and testosterons from the results my estrodil was high 59.9 and testosterons 704/1193 also urologist took ultrasound blood for penile at 9:30 am in August month and urologist gave report saying that my venous drinage is normal with the blood velocity PSV (41.2) and lower is 3.8
So please doctors let me know what is causing my ED estrodil or mint oil that I applied for penile.
I'm having ED problem started 3 to 4 months back.
with out knowing details of the product, I applied mint oil (Navartna) only once to penile does this cause any damage to it and can cause ED(erectile dysfunction).
I went to urologist he prescribed for blood test for estrodil and testosterons from the results my estrodil was high 59.9 and testosterons 704/1193 also urologist took ultrasound blood for penile at 9:30 am in August month and urologist gave report saying that my venous drinage is normal with the blood velocity PSV (41.2) and lower is 3.8
So please doctors let me know what is causing my ED estrodil or mint oil that I applied for penile.
Brief Answer:
Its most likely high estardiol or other cause
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read your query word by word and understand your concern.
Please get assured again that the local application of navratna oil can not be responsible for erectile dysfunction in a men. This is also evidenced by the normal venous drainage system of your penis on penile ultrasound.
The high estradiol is generally associated with low sex drive but it may be cause of erectile dysfunction. There is possibility that high estradiol is just a contributing factor rather than a causative factor or merely a coincidental finding.
Having said this please note that the most common cause of ED is psychogenic and presence of high anxiety accelerates the problem.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
Its most likely high estardiol or other cause
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read your query word by word and understand your concern.
Please get assured again that the local application of navratna oil can not be responsible for erectile dysfunction in a men. This is also evidenced by the normal venous drainage system of your penis on penile ultrasound.
The high estradiol is generally associated with low sex drive but it may be cause of erectile dysfunction. There is possibility that high estradiol is just a contributing factor rather than a causative factor or merely a coincidental finding.
Having said this please note that the most common cause of ED is psychogenic and presence of high anxiety accelerates the problem.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hello Doctor,
I'm bit confused with your reply.
What you mean by "Please get assured"?.
Shall I check with other doctors or shall I undergo for any test? If so please recommend me with the test name's.
I can follow-up with my local urologist regarding the test and see what he can do .
Please suggest me.
I'm bit confused with your reply.
What you mean by "Please get assured"?.
Shall I check with other doctors or shall I undergo for any test? If so please recommend me with the test name's.
I can follow-up with my local urologist regarding the test and see what he can do .
Please suggest me.
Brief Answer:
This was kind of double assurance
Detailed Answer:
Hello,
Welcome back to Healthcaremagic.
I mean to say that there is no reason of doubt about effect of local application of navratna oil. This was obvious in my next statement that " his is also evidenced by the normal venous drainage system of your penis on penile ultrasound."
I mean to say with presence of normal venous drainage system there is no reason to believe that it was caused by navratna oil. In simple terms navratna oil local massage is not responsible for erectile dysfunction problem.
Having said this there is no need to go for further investigation or check with other doctors.
I completely agree with you in regard to further follow up with your urologist but at the same time I need to stress out that an evaluation from psychological point of view is necessary. This will help you in long run to understand your problem and likely cause which may not be revealed on investigations.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
Thanks and regards
This was kind of double assurance
Detailed Answer:
Hello,
Welcome back to Healthcaremagic.
I mean to say that there is no reason of doubt about effect of local application of navratna oil. This was obvious in my next statement that " his is also evidenced by the normal venous drainage system of your penis on penile ultrasound."
I mean to say with presence of normal venous drainage system there is no reason to believe that it was caused by navratna oil. In simple terms navratna oil local massage is not responsible for erectile dysfunction problem.
Having said this there is no need to go for further investigation or check with other doctors.
I completely agree with you in regard to further follow up with your urologist but at the same time I need to stress out that an evaluation from psychological point of view is necessary. This will help you in long run to understand your problem and likely cause which may not be revealed on investigations.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hello Doctor,
Thanks a lot for replying to my questions.
I got couple of question.
My weight is 76 kg's, I got normal blood pressure and I'm not under any medications before.I don't smoke and dont drink alcohol.
I will do 30 mins of workout alternative days.
1. I use to get erections and ejaculate very strong and effectively when ever I want to have sexual intercourse with my wife,during my sleeps at night and while watching pronography videos all the sudden things has been changed 4 months back when my self and my wife want to have sexual intercourse i got erection and suddenly my erection became week since then i wasn't able to get strong and effective erections (when ever i want to have), sometimes I get erections at night in my sleep and during I wakeup from bed also I tried to mastrubate I didn't get any erections.
2.In the month of XXXXXXX I went to endocronologist and explained about my problem(Saying I was not able to get erections on my need bases), So endocronologist has written for blood test for list of hormones
1.Albumin I have 4.8 (3.6-5.1 g/dL) In range
2.FSH I have 4.1 (1.6-8.0 mIU/mL ) In range
3. LH I have 6.4 (1.5-9.3 mIU/mL ) In range
4.Testosterones I've 413 (241-827 ng/dL) In range
5.Sex harmones I have 29 (10-50 nmol/L ) In range
3. Does low level of good cholestrol could case erection problem? because when the problem was started I went to primary physican he prescribed for blood test from that result it say I got low level of good cholestrol
by having this range level of harmones, Can i get back my erections and We can have Kids in atleast 1 to 2 years of time?
I really want to have sexual intercourse with my wife and to have kids, but I'm not able to get erections.
Do this harmone levels goes down if I doen't have sexual intercourse or very rapidly?
Yesterday I went to urologist local to me in USA he told me that I dont have any physical problem and not to see him in office if necessary he asked me to call him.
What could be the problem? either navrtna oil I applied or my mind or having low level of good cholestrol or having high estrodil Please suggest me !!!
Thanks a lot for replying to my questions.
I got couple of question.
My weight is 76 kg's, I got normal blood pressure and I'm not under any medications before.I don't smoke and dont drink alcohol.
I will do 30 mins of workout alternative days.
1. I use to get erections and ejaculate very strong and effectively when ever I want to have sexual intercourse with my wife,during my sleeps at night and while watching pronography videos all the sudden things has been changed 4 months back when my self and my wife want to have sexual intercourse i got erection and suddenly my erection became week since then i wasn't able to get strong and effective erections (when ever i want to have), sometimes I get erections at night in my sleep and during I wakeup from bed also I tried to mastrubate I didn't get any erections.
2.In the month of XXXXXXX I went to endocronologist and explained about my problem(Saying I was not able to get erections on my need bases), So endocronologist has written for blood test for list of hormones
1.Albumin I have 4.8 (3.6-5.1 g/dL) In range
2.FSH I have 4.1 (1.6-8.0 mIU/mL ) In range
3. LH I have 6.4 (1.5-9.3 mIU/mL ) In range
4.Testosterones I've 413 (241-827 ng/dL) In range
5.Sex harmones I have 29 (10-50 nmol/L ) In range
3. Does low level of good cholestrol could case erection problem? because when the problem was started I went to primary physican he prescribed for blood test from that result it say I got low level of good cholestrol
by having this range level of harmones, Can i get back my erections and We can have Kids in atleast 1 to 2 years of time?
I really want to have sexual intercourse with my wife and to have kids, but I'm not able to get erections.
Do this harmone levels goes down if I doen't have sexual intercourse or very rapidly?
Yesterday I went to urologist local to me in USA he told me that I dont have any physical problem and not to see him in office if necessary he asked me to call him.
What could be the problem? either navrtna oil I applied or my mind or having low level of good cholestrol or having high estrodil Please suggest me !!!
Brief Answer:
This seems to be your mind
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
After going through your first point the first thing came to my mind was psychological issues for ED problem.
