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Dr. Arun Phophalia
Dr. Arun Phophalia, Urologist
Category: Urology
Satisfied Customers: 44146
Experience:  MBBS MS (Surgery) Vast experience and routinely perform all urology procedures including endoscopy.
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I'm wondering who can help with erectile dysfunction issues

This answer was rated:

I'm wondering who can help with erectile dysfunction issues
Assistant: Have you seen a doctor about this yet? What medications are you taking?
Customer: I have seen a doctor and a urologist. Urologist said my testosterone was on the low side of normal and I had a cpl of testosterone injections. But they made no difference
Assistant: Anything else in your medical history you think the doctor should know?
Customer: Which doctor? You?

What is your age?

Since when are your symptoms?

Are you on any medications?

Customer: replied 9 days ago.
I'm 49
Symptoms since 2013
Not on any official medications but was taking a natural supplement similar to viagra

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Customer: replied 9 days ago.
The supplement had been working until very recently

One of the commonest cause of erectile dysfunction is psychological issues like depression, anxiety, etc.

While low testosterone can affect the libido, in the range testosterone is not likely to be the sole culprit. ED is likely to be a complex problem which may have multiple reasons playing together.

A single erection problem plays in the mind. This can give in the back of mind performance anxiety and you start watching yourself more closely. This close scrutiny of yourself can lose the concentration from the sex and you get a bit softer. Please remember sex is not in the organ but in mind. Once you start enjoying it you will regain the same strength. Nothing happens suddenly in sex, it is like sports, sometimes you excel and sometimes you are mediocre. If your wife/partners are part of all this understanding you would be back to your best. Don't put yourself under the scrutiny and just start enjoying it. Things are likely to come back to normal.

You may need psychosexual therapy which helps to reduce performance anxiety, develop the new sexual skills and knowledge, modify negative sexual attitudes, and improve communication between both of you. Involving the partners in the counseling process and psychosexual therapy helps dispel misperceptions about the problem, decreases stress, enhances intimacy and ability to talk about sex, and increases the chances of a successful outcome.

Still, if you feel that problem can be organic; you may consider consulting a urologist who would advise you the following investigations;

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

You may consider taking Viagra, Cialis, or Levitra, meanwhile.

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Customer: replied 8 days ago.
I was referred to a psychosexual therapist but my issues started gradually over time so we both agreed it was probably more physiological/hormonal.How do I go about requesting those various tests?

Your GP may need to refer you to a urologist who would do these tests.

Customer: replied 8 days ago.
Would those penile tests you suggested be available on the NHS?

Yes, sure. These tests in all likelihood would be available on the NHS.

Customer: replied 8 days ago.
Ok...cos what has got me worried recently is on the head of my penis, at the bottom, it has become swollen/inflamed over the last few months. It doesn't hurt or itch and when I went to a GUM clinic they tested for infections that came back negative.
I'm wondering if something is happening internally and causing it.

Swelling, inflammation in the head of the penis is likely due to some local issue in the penis. It is not likely due to internal organ issues.

Customer: replied 8 days ago.
It just seems coincidental that in the last week or 2, the supplement I used to gain an erection, doesn't seem to work anymore. So it seems like I can't have sex til I find a resolution to this. Which is worrying.

You may take Cialis which is a good drug. Your GP can write a prescription for it.

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

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Stay blessed.

Customer: replied 8 days ago.
I will ask him for it, tho I was interested in more natural remedies.I can't see where to rate you. You've been very helpful

There are some herbs which too may help you;

1) For increasing libido, ambrein, a major constituent of Ambra grisea, is used.

2) Bufo toad skin and glands contain bufotenine.

3) Chinese medicine, Panax ginseng.

Please see reference;

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3731873/

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