Hello and welcome to Healthcare Magic. Thanks for your query. I can understand that you have been going through a lot of distress due to your sexual problems. From your description of your symptoms, I can see that you are having two problems: 1) Inadequate sexual desire 2) Erectile dysfunction Now, there can be a variety of causes for your sexual problems - both medical causes as well as psychological causes. So, the first and most important step in management 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. So, in my opinion, first diagnosing the problem is more important, so that treatment can be targetted specifically. I would advise 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) These tests will give you a clear picture about what your sexual problem is due to - any hormonal problems or any other systemic problems or local problems in the penis. According to the diagnosis, further treatment can be planned. Regards,Regards, Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.) Consultant Psychiatrist