None of the problem described by you can cause overnight problem in a healthy male and in these conditions there is gradual onset of problem and for an individual difficult to describe how it was started (as in your case).
Low HDL, high estradiol can not explain your symptoms.
In patients with dyslipidemia there is formation of plaque or narrowing which can be observed on Penile ultrasound. Fortunately that is not there.
In cases of high estradiol the problem generally starts with loss of libido or desire. Again that is not the case with you and you have good sexual appetite as in past.
The issue of navratna oil we already discussed.
Having said this all your biochemical parameters are in perfect shape.
Above all a experienced and well qualified urologist confirmed to you that there is no physical issue.
After going through all these issues only thing that left is psychological issues. It is a well known fact that male ego is very fragile and once you encounter any problem there is development of vicious cycle.
Only thing that is important for you is to break this vicious cycle and get the same or better self confidence you had four month back.
Thanks and regards
Dr Ashok Kumar
This seems to be your mind
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
After going through your first point the first thing came to my mind was psychological issues for ED problem.
None of the problem described by you can cause overnight problem in a healthy male and in these conditions there is gradual onset of problem and for an individual difficult to describe how it was started (as in your case).
Low HDL, high estradiol can not explain your symptoms.
In patients with dyslipidemia there is formation of plaque or narrowing which can be observed on Penile ultrasound. Fortunately that is not there.
In cases of high estradiol the problem generally starts with loss of libido or desire. Again that is not the case with you and you have good sexual appetite as in past.
The issue of navratna oil we already discussed.
Having said this all your biochemical parameters are in perfect shape.
Above all a experienced and well qualified urologist confirmed to you that there is no physical issue.
After going through all these issues only thing that left is psychological issues. It is a well known fact that male ego is very fragile and once you encounter any problem there is development of vicious cycle.
Only thing that is important for you is to break this vicious cycle and get the same or better self confidence you had four month back.
Thanks and regards
Dr Ashok Kumar
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Hello Doctor,
Thanks a lot for valuable details.
I haven't got details on my question regarding "by having this range level of hormones, Can i get back my erections and We can have Kids in atleast 1 to 2 years of time?"
Since 1 week I'm not able getting erections in my sleep or while I wakeup from bed.
still its a psychological problem?
Shall I go to endocrinologist again to check my hormone level's do my hormone levels could change between XXXXXXX and Now(September).
Please suggest me, so I can schedule an appointment with endocrinologist.
Thanks a lot for valuable details.
I haven't got details on my question regarding "by having this range level of hormones, Can i get back my erections and We can have Kids in atleast 1 to 2 years of time?"
Since 1 week I'm not able getting erections in my sleep or while I wakeup from bed.
still its a psychological problem?
Shall I go to endocrinologist again to check my hormone level's do my hormone levels could change between XXXXXXX and Now(September).
Please suggest me, so I can schedule an appointment with endocrinologist.
Brief Answer:
Definitely yes
Detailed Answer:
Hello,
Thanks again at HCM.
During our interaction in last two days with available details I do not find any reason (read organic problem) that suggests you will not be able to achieve normal erection. There is ample evidence to suggest that current ED problem is treatable. So my answer is definitely yes. At least I do not doubt about positive outcome.
Having said this there is no harm in meeting your endocrinologist to know his opinion. I do not think repeat hormone asessment will be useful but I must acknowledge that your endocrinologist can decide better than me in regard to hormones.
One week period is too short to say that it is not psychological but at the other hand nothing indicative of physical or organic problem other than slight high level of estradiol. I can not guarantee that it is 100% psychological but I am of the opinion that just psychological intervention can help you for a large extent.
Thanks andregards
Dr Ashok
Definitely yes
Detailed Answer:
Hello,
Thanks again at HCM.
During our interaction in last two days with available details I do not find any reason (read organic problem) that suggests you will not be able to achieve normal erection. There is ample evidence to suggest that current ED problem is treatable. So my answer is definitely yes. At least I do not doubt about positive outcome.
