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What Causes Difficulty In Getting Erections?

Posted on Wed, 22 Oct 2014

Question: I am embarrassed to ask my own doctor but at 48 I don't become aroused like I use to even 10 years ago. However I went for my physical 2 months ago, he was checking me for hernias and a prostate exam and I had an erection. Normally I dont get erections as often as I use to, but after that incident it was difficult to tell my doctor that I had a sluggish erectile response having had one embarrassingly in front of him. Is this normal or am I wacky? Thank you

Answered by Dr. Dr. Chintan Solanki (59 minutes later)

Brief Answer:
See detail answer

Detailed Answer:
Hello,

Thanks for writing to us.

As age increases, there is aging in all parts and function of the body which also includes erection capacity.

Are you normal or not, that is difficult to say from this narration.
Please provide me more details as below.

Do you have any hernia or prostate problem? If yes, give detail.

Do you use alcohol,smoke or any other substance? If yes ,detail regarding that.

Do you have Blood Pressure or diabetes or any other ailment? if yes provide details with medicines for the same.

And your question clarity! Are you asking also that you are not able to tell your doctor is the problem apart from erectile dysfunction(ED)?

I will be happy to help further, reply with details.

Thanks & regards.
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Chintan Solanki (1 hour later)

Hello - thanks for the reply. No hernia or prostate that I know of. I don't smoke, drink only once or twice a week 2 drinks XXXXXXX when I do. My blood pressure is borderline at times but I was told that I have " white coat" syndrome when my blood pressure is taken at the doctor's office. It drops after a second reading to a more normal level. It is being watched with possible medication if it gets too high. I am not diabetic. I guess I am saying if I get an embarrassing erection if being examined how do I ask if I have erectile dysfunction? Thanks for your time

Answered by Dr. Dr. Chintan Solanki (4 hours later)

Brief Answer:
you can start medicines

Detailed Answer:
Hello,

thanks for detail information.

Considering your physical health, I guess you do not have significant pathological Erectile Dysfunction(ED).

I can understand your embarrassing feelings.Sometime patient is not able to express his/her complain regarding sex to the doctor due to cultural,religious or personal view towards sex.

No doctor see patients complaint in awkward manner.As much as you can tell to your treating doctor about your problem, better the outcome. So without hesitation you can ask for help to your doctor for treatment of ED.

I can provide you treatment option as follows if I were your treating doctor.

I will check for your testosterone level.

If testosterone level is low, oral or injectable form of testosterone can be taken under medical supervision.

If testosterone level comes normal I will go for either medicinal approach and/or psycho sexual counseling therapy after discussion with you.

Medicines: Sildenafil 50 to 100 mg or Tadalafil up to 10-20 mg.These are same group(PDE-5 inhibitor) of medicines which should be taken one-two hours before sex after doctor's prescription.They are causing least side effects except morning headache in some patients, that is specifically with sildenafil less with tadalafil.

One recent molecule containing methylfolate and pyridoxal phosphate(vitamins, trade name tetrafol plus) taken to be two times daily after meal is also useful in some patients particularly with homocystiene deficiency.

Other medicines are trazodone and yohimbine which are useful in many patients in erectile dysfunction.But secondary choice.

Psycho sexual counselling cum psychotherapy for sex:

Sex is act of two.So preferably your partner should be involved in counseling, that's why it is called couple therapy.Master & XXXXXXX technique is specifically useful which can be learnt from psychiatrist/qualified sexologist.

Do not worry about embarrassing erection while examination and go to doctor for the treatment.

Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari