Erectile Dysfunction

I experienced mild erectile dysfunction from about 2000-2002.  During this time I only really had a problem if I had been drinking a bit (which I think is quite normal).
Then in 2002 I had unprotected sex and a few weeks later I got a sensation in my penis like there was something lodged in it. All tests (chlamydia, gonorrhea, syphilis and HIV have come back negative) Since about 2003 (I don't think the 2 things are related) I have been struggling to get/maintain an erection.  I still get morning erections most days but they don't seem quite as hard as they used to be. Also I have masturbated a fair bit (sometimes more than once a day and tended to contract my muscles to help keep an erection)

The urologist performed a prostate exam but this basically involve him putting his finger up it to see if it was sore. What I was wondering is could my symptoms be related to a prostate problem.  I, on occassion, have drank quite alot but there have been a few periods when I have given up alcohol completely for 40 days but have continued drinking coffee (5-10 cups a day) throughout.  Do you think my erectile dysfucntion could be as a result of a recation to coffee because i didn't drink that when I was younger?  I have noticed now after a night's drinking alcohol or coffee i get alot of discomfort (like a mix of pain and itchyness) in the anus and there is sometimes blood on the toilet roll.    Do you recommend I give up alcohol and caffeine (I also sometimes eat quite alot of spicy food)?  I do get alot of exercise (running/walking) but I do not have much in the way of muscle? would putting on muscle help me maintain an erection?  Sorry for all the questions but I really need help and I'm only 25.

[Kevin Pho, MD]

I am not aware of erectile dysfunction being associated with coffee.  There may be association with alcohol - you can try abstaining to see if the symptoms improve.  

If there is blood on the toilet roll, that should be evaluated by a physician to evaluate the cause (and perhaps consider a sigmoidoscopy).

You can evaluate a testosterone level to ensure it isn't low.  Low levels (hypogonadism) can lead to erectile dysfunction.  

I am not aware of erectile dysfunction being related to the amount of exercise.

These options can be discussed with your personal physician.

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

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