Hello and welcome to Healthcare Magic. Thanks for your query.

Erection problems can be due to various causes - both medical causes as well as psychological causes. The first and most important step in management of this problem is proper evaluation. This will include a detailed medical, sexual, personal and social history, a thorough physical examination and certain investigations, as per the necessity.

Firstly, we need to find if there are any medical problems which are the primary cause of your erectile dysfunction. For example, blood flow problems, high cholesterol, hormonal problems, vitamin deficiencies, etc. need to be ruled out. For this, you may need to undergo a few blood tests.

Side effects of medication can also be a cause for sexual problems. In your case, one likely cause could be the side effect of the medications which you are on: neuro-psychiatric medication can very often cause ED.

I would also like to let you know that in a large proportion of cases of erectile dysfunction, psychological factors also play a major role in aggravating the problem. Stress, anxiety, depression, relationship problems, etc. can all influence sexual functioning in a negative way. Since you have mentioned that you have depression and anxiety, these could very well be contributory causes for your ED.

Treatment is targeted according to the findings on evaluation. If there are any underlying medical problems resulting in the erectile dysfunction, then those problems have to be first corrected or controlled. If there are psychological factors as well, then addressing them and improving the person's self-confidence levels will also be helpful in improving sexual performance.

I would advise you to first have a detailed assessment and evaluation done by a sexologist, so that further treatment options can be discussed and planned. I would suggest you to have the following tests:
1) Basic blood tests - including lipid profile (cholesterol), blood sugar, urea, creatinine, etc.
2) Testosterone levels - total and free testosterone
3) FSH / LH levels
4) Thyroid function tests
5) Ultrasound doppler of the penis (to check for any blood flow problems)

Alos, discuss with your doctor whether there you current neuro-psychiatric medication can be changed to something with minimal sexual side effects. Avoid alcohol, smoking or any unnecessary medication and try to stay stress-free and positive. Eating a healthy, nutritious diet and doing regular physical exercise is also important.

Wish you all the best.

Regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist & Sexologist

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