Having said this there is no harm in meeting your endocrinologist to know his opinion. I do not think repeat hormone asessment will be useful but I must acknowledge that your endocrinologist can decide better than me in regard to hormones.
One week period is too short to say that it is not psychological but at the other hand nothing indicative of physical or organic problem other than slight high level of estradiol. I can not guarantee that it is 100% psychological but I am of the opinion that just psychological intervention can help you for a large extent.
Thanks andregards
Dr Ashok
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hello Doctor,
Yesterday night 45 mins before of sexual intercourse, I took drug cialis(tadalafil) 10mg I got week erection and druing night in sleep and while weakup from bed I got strong and effective erection (which I haven't got for 4 days).
I'm totally confused with problem i suffering from, sometimes i feel like it my mind, sometimes I feel I have some physical problem like (venous leak) and soon.
to make my self clear on this, could you please check my report(penile doppler ultrasound report) I've attached and let me know if I've have any such physical problem's.
Please help me doctor !!!
Yesterday night 45 mins before of sexual intercourse, I took drug cialis(tadalafil) 10mg I got week erection and druing night in sleep and while weakup from bed I got strong and effective erection (which I haven't got for 4 days).
I'm totally confused with problem i suffering from, sometimes i feel like it my mind, sometimes I feel I have some physical problem like (venous leak) and soon.
to make my self clear on this, could you please check my report(penile doppler ultrasound report) I've attached and let me know if I've have any such physical problem's.
Please help me doctor !!!
Brief Answer:
report is completely normal
Detailed Answer:
Hello,
Welcome back.
I read your penile doppeler report and found nothing abnormal other than possible chordee which is just an coincidental finding. Nowhere the report suggests that there is venous leak from penis. The report clearly states that there was 100% tumuscence following injection during test.
It also mentions about normal penile and venous flow.
Presence of normal erection during sleep and early morning points for something which is not griveous.
These are most commonly used to differentiate from organic problem in suspected psychogenic ED. You may argue with me that this was in response to cialis but you might be knwoing that cialis do not produce erection without thoughts or stimulation and if it was cialis why it did not resulted in normal erection at time of sexual intercourse. The answer is anxiety which was present during time of sex but that was absent during sleep and early morning.
I hope this clears your doubt.
Thanks and regards
Dr Ashok XXXXXXX
report is completely normal
Detailed Answer:
Hello,
Welcome back.
I read your penile doppeler report and found nothing abnormal other than possible chordee which is just an coincidental finding. Nowhere the report suggests that there is venous leak from penis. The report clearly states that there was 100% tumuscence following injection during test.
It also mentions about normal penile and venous flow.
Presence of normal erection during sleep and early morning points for something which is not griveous.
These are most commonly used to differentiate from organic problem in suspected psychogenic ED. You may argue with me that this was in response to cialis but you might be knwoing that cialis do not produce erection without thoughts or stimulation and if it was cialis why it did not resulted in normal erection at time of sexual intercourse. The answer is anxiety which was present during time of sex but that was absent during sleep and early morning.
I hope this clears your doubt.
Thanks and regards
Dr Ashok XXXXXXX
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hello Doctor,
Today after coming back home from work, my self and my wife had foreplay I got erection strong and effective as before 4 months back and I was able to ejaculate as well.
I got this erection because of drug cialis(tadalafil) 10 mg I took 2 days back or its natural erection got during my foreplay?
I've no pain on penile when it got erected and soon.
This means I'm all good (no damage caused) correct with my penile and erections.
Please suggest me.
I can be the happiest person in the world !!!!!
Today after coming back home from work, my self and my wife had foreplay I got erection strong and effective as before 4 months back and I was able to ejaculate as well.
I got this erection because of drug cialis(tadalafil) 10 mg I took 2 days back or its natural erection got during my foreplay?
