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What Causes Erectile Dysfunction Inspite Of Normal Testosterone Tests?

Posted on Thu, 15 May 2014

Question: Hello. I think I maybe having erectile dysfunction. My blood tests are normal. Testosterone, oestradiol, cholesterol and prolactin are within normal ranges. I also experience regular nocturnal erections and emissions. Cannot seem to maintain hard erection for vaginal penetration. What is my next course of diagnosing action? What should I do?

Answered by Dr. Dr. P. T. Patil (3 hours later)

Brief Answer:
It could be due to Performance anxiety.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you are facing problem in maintaining hard erection and in penetration of vagina during exual intercourse.

Looking at the facts that you are getting morning erection,night emission and all your common blood tests results being within normal limits it is unlikely that your problem in maintaining hard erection is due to organic cause..

In majority of cases it is mind related and due to what is called as performance anxiety.
Following measure will help you to boost up your confidence and getting good erection.and delay ejaculation.
1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.
2) Take high protein diet rich in vegetables and fruits and Vitamin A,C,D,E.and Zinc
3)Take anti oxidants like Almonds 5-6 everyday..
4) Avoid alcohol and smoking..

You may take Sidenafil (Viagra)as on demand to get hard sustainable erection to have enjoyable sex .

Consult your family physician for prescription and advice regarding dosage and timing of the drug to be taken.

Hope I have answered your query ,please feel free to ask if you have more questions ,
I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (20 minutes later)

hello. thank you for the reply. i was circumcised 4 years ago so im not sure if that has anything to do with it. plus i have vigoursly masturbated for many years. i have stopped for the last 4 months. could there be a venous leak? would there be any point in taking the doppler penile test? why would the erection even diminish from visual arousal after two or three minutes? visual stimulation doesnt have anything to do with performance anxiety.

Answered by Dr. Dr. P. T. Patil (28 minutes later)

Brief Answer:
Circumcision can not not be cause of your problem.

Detailed Answer:
Hello
Thanks for follow up.
I would answer your queries point to point .
1) Circumcision can not be a cause of your problem.
2) You do not have problem of ED but early ejaculation
3) Masturbation does not have any negative effect on any system or organ .
4) Venous leak can be confirmed only by colour Doppler study of penile circulation.
5) Sexual stimulation on visual arousal can stimulate brain and sympathetic system involved in erection and ejaculation to get early ejaculation even on visual arousal.

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (12 hours later)

Thank you. I understand.

Compared to 2 years ago, my genital feels spongier. If there was any damage to the corpora cavernorsa, how could I find out?

What could be the reason as to why visual arousal doesn't keep me erect for too long?

And also my doctor will not refer me for a doppler penile x ray because he sees there is no symptoms that are of a concern. Do you feel I need one? By what other safe means can I find out if I have a venous leak?

Answered by Dr. Dr. P. T. Patil (4 hours later)

Brief Answer:
Damage to corpora cavernosa will cause ED.

Detailed Answer:
Hello
Thanks for follow up.
Damage to corpora cavernosa will lead to erectile dysfunction.You can find it out on ultrasound scanning of penis.

Visual arousal will initiate erection but you need actual sexual stimulation (Vaginal Penetration) and to and fro movements to sustain erection and ejaculation.

Venous leak can be confirmed only.by colour Doppler Ultrasound scanning of penis There is no other test to confirm it.

Please have a trial of Sildenafil (Viagra ) for 2-3 weeks before you decide to get these tests done.

Thanks and Regards.
Dr.Patil.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj