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What is the cause and treatment for erectile dysfunction?

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Posted on Sat, 12 Jul 2014
Question: I m suffering from ed i met toan urologist.he had taken my hormonal test results are fsh-1.48 mlu/ml,prolactin 5.53ng/ml, 1.86miu/ml,testosterone-386.52ng/dl.doctor said i hav normal testosterone.but i hav read that young male of my age should have normal testosterone level upto 700ng/dl to 800ng/dl.my doctor said its psychlohical.but i think it is due to low testosterone.on my request he prescribed me oligocare forte and sylkam 0.5mg.i am also taking himalaya confido prescribed by dermatologist on healthcaremagic.amway daily and salmon omega3 without prescription.what should i do.the medicine i am taking is right for me.pls suggest
doctor
Answered by Dr. Ashok Kumar (55 minutes later)
Brief Answer:
You need to meet in person with a psychiatrist

Detailed Answer:
Hi XXXXXXX
Thanks for using healthcare magic.

First regarding the test they are absolutely normal and there is nothing in the tests which shows something grievous.
I agree with your previous doctor that testosterone level of 386.52 is whithin normal range and the reports vary from one laboratory to another. You need to check the reference value of laboratory where the test are conducted for you.

Ed can be due to multiple factors and psychological means there is no abnormality in the system but the excessive anxiety makes the penetration impossible. Generally this is the most common cause of ED worldwide and fortunately it is treatable.
Regarding your current medication I do not have any data but I am sure that these are not meant for the long term treatment. You may need to continue for months or years with these medicines without much improvement. So in my view stopping these medicines are not a bad idea. What you are receiving in these medicines, you can get the same chemical in one piece of onion and garlic.

Before we proceed further I have few questions for you
1 Do you have any sexual experience?
2. If yes what was the result of intercourse
3. Do you get your penis erected while you come out of the bed or in early morning
4.Do you have erection while watching porn
5. Do you masturbate, if yes frequency per week

Please revert with these details so I can primarily determine whether it is psychological or otherwise.
I hope to see you again.
Thanks and Regards
Dr Ashok
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ashok Kumar (4 hours later)
yes i had sexual experiance but i faile d to penetrate.one time i hav compleated my intercourse with the help of viagra.two time i ejaculate without erection.due to this i gone through sevre depression.after treatment i come out of depression totaly.again i had a intercourse i failed to penetratewith weak erection and ejaculated with in 2 mints.i cant make intercourse that night even after taking viagra.i had a deep fear of faliure in my mind.most of the time i get morning erection some time my erection is weak.i got
doctor
Answered by Dr. Ashok Kumar (11 minutes later)
Brief Answer:
This is ED and PE

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.

Be assured that it is psychological one and completely treatable. One thing that I noticed from your added description that it is not a isolated Ed and actually it is erectile dysfunction plus premature ejaculation.
As most of the treatment of ED and PE is done with talk therapy it requires a lot of understanding between patient and a doctor. I like to tell you that now you can stop your current medication and contact a psychiatrist in local area. If you are from XXXXXXX Pradesh you can contact me, I am practicing in XXXXXXX
I understand your fear and it is very common for ED to be associated with PE.

Hope this will be of help to you. If you need any further clarification do contact me. I will be happy to help you.
Regards
Dr Ashok
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Ashok Kumar (1 hour later)
sir i got erection when i see porn.i masterbate when i talk with my girl frnd at night.some time my erection is weak and some time erection is hard.i also hav a problem of depression.the medication im taking can cause any side effect to me.pls.say.my father had also problem of low tetosterone in his young age and he is also suffering from depression.i heard that h had taken injection for low testosterone.my problem genetic.what is your opinion.my testosterone level in january is 580ng/dl and 1 month ago testosterone level is386.52ng/dl.pls.suggest me.my parents forcing me to marry.what should i do.many doctor said that my problem will go away after marriage.
doctor
Answered by Dr. Ashok Kumar (1 hour later)
Brief Answer:
I agree to some extent with you

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.

As I said there is psychological component in your problem, it does not mean there is no issue with testosterone. I am a psychiatrist and well aware of my own field but beyond that other specialist have better say.

After getting fresh input about your family history I feel it is worthwhile to get testosterone treatment before shifting to psychiatrist treatment. Although level above 300 is considered normal but sudden drop in your testosterone of more than 200 ng/ml in period of four months makes me to think in other possibilities too.
Testosterone injections are generally harmless and given at weekly intervals. You can ask a local doctor or your urologist to prescribe same and if it is due to low testosterone than I am sure that you will feel improvement in a very short period.

Having said this in my opinion all the problems are not due to low testosterone, if any. Although depression and ED can occur because of low testosterone but there is no report of premature ejaculation due to low testosterone. So agree partially with your statement that your problem is genetic rather than psychological. My take at this point is "your problem have both psychological and testosterone component."

Regarding your doubt with marriage I recommend to post pone the marriage. It is rubbish to say that marriage solves such problems. Marriage itself is a stressful event and all psychological problems generally exacerbate after marriage. Only exception is that if your partner is very supportive but that thing is very unlikely in newly married couples.

'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
doctor
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Follow up: Dr. Ashok Kumar (1 hour later)
i hav given first time testosterone teston 25/02/2012 result was 284.50ng/dl and on 25/012014 result was 580ng/dl and recently 386 52ng/dl 1 month ago. my disease is curable or not or i hav to never marry.my disease hav permanent cure or not.pls.suggest me the best doctor in XXXXXXX for my problem.when i got treated with a neurologist i became mentally well.erection was satisfactory during masturbation that time.when i go for sex i got weak erection and quick ejaculation.should i consult that doctor again.i am only26 year old .i cant tolerate the pressure sir pls help me.i will be always helpful.sir pls.help me .i want to contact with u.your answer is satisfactory.
doctor
Answered by Dr. Ashok Kumar (17 minutes later)
Brief Answer:
Yes you can contact him back

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.

I appreciate your keen interest in seeking help and good awareness and regular visit with the treating doctor. I won't comment anything about testosterone as all results are within lower normal limits and option of exploring testosterone is valid.

First I assure you that this is completely treatable and may be curable for life long. Recovery of near normal erection with treatment of depression is proof of my above said statement that you have experienced while getting treatment from the neurologist.
Regarding marriage I would say again postpone at least for period of three to six months before you recover.
Regarding your problem you do not need the best doctor you need best therapist who can understand your problem. Almost all psychiatrist are well qualified and experienced enough to treat depression, Ed and premature ejaculation. You can contact one in your city. If you are in UP you can call me for appointment at 0000 and I will be happy to help you.
Neurologist also treat the depression but I won't say they are the best person. They can prescribe you the medication but at the time of counselling they are not well trained which is absolute requirement in ed of psychological origin.

I am happy with your feedback and will be of service for you when ever you need it.

"If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health".
Regards
Dr Ashok
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Ashok Kumar (24 minutes later)
it means my problem is treatable.i m satisfied with ur answer.sir i m not from up.pls.help me sir i am seeing a hope in your answer .sir pls.help me i will be life time thankful to u.pls. help me like ur younger brother.i want to do a lot in life but this disease is obstructing all hope and progress of my life..i m taking oligocare forte sylkam0.5mg(etizolam 0.5mg) prescribed by urologist and herbal product himalaya confido prescribed by dermatologist on this same site.what should i do with these medicine.suggest pls
doctor
Answered by Dr. Ashok Kumar (14 minutes later)
Brief Answer:
yes it is treatable

Detailed Answer:
Dear XXXXXXX
Thanks again.

As I said earlier this is treatable. You will be surprised to know that one in four of us suffer from this kind of problem and they do well once they get treated.
Regarding current medicine I inform you again that it is not going to solve problem.
Although you are not from UP but still you can call me if you wish. I will guide you whatever is possible over phone.
Thanks and Regards
Dr Ashok
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Ashok Kumar (12 minutes later)
prescribe some medicine for me.give me the time when i can call u..
doctor
Answered by Dr. Ashok Kumar (10 minutes later)
Brief Answer:
Call me at 8 PM

Detailed Answer:
Dear XXXXXXX

Thanks for relying on my advice and your feedback.

Call me at 8 PM and I will be ready to discuss more in detail what can be done.

Regarding medication I need to discuss more and if it is possible to prescribe over the counter medication I will ready to prescribe. But the prescription medicine (which require doctor's written prescription) will be not possible as ethics does not allow mw to do so.

I hope to receive a call from you at 8 PM.
Regards
Dr Ashok


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Ashok Kumar (2 hours later)
sir i hav purchased XXXXXXX cr 12.5 .tell me the dosage how to take..
doctor
Answered by Dr. Ashok Kumar (9 minutes later)
Brief Answer:
Medical ethics does not allow me to do that

Detailed Answer:
Dear XXXXXXX
Please contact the local medical practitioner for same. The medical ethics does not allow me to prescribe medication here. What I suggested over phone was a clue about right medication.
"If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health".
Thanks and Regards
Dr Ashok
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Dr. Ashok Kumar

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Practicing since :2000

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What is the cause and treatment for erectile dysfunction?

Brief Answer: You need to meet in person with a psychiatrist Detailed Answer: Hi XXXXXXX Thanks for using healthcare magic. First regarding the test they are absolutely normal and there is nothing in the tests which shows something grievous. I agree with your previous doctor that testosterone level of 386.52 is whithin normal range and the reports vary from one laboratory to another. You need to check the reference value of laboratory where the test are conducted for you. Ed can be due to multiple factors and psychological means there is no abnormality in the system but the excessive anxiety makes the penetration impossible. Generally this is the most common cause of ED worldwide and fortunately it is treatable. Regarding your current medication I do not have any data but I am sure that these are not meant for the long term treatment. You may need to continue for months or years with these medicines without much improvement. So in my view stopping these medicines are not a bad idea. What you are receiving in these medicines, you can get the same chemical in one piece of onion and garlic. Before we proceed further I have few questions for you 1 Do you have any sexual experience? 2. If yes what was the result of intercourse 3. Do you get your penis erected while you come out of the bed or in early morning 4.Do you have erection while watching porn 5. Do you masturbate, if yes frequency per week Please revert with these details so I can primarily determine whether it is psychological or otherwise. I hope to see you again. Thanks and Regards Dr Ashok