I've no pain on penile when it got erected and soon.
This means I'm all good (no damage caused) correct with my penile and erections.
Please suggest me.
I can be the happiest person in the world !!!!!
Brief Answer:
Its is natural
Detailed Answer:
Hello,
Welcome again.
First of all I like to congratulate you for overcoming the psychological issues and stepping forward to get lost ground.
This seems to be natural erection as cialis has half life of 18 hours and I do not think it will remain in the system with effective concentration beyond 24 hours.
To make it more strong evidence if it was cialis why it did not work two days back on the day when you took it.
All the available evidence points toward everything normal physically and it does not leave any doubt about organic or serious problem.
The concern you showed in last couple of days was laudable and it started showing its results.
Congratulations again.
Thanks and regards
Dr Ashok Kumar
Its is natural
Detailed Answer:
Hello,
Welcome again.
First of all I like to congratulate you for overcoming the psychological issues and stepping forward to get lost ground.
This seems to be natural erection as cialis has half life of 18 hours and I do not think it will remain in the system with effective concentration beyond 24 hours.
To make it more strong evidence if it was cialis why it did not work two days back on the day when you took it.
All the available evidence points toward everything normal physically and it does not leave any doubt about organic or serious problem.
The concern you showed in last couple of days was laudable and it started showing its results.
Congratulations again.
Thanks and regards
Dr Ashok Kumar
Above answer was peer-reviewed by :
Dr. Prasad
Hello Doctor,
Thanks a lot I got lot of confidence, from past 2 days(Friday and Saturday) I'm doing well with sexual intercourse with out taking any drug cialis(tadalafil).
All I'm doing is Yoga for 30 mins since Wednesday in addition to my 30 mins of workout alternate days.
During nights in my sleep I'm getting erections like before.
I got couple of questions
On Saturday I had sexual intercourse with my wife 3 times
a.Morning around 11:00 AM I got ejaculation in less than 3 minutes.
b.I had sexual intercourse 3 hours after first one, I did intercourse for more than 10 mins but I haven't got ejaculation.
c. I had intercourse again in night around 11:00 PM, I haven't got ejaculation this time as well.
Why I haven't got ejaculation? I was asking this question becuase I dont to do myself wrong assumptions and get my health worst.
I want my erections to be permanent like before.
Please suggest me.
Thanks a lot.
Thanks a lot I got lot of confidence, from past 2 days(Friday and Saturday) I'm doing well with sexual intercourse with out taking any drug cialis(tadalafil).
All I'm doing is Yoga for 30 mins since Wednesday in addition to my 30 mins of workout alternate days.
During nights in my sleep I'm getting erections like before.
I got couple of questions
On Saturday I had sexual intercourse with my wife 3 times
a.Morning around 11:00 AM I got ejaculation in less than 3 minutes.
b.I had sexual intercourse 3 hours after first one, I did intercourse for more than 10 mins but I haven't got ejaculation.
c. I had intercourse again in night around 11:00 PM, I haven't got ejaculation this time as well.
Why I haven't got ejaculation? I was asking this question becuase I dont to do myself wrong assumptions and get my health worst.
I want my erections to be permanent like before.
Please suggest me.
Thanks a lot.
Brief Answer:
Please answer few questions before
Detailed Answer:
Hello,
Thanks for reverting back to me with very good news.
Before I answer your question need to know few facts from you.
1. What was the average duration of sexual intercourse in past (before four months)- please write down both minimal and maximum time since start of sexual activity.
2. What was the duration in last four months since onset of problem
3. How long you are taking clomid?
4. Reason for prescription of clomid and its dose
5. Are you taking any anti depressant?
6. Do you have any other prescription?
Once I get your answer, I will revert back with my understanding of the problem.
Thanks and regards
Please answer few questions before
Detailed Answer:
Hello,
Thanks for reverting back to me with very good news.
Before I answer your question need to know few facts from you.
