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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 49215
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I have quite severe ED, but mentally I am extremely

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I have quite severe ED, but mentally I am extremely attracted to my female partner. My partner is very much turned on by some of my touching in various places on her body. She holds back from orgasm in fear of it embracing me. Obviously I am extremely embarrassed of my lack of an erection but mentally I am very turned on. We do think the world of each other, but I wonder how long this will last. We are in our seventies and are both widowed, however she can get turned on ready for sex very quickly. My GP has prescribed Sildenafil 100mg tabs but she prefers I don't use them.
JA: The Psychologist can help. To begin, how long have you been taking Sildenafil? Any recent changes in dosage?
Customer: It has bee prescribed but I haven't used it yet at my partner's request
JA: Thanks for that. How have you been sleeping? Any insomnia or other issues?
Customer: Not real sleeping problems, but I feel so strongly for her I do think a lot about her at night.
JA: Thank you so much for your answers. Finally, is there anything else in your medical history the Psychologist should know?
Customer: Yes I necessarily take medication for heart issues and rheumatoid Arthritis.

You should use Sildenafil, this is the first option.

Or you may get it investigated. If your testosterone may be low, you can get replacement therapy.

You may get the following investigations done;

1) All hormones; thyroid, prolactin, testosterone, adrenal functions.

2) Autonomic nervous system testing;

Penile thermal sensory testing

3) Somatic nervous system testing;

Penile glans biothesiometry

Bulbocavernosus reflex latency test

4) Penile magnetic resonance imaging (MRI)

5) Penile angiography

6) Duplex ultrasonography

7) Combined intracavernous injection and stimulation

The treatment would entail;

1) Selective PDE5 inhibitors are safe and effective (sildenafil, vardenafil, and tadalafil). So this is not only the first line but one of the best. The other things which can help are;

2) Vacuum Devices for Inducing Erection

3) Intraurethral Therapies

4) Intracavernosal Injection of Vasoactive Agents; you can be taught to take the injection.

Was this information helpful to you?

Please feel free for your follow up questions.

I would be happy to assist you further if you need any more information.

Thanks for using Just Answer.

Customer: replied 4 days ago.
I did get a blood test for a lack of testosterone and the result was "normal for may age" however as I understand it this might still mean it's quite low? The list of "investigations I might get done" is this something I need to show my doctor?

The doctors (the specialist is a urologist, but some of these can be done by your primary care physician) usually know these tests.

The investigations are done in steps.

Wishing you a speedy resolution and all the very best in life.

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Stay blessed.

Stay safe,

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