FrankTalk.org

Hi all,

I'm new here, and wanted to give an introduction to my experiences and frustrations.

I'm 22 years old, and I've experienced a degree of erectile dysfunction for some time now. During my late teens, I remember a few instances of difficulty achieving an erection with my girlfriend at the time, but I would definitely chalk those experiences more up to nervousness than to anything else. I went through a pretty bad break-up with her, and didn't have sex again for about 2 years. During that period, I remember becoming somewhat concerned that the quality of my erections during masturbation was somewhat diminished, and at times, I had difficulty staying erect at all. I was quite depressed at this time (and for part of it, I took SSRIs, though I have been off of them for a year now) I got into another relationship, and had a lot of difficulty performing with her at the start. Eventually, things improved, and I could successfully have sex most of the time, but there were still instances where I failed or had difficulty. I broke up with her, and have since only attempted sex once, with an embarrassing lack of success. This affected me quite a bit. Since then, even masturbation has been about a 50/50 prospect for me. I've seen doctors about my problem. The first indicated that the fact that I could achieve erections at all indicated that there wasn't a serious issue with the mechanics of my penis. I still had my issues though, with very few morning or spontaneous erections, though they do occur at some times. Another doctor recommended a testosterone test for me, which came in at slightly below 400 (the test wasn't taken in the morning, so it may not have been a completely accurate representation of my normal levels). He didn't feel this warranted treatment, though he did refer me to an endocrinologist, and I discussed my findings with him. he explained why he felt he agreed that treatment likely wasn't warranted, and suggested that my mood (I still have depression issues) and habits may actually affect my hormone levels. I was prescribed cialis, which usually helps a good bit (at least on my own,a s the opportunity to test it with a woman hasn't presented itself just yet), though even with it, I sometimes have issues achieving an erection.

I am a medical student, and as such I have a pretty good understanding of the mechanics and biological processes of erection. I'm well aware of the significant affect one's mental state can have, and given that I've always had a good deal of anxiety about sexual issues, I'm aware that this could all be in my head, but I still have a number of concerns about other potential causes. I've read a lot about the different etiologies of erectile dysfunction, and I'm concerned that my comparatively low testosterone for my age may be producing the issue. I'm also concerned that my problems may be due to a venous leak, which seems a particularly difficult form of the disease. I'm curious to see how the experiences of others with such etiologies compare to my own experience in order to figure out what t expect and how it would be best for me to proceed.

Thanks.

-Razor12

Hi Razor,
matey, I am 59 y/o, but have had problems for 15 years or more but have finally done something about it.
I had depression bought about my low self esteem in not being able to hold or at times attain an erection.
The more failures I had, the more depressed i became until it got to the point that I did not bother with sex at all save for masturbation.
Like you even masturbating did not always give me a firm erection.
Things got so bad I looked elsewhere for sexual gratification away form the norm.
Finally followed up on trimix at a clinic here in australia.
had achieved great results and even though the urge for sex is not always there, I feel quite staified that I can now inject my old fella and achive a good erection.

Do hope you work things out.

cheers


pete

Thank you. I'm gad that things are working out for you.

I really just wish I could believe my doctors' suggestions that it's likely a psychological issue rather than a physiological one, but that's not easy for me to accept, and if it is the case, I'm not sure of the best way to overcome it.

Razor,

I hope you will consider specializing in urology, as your personal perspective on this should give you an empathy for your patients with ED that is sometimes lacking in doctors who haven't experienced it. It takes lots of introspection and reflection to connect the dots on what might lead to ED, and I really suspect that the anti-depressants played a major role in this. It seems to be a vicious circle, as ED causes depression and anti-depressants cause ED. I sometimes wonder whether anti-depressants cause long-term, but hopefully not permanent, changes in our brains that studies haven't documented yet. I would like to think that we can counteract or overcome those changes. Recreational drug use, including too much alcohol, is known to result in ED, as has smoking. I'm sure that as a medical student you know well how important diet, exercise, and sleep are to our mental and physical vitality. It seems worthwhile to have your testosterone level checked again. At age 71 I take regular testosterone shots, and I take daily Cialis 5mg and have early morning erections of the kind that I had when I was your age. Stay with us and keep us posted on your progress in conquering your ED, as we all know how vital that is to your life.

