Intermittent ED

Hi - this is extremely extremely frustrating.  Sometimes, for days/weeks in a row, I have partial ED - I can't get an erection even when masturbating, and I don't really have nighttime erections either.  Then, for a couple weeks, everything is fine - including erections when masturbating and nightime erections.  Then, back to problems.  I've been to the doctor and had a physical, everything came back normal or great, with the one exception that my HDL was low.  My testosterone was approx. 460, which I understand isn't great but isn't in the problem area.  I didn't specically ask about diabetes but I assume that would have come out during either the bloodwork or the urine sample.  I do suffer from anxiety and depression, but at this has been going on for a couple years, I think the ED is at the root of alot of the depression so I hesitate to say that the depression caused the ED.  Sometimes Viagra/Cialis/Levitra work GREAT, other times, I get an erection but still not great.  

Questions:  1)  what do I do?  I'd say it was just "all in my head" - especially since it worked great for almost a month in a row when I was on vacation overseas a few months ago - but I can't say I "feel" different mentall when it is working or not working.  Could there be a diet element to it?

2)  Can taking an SSRI to control anxiety (and yes I know that they sometimes cause or contribute to a problem) help me here?  If the anxiety is conquered and I don't get the sexual side effects, could this be a solution?  

Thanks for your response.  This is stopping my life from moving forward at this point.

[Kevin Pho, MD]

To answer your questions.
1) I am not aware of specific diets that can affect erectile dysfunction.  There are some small studies that suggest that alcohol may exacerbate the dysfunction.

2) If anxiety is contributing to problems, an SSRI will help with that.  However, erectile dysfunction is a common side effect of SSRIs and likely would not help.  

I would consider an ultrasound to evaluate the blood flow to the penis.  This can be discussed with a urology specialist.  

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.
Medical Weblog:
kevinmd_b

[calaban]

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