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Urology (Expert Forum)
Infection and Erectile Dysfuntion
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Infection and Erectile Dysfuntion
by kdouglas, Apr 29, 2004 12:00AM
I am a 38yo male. I have always had a healthy sex drive, stamina, etc. Up until this problem, I've been about 20lbs overweight, but exercised 2-3x per week. My last long term relationship (2 yrs ago) was filled with sex sometimes multiple times/night,with sometimes little rest between erections. When we broke up 1yr ago, I started drinking a lot and was depressed for about 8 mos. My sex drive was very low. I found at that point I had high blood pressure (~150/90 at times), which I had not had earlier.
I slowly started dating again, but continued to drink. I had 2 other partners in the last 8 mos, and erections were still not that slow. Last Nov I think I got a ut infection through anal sex. I was prescribed Doxycycline, and it seemed to go away. It came back, but maybe because of more anal sex. I got fully scanned (HIV,gon,Chlm,syph, herps,Hep, etc) and only Herp showed up as expected (type1 and exposed to 2, assymtomatic). my symptoms seemed like track inf, feeling like I had to go all the time, and slightly sore at head. Another Dr said I had PPP.
In March I started dating someone seriously, started exercising a lot (losing weight cycling, running, and training for competitive waterskiing), and my drinking is almost nill now (1/night), but I noticed a slight ED issue. I can't get erect without manual stim, and went limp during sex once. I went to a Urologist this time. He confirmed PPP, and prescribed same med as above, but 2x21 day instead. Pain still comes and goes, and I'm scheduling another appt, but to get to my question...
What are the chances that my ED issue is physical and not mental? It does not help that my new girlfriend is disappointed when she doesn't see me with an erection. To her, that is the indicator that I'm ready, so she becomes ready. Her disappointment does not help. She is just now reading that things change when men approach 40's. So part of it could be psychological. I feel like I'm ready, and that I should be erect, so I don't think that an aging thing should come so abruptly. I've always been a little slow to get there, but maybe I've had a problem all along and haven't known it. Question 2: Is there any data that exists showing the psychological impact of watching porn or masterbating (masturbating) frequency compared to arousal when not doing either of those (ie can one become calous to normal sex)? One would think with the intense workout schedule I have now (1-2 exercises per day, at 45-90 min each), that I would be healthier, but I still need sustained manual stim to keep going. I'm wondering if I have some kind of a blood flow problem, and am worried about someone wanting to put me on blood pres med, which is suppose to make it worse.
Suggestions/Ideas?
Thanks, Kevin
I slowly started dating again, but continued to drink. I had 2 other partners in the last 8 mos, and erections were still not that slow. Last Nov I think I got a ut infection through anal sex. I was prescribed Doxycycline, and it seemed to go away. It came back, but maybe because of more anal sex. I got fully scanned (HIV,gon,Chlm,syph, herps,Hep, etc) and only Herp showed up as expected (type1 and exposed to 2, assymtomatic). my symptoms seemed like track inf, feeling like I had to go all the time, and slightly sore at head. Another Dr said I had PPP.
In March I started dating someone seriously, started exercising a lot (losing weight cycling, running, and training for competitive waterskiing), and my drinking is almost nill now (1/night), but I noticed a slight ED issue. I can't get erect without manual stim, and went limp during sex once. I went to a Urologist this time. He confirmed PPP, and prescribed same med as above, but 2x21 day instead. Pain still comes and goes, and I'm scheduling another appt, but to get to my question...
What are the chances that my ED issue is physical and not mental? It does not help that my new girlfriend is disappointed when she doesn't see me with an erection. To her, that is the indicator that I'm ready, so she becomes ready. Her disappointment does not help. She is just now reading that things change when men approach 40's. So part of it could be psychological. I feel like I'm ready, and that I should be erect, so I don't think that an aging thing should come so abruptly. I've always been a little slow to get there, but maybe I've had a problem all along and haven't known it. Question 2: Is there any data that exists showing the psychological impact of watching porn or masterbating (masturbating) frequency compared to arousal when not doing either of those (ie can one become calous to normal sex)? One would think with the intense workout schedule I have now (1-2 exercises per day, at 45-90 min each), that I would be healthier, but I still need sustained manual stim to keep going. I'm wondering if I have some kind of a blood flow problem, and am worried about someone wanting to put me on blood pres med, which is suppose to make it worse.
Suggestions/Ideas?
Thanks, Kevin
Doctor's Answer
by Kevin Pho, MD, Apr 30, 2004 12:00AM
, Apr 30, 2004 12:00AM
It is difficult to say what the chance is the ED is due to psychological vs physiological reasons. However, I can suggest further tests to elucidate a cause. Certainly the alcohol won't help - increased use can lead to erectile dysfunction. The lack of sex drive may be cause by a low testosterone level. Having your physician test for a free testosterone level can be considered and treated if this is the case.
As for the second question, I am not aware of data suggesting a connection between masturbating frequency and arousal.
I would suggest obtaining a testosterone level. To evaluate the blood flow to the penis, an exam to evaluate the groin pulses as well as an ultrasound can be considered.
Regarding the blood pressure medication - not all of them increases erectile dysfunction. The class known as beta-blockers would probably have the most impact.
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.
Thanks,
Kevin, M.D.
As for the second question, I am not aware of data suggesting a connection between masturbating frequency and arousal.
I would suggest obtaining a testosterone level. To evaluate the blood flow to the penis, an exam to evaluate the groin pulses as well as an ultrasound can be considered.
Regarding the blood pressure medication - not all of them increases erectile dysfunction. The class known as beta-blockers would probably have the most impact.
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.
Thanks,
Kevin, M.D.
