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Urology (Expert Forum)
erectile dsyfunction (physical or psychological?)
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.
erectile dsyfunction (physical or psychological?)
by Jef-B, Sep 01, 1998 12:00AM
Hi. I am a 31 year old male who currently suffers from erectile dysfunction. My doctor tested my blood and testosterone, and everything from the lab report looks normal. He suspected that possibly some bouts with depression over the last few years may be the culprit, so he prescribed Wellbutrin, which I have been taking for about 3 weeks now. While I do feel better, there has been no change in my erections, though I'm still waiting.
For the past several months I have been unable to even masterbate. Sometimes I will have an erection in the morning when I wake up, but it subsides immediately if I try to masterbate. Apparently, the relaxation from sleep can produce an erection, but physical stimulation does not. My doctor gave me some Viagra samples, and it seems to help, however, a great deal of physical stimulation (and time) is required BEFORE achieving an erection.
It seems to me that I (at least) should be able to masterbate when I have a morning erection, when I am the most relaxed. This suggests to me that my problem may be physical in nature, and not purely psychological. Yet my doctor is reluctant to refer me to a Urologist. What do you think? Do the symptoms I have related to you suggest that the cause may be physical in nature? If so, how can I convince my doctor to refer me to a Urologist? Any help appreciated. thanks
jeff
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Dear Jeff,
Erectile dysfunction is a common problem. The factors associated with erection problems include medical conditions (diabetes, hypertension and heart disease) as well as psychological factors such as depression and anxiety. The ability to achieve erections adequate for sexual intercourse requires that all of the nerves arteries and vein to the penis be functioning appropriately and that the overriding psychological state is positive. The exact mechanisms that cause erectile dysfunction in the depressed or anxious person is not completely understood but these are well known to occur.
In your case, the fact that you are awakening with morning erections is encouraging. Medical conditions such as those mentioned earlier often cause cessation of the morning erections.Men with depression and other psychological conditions often maintain this ability. This is most likely why your doctor is hesitant to send you to a urologist. I agree with him. It may be worthwhile to see a sexual therapist or psychologist as counseling often helps in these situations. This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).
HFHS MD-KR
*keyword:erectile dysfunction
For the past several months I have been unable to even masterbate. Sometimes I will have an erection in the morning when I wake up, but it subsides immediately if I try to masterbate. Apparently, the relaxation from sleep can produce an erection, but physical stimulation does not. My doctor gave me some Viagra samples, and it seems to help, however, a great deal of physical stimulation (and time) is required BEFORE achieving an erection.
It seems to me that I (at least) should be able to masterbate when I have a morning erection, when I am the most relaxed. This suggests to me that my problem may be physical in nature, and not purely psychological. Yet my doctor is reluctant to refer me to a Urologist. What do you think? Do the symptoms I have related to you suggest that the cause may be physical in nature? If so, how can I convince my doctor to refer me to a Urologist? Any help appreciated. thanks
jeff
------------------------------------------------------------------------------------------------------------
Dear Jeff,
Erectile dysfunction is a common problem. The factors associated with erection problems include medical conditions (diabetes, hypertension and heart disease) as well as psychological factors such as depression and anxiety. The ability to achieve erections adequate for sexual intercourse requires that all of the nerves arteries and vein to the penis be functioning appropriately and that the overriding psychological state is positive. The exact mechanisms that cause erectile dysfunction in the depressed or anxious person is not completely understood but these are well known to occur.
In your case, the fact that you are awakening with morning erections is encouraging. Medical conditions such as those mentioned earlier often cause cessation of the morning erections.Men with depression and other psychological conditions often maintain this ability. This is most likely why your doctor is hesitant to send you to a urologist. I agree with him. It may be worthwhile to see a sexual therapist or psychologist as counseling often helps in these situations. This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).
HFHS MD-KR
*keyword:erectile dysfunction
