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What Causes Erectile Dysfunction?
Question: Thanks, I have an erectile dysfunction. I am able to get an erection, keep it and have intercourse but unable to ejaculate or orgasm. I am a 64 year old male in very good physical health. What could be the cause?
Brief Answer:
you need to be evaluated
Detailed Answer:
Hi XXXXX,
Thanks for writing to us.
Your problem is not erectile dysfunction but it is called anorgasmia(absence of orgasm)
Causes of this problem divided in two parts.
1. Psychological factors:performance anxiety, stress, problems in relationship, past sexual trauma or abuse,guilt about sex and many psychiatric disorders. Anti depressant medicines particularly SSRI- Selective Serotonin reuptake inhibitor are also an important cause.
2.Physiological/pathological factors: Anti depressant and some other medications, diabetes, hypertension, excessive drug and alcohol use particularly opioid and heroine, chronic back pain, spinal cord injury, multiple sclerosis, hormonal problems etc.
If you can find anything related from above factors in your case, late me provide more detail.
Otherwise following investigations are required:
Blood pressure,
Diabetes check up-fasting blood glucose,
Serum testosterone level
Prostate Sonography-Ultrasound
Serum PSA(Prostate Specific Antigen)
Evaluation by psychiatrist for psychological factors.
If you are taking any medicine, late me know.
I hope you have got important clues from this answer,
I am waiting for your reply to help you further.
regards,
Dr.Chintan Solanki.
you need to be evaluated
Detailed Answer:
Hi XXXXX,
Thanks for writing to us.
Your problem is not erectile dysfunction but it is called anorgasmia(absence of orgasm)
Causes of this problem divided in two parts.
1. Psychological factors:performance anxiety, stress, problems in relationship, past sexual trauma or abuse,guilt about sex and many psychiatric disorders. Anti depressant medicines particularly SSRI- Selective Serotonin reuptake inhibitor are also an important cause.
2.Physiological/pathological factors: Anti depressant and some other medications, diabetes, hypertension, excessive drug and alcohol use particularly opioid and heroine, chronic back pain, spinal cord injury, multiple sclerosis, hormonal problems etc.
If you can find anything related from above factors in your case, late me provide more detail.
Otherwise following investigations are required:
Blood pressure,
Diabetes check up-fasting blood glucose,
Serum testosterone level
Prostate Sonography-Ultrasound
Serum PSA(Prostate Specific Antigen)
Evaluation by psychiatrist for psychological factors.
If you are taking any medicine, late me know.
I hope you have got important clues from this answer,
I am waiting for your reply to help you further.
regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanks Doctor,
It is helpful. Further history:
Wife passed away 6 months ago.
I am taking 20mg Lexapro daily.
I have started a new relationship.
Recent physical and blood work and no blood pressure, PSA, testosterone or physical issues.
I should probably, with my doctor's input, reduce to 10mg Lexapro or discontinue.
Thanks
It is helpful. Further history:
Wife passed away 6 months ago.
I am taking 20mg Lexapro daily.
I have started a new relationship.
Recent physical and blood work and no blood pressure, PSA, testosterone or physical issues.
I should probably, with my doctor's input, reduce to 10mg Lexapro or discontinue.
Thanks
Brief Answer:
yes reduce lexapro or start bupropion
Detailed Answer:
Hi XXXXXX,
Sorry for your wife. Yes lexapro is likely to cause anorgasmia at dose of 20 mg. It should be reduce to 10 mg if your condition allows.
Another option is Bupropion .It has anti depressant property without effects on sexual life.
Wish you luck in new relationship.
Regards,
Dr.Chintan Solanki.
yes reduce lexapro or start bupropion
Detailed Answer:
Hi XXXXXX,
Sorry for your wife. Yes lexapro is likely to cause anorgasmia at dose of 20 mg. It should be reduce to 10 mg if your condition allows.
Another option is Bupropion .It has anti depressant property without effects on sexual life.
Wish you luck in new relationship.
Regards,
Dr.Chintan Solanki.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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