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Dr Uzair
Dr Uzair, Doctor
Category: Medical
Satisfied Customers: 6575
Experience:  MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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I'm a 26 year old healthy man. last three years now I have

Resolved Question:

Hi, I'm a 26 year old healthy man. For the last three years now I have been unable to achieve and/or maintain an erection. I travel around a lot and everytime I go to the doctors they just give me cialis. Don't think it works very well anymore, the other day i took 2 and nothing despite having to hottest girl id ever taken home in my bed. Im extremely attracted to the female form but for some reason am not as aroused by it as I used to be. Used to be I'd see a pair of boobs and spring to attention. Now it seems I have to make my excuses and hope for a morning glory to keep my honour intact. It's stressful, embarrassing and has to stop. I just want to be able to have sex unaided again. Is my bloodflow poor? Testosterone to low? Estrogen too high? Help Please. 'PoP another pill' I'd not the way I want to live my life.
Thanks
Austin
Submitted: 9 months ago.
Category: Medical
Expert:  Dr Uzair replied 9 months ago.

Hi and thanks for the query.

You are right. Popping a pill every time at your age is a temporary solution. However, for your reassurance, if you have the occasional morning erection called Nocturnal Penile Tumescence (NPT), then your problem is not a permanent one. Having an NPT means that the mechanism responsible for causing an erection is intact, however, not being able to maintain it is the problem. This is known as inorganic erectile dysfunction and is due to performance anxiety, increased stress levels (physical or mental or both).

It attains the form of a vicious circle and the anxiety promotes to further stress and this goes on.

I would encourage that you visit a Sex therapist for counselling and some tests to rule out hormonal fluctuations, blood flow and nerve issues first. Once, these are ruled out attention can be paid to solving the inorganic ED issue. This is mostly resolved by counselling, exercises, anxiolytics and techniques that help boost the self confidence.

Let me know if you have further questions.

Please do not forget to leave a positive rating by clicking on stars on top right corner.

Wish you good health

Expert:  DrRussMD replied 9 months ago.

Hello

It can not be stated that your problem is only from performance anxiety.

You can still get morning erections with low T and from other causes. And in fact physical causes are on a spectrum, and can start with intermittent dysfunction. It is with advanced disease that complete impotence occurs and you don't want to get to that stage.

Cialis would not be indicated for psychological causes: therefore, find out what diagnosis your doctors are using.

Thyroid disease and other undiagnosed diseases.

Heart problems.

Diabetes.

Prostate disease.

Alcohol.

Medications.

See a medical doctor first.

I am a double board ceritified clinical doctor.

You have not stated that you have any anxiety at all, but this would be another cause of this problem.

However, anxiety can be secondary to medical causes as well.

I would suggest

A: Internal medicine doctor and urologist evaluations.

B. Then, depending on findings, psychiatric or psychological evaluations.

Customer: replied 9 months ago.
Thanks for the reply.
I feel the morning erection's are few and far between now also. It's more my lack of desire to actually have sex thats got me worried. I love sleeping with women but I can't. This is why it's got me thinking it's a hormone imbalance or something.Cheer's
Austin
Expert:  DrRussMD replied 9 months ago.

OK

The progression of a loss of morning erections means that this can be a disease state.

Low testosterone is very possible as you describe this.

You should have the following tests

testosterone

free testosterone

bioavailable testosterone

SHBG

thyroid function tests

adrenal function tests.

good luck.

please click a positive rating [hopefully excellent—that’s how we are paid, per rating]. If you forgot something, come back. I am here http://www.justanswer.com/medical/expert-dr-thomas/

Expert:  Dr Uzair replied 9 months ago.

Thanks for reply,

Yes that is what i have already told you to get these hormone levels so that exact cause can be found and treated accordingly.

Let me know if you have further questions.

Please do not forget to leave a positive rating by clicking on stars on top right corner.

Wish you good health

Dr Uzair, Doctor
Category: Medical
Satisfied Customers: 6575
Experience: MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
Dr Uzair and other Medical Specialists are ready to help you
Customer: replied 9 months ago.
Thank you very much, I'll take his information forward.
Kind regards

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