1. What was the average duration of sexual intercourse in past (before four months)- please write down both minimal and maximum time since start of sexual activity.
2. What was the duration in last four months since onset of problem
3. How long you are taking clomid?
4. Reason for prescription of clomid and its dose
5. Are you taking any anti depressant?
6. Do you have any other prescription?
Once I get your answer, I will revert back with my understanding of the problem.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hello Doctor,
Good Evevnig !!!
Answers to your questions :
1.What was the average duration of sexual intercourse in past (before four months)- please write down both minimal and maximum time since start of sexual activity
Ans:Include foreplay, penetrations and ejaculation minimum is 15 Mins and maximum 20 mins before 4 months.
2.What was the duration in last four months since onset of problem.
Ans: ejaculation anytime betweem 1 to 3 mins
3. How long you are taking clomid?
Ans: 1 1/2 Month
4.Reason for prescription of clomid and its dose
Ans: Urologist has prescribed clomid ( clomphine citrate ), because he(urologist) told me I might have estrodil and that causing ED problem. I'm using 25 mg alternative days.
5.Are you taking any anti depressant?
Ans: Fortunately no
6. Do you have any other prescription?
Ans: Fortunately no
Good Evevnig !!!
Answers to your questions :
1.What was the average duration of sexual intercourse in past (before four months)- please write down both minimal and maximum time since start of sexual activity
Ans:Include foreplay, penetrations and ejaculation minimum is 15 Mins and maximum 20 mins before 4 months.
2.What was the duration in last four months since onset of problem.
Ans: ejaculation anytime betweem 1 to 3 mins
3. How long you are taking clomid?
Ans: 1 1/2 Month
4.Reason for prescription of clomid and its dose
Ans: Urologist has prescribed clomid ( clomphine citrate ), because he(urologist) told me I might have estrodil and that causing ED problem. I'm using 25 mg alternative days.
5.Are you taking any anti depressant?
Ans: Fortunately no
6. Do you have any other prescription?
Ans: Fortunately no
Brief Answer:
Check with urologist to stop clomid
Detailed Answer:
Hello,
Thanks for reverting back to me.
After going through details provided by you I do not think there is need to worry about anything.
The decreased duration in last four months and yesterday morning can be explained on basis of anxiety associated with performance.
The delayed ejaculation is common thing on second time intercourse but time generally doubles and most of men can achieve orgasm.
The second most common reason is under stimulation. If that is present or enough time is not devoted to foreplay this may result in delayed ejaculation.
As only change in your life was clomid along with other issues (fortunately resolved) there is need to talk to your urologist about tapering to lower dose or discontinuation of clomid if he feels so. I must acknowledge that clomid is not reported to have side effect of delayed ejaculation or dry orgasm but there is little chance of developing this side effect that can be answered by your urologist. (I searched literature beforehand but did not find any evidence in support of this side effect).
In nutshell there is nothing serious about delayed ejaculation and you can enjoy your sex life as in past.
Thanks and serious
Check with urologist to stop clomid
Detailed Answer:
Hello,
Thanks for reverting back to me.
After going through details provided by you I do not think there is need to worry about anything.
The decreased duration in last four months and yesterday morning can be explained on basis of anxiety associated with performance.
The delayed ejaculation is common thing on second time intercourse but time generally doubles and most of men can achieve orgasm.
The second most common reason is under stimulation. If that is present or enough time is not devoted to foreplay this may result in delayed ejaculation.
As only change in your life was clomid along with other issues (fortunately resolved) there is need to talk to your urologist about tapering to lower dose or discontinuation of clomid if he feels so. I must acknowledge that clomid is not reported to have side effect of delayed ejaculation or dry orgasm but there is little chance of developing this side effect that can be answered by your urologist. (I searched literature beforehand but did not find any evidence in support of this side effect).
In nutshell there is nothing serious about delayed ejaculation and you can enjoy your sex life as in past.
Thanks and serious
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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