Longjohn

While I won't completely dismiss the possibility of SSRIs being at the center of my present issues, I have my doubts. The vast majority of people that have such problems from SSRIs regain full functionality after cessation, and their issues are more frequently associated with a loss of desire and sensation, which isn't really my problem. I'm not even convinced that those that have persistent sexual dysfunction after stopping SSRIs are actually experiencing a side effect of the drug, seeing as the depression and anxiety that would lead one to take these medications in the first place can easily be accompanied by sexual dysfunction.
Plus, I think I had some issues before I began the drugs.
Though if that IS the cause, perhaps there's room for hope, as most people that experience this eventually recover functionality.
Regardless, I fully intend to get over my issues, if they are psychoogical or completely manage it (and possibly recover) if the cause is physiological.

Razor:

I can relate, my friend. I too have had problems since my teens. I will agree, sort of, with some of your doctors. Part of the problem is in your head. Just like one athlete or team can "get in the head" of the other and convince them they are inferior, your experience and your own thoughts have got in your head to the point you expect to have problems. That said, the cure for that is success. You need to find something, (thought about shots? the porn stars use them for a reason!) anything, to give you an erection that just won't go down. It is amazing how much fun you can have with sex when you don't have to concentrate on keeping your dick hard, just on how good it feels! You need a f___ buddy that knows of your problem and won't judge you, a true friend to help you. Good luck!

Dave

Razor,
Wanted to wait to comment on your situation. Did any of your doctors do a full physical on you? Blood work, everything? ANY DOCTOR who did not do this should be fired now. It is now considered standard procedure to rule out any and all underlying factors - especially in a guy as young as you are. Because the practice of medicine is largely following patterns, most docs will look at a guy like you and find some way to justify their first impression that your ED is psychogenic. It's what they do. The easiest, and most logical (to them) reason is that you are bringing this on yourself. Therefore, they try to support that assumption.
Bottom line, at 22 you should be waking with a raging erection every morning...and the slightest breeze should get you aroused. You should be able to masturbate 5 times a day and have no trouble getting hard. For them to not pay attention to the fact that you are NOT waking every morning with an erection and that you do not get hard instantly while mastubating is unforgivable.
You must go immediately to a male sexual medicine specialist. Not just a urologist. Uros get almost NO training in ED treatment. Even the ones who claim to be the "ED guy" in their practice, usually have only taken a couple of continuing education courses. Where do you live? Get used to saying "This is not acceptable".
contact me if you want to talk further.
Paul

Yep, "this is not an acceptable outcome" was my mantra. Fortunately, my entire medical team (cardiologist, cardiac surgeon(s), internist, and urologist) agreed. From what I'm reading about your doc, maybe you should fire his happy ass and find a new doctor. Just saying.

Greg
Baton Rouge

My primary physician tested my testosterone levels, which came back in normal ranges, though somewhat lower than average for my age. He didn't feel this warranted TRT, though he did refer me to an endocrinologist for a second opinion on that matter. The endocrinologist came to the same conclusion and suggested that lifestyle adjustments may improve the numbers and my functioning. I haven't seen my primary doctor since then, and honestly I feel he's done everything that could reasonably be expected of a primary care physician in this situation (performed diagnostic tests he was capable of, referred me to relevant specialist, etc.). He did prescribe me cialis, which yields results more often than not. I'm sure if I went back he would refer me to a uro. I'm somewhat limited by my insurance in terms of what physicians I can go to, so it will not really be possible for me to seek out a male sexual health expert at this time.