ED

I've been having performance problems in bed for as long as I've been sexualy active.  I'm 26 years old and in spectacular shape (never taken steriods though); however,  I do take ritalin for ADHD.  I've even tried cialis and well it helped for a few weeks, it seems that it is no longer working for me.  I don't have this problem when I masturbate only during sex.  I'm engaged and my fiancee doesn't really care but my self image is horrible.  I can't go to a doctor because i don't want this sortof thing recorded on a permanent medical record (I also dislike the medical community in general as they often seem to think they're above me).
Chances are this is a mental problem rather than a physical one, is there anything I can do that doesn't involve visiting a doctor?

[Kevin Pho, MD]

I'm always going to suggest seeing a physician.  Keep in mind that whatever is recorded is 100% confidential and will be available only to health care professionals and yourself.  

Testing for metabolic disorders - like thyroid diseases, testosterone deficiency, and diabetes - should be routinely done.

You can also consider an ultrasound the penis to ensure proper blood flow.

If there are no physical causes, psychological causes can be considered.  

These options can be discussed with your personal physician or urologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b