A Case of Psychological Erectile Dysfunction

"I guess that I was going through a kind of mid-life crisis and although I am happily married, I sometimes had problems getting an erection. I worried that it could be she was not as physically attractive to me as she once was.

Of course, I still love her dearly. I know that I do not have erection problems per se, as I still get good erections most mornings and when I am by myself."

Russell has a problem called psychogenic erectile dysfunction. He is able to get good erections on his own, but not with his wife. There are many reasons for this problem, including guilt, stress, insecurity and tension in the relationship.

We measured Russell's blood flow through the penis using echo Doppler studies and found it to be in the normal range.

We prescribed a course of treatment to ensure that he had an erection every time he made love regardless of his state of mind. He was able to overcome the nervousness and tension when he made love, as he had the certainty that he would not fail.

Not long after, Russell's confidence had been restored and he had overcome his fear of failure. He began to enjoy lovemaking once again and was able to stop using the treatment we prescribed.

A Case of Physical Erectile Dysfunction

George is a 68 year old diabetic. He was once a heavy smoker but he gave this up years ago. He used to work as a real estate agent and he was forced to retire 10 years ago due to the immense stress of his job.

"I retired shortly after my first heart-attack. My physician advised it, or he said that I may not see sixty. I also have high cholesterol and high blood pressure for which I take medication.

The thing is, I really feel young. Since I have retired, I have become active again. I now play tennis at the club three times a week and my wife and I swim most mornings, either at the beach if it is warm enough, or at the local indoor pool. I really enjoy life but for one thing it has been 10 years since I had my last erection.

I did try Viagra®, although my own physician advised against it. I was desperate I guess, and was prepared to try anything. Looking back, I wish I knew all the side-effects that Viagra® has, especially in someone like me with so many medical problems.

Well, Viagra® did kind of work the first few times that I used it but now, even using the strongest dose, it does not work. I was concerned about the effects that anay new treatment might have on my existing health problems. I put off making an appointment for several months. Now I wish I would have come in sooner.

We then examined him and measured the blood flow through his penis using an Echo Doppler and found it to be below the normal range. We also did biothesiometry studies to see if there was any nerve deterioration due to his diabetes. Fortunately, there was not.

We explained the results to George and recommended that we treat him using a combination of locally acting vasodilators. These medications are very safe to use even in people with as many medical problems as George.

We administered a test dose of medication in the clinic to make sure that it worked. He is now able to achieve erections on a regular basis and most of the time he can perform without the use of the medications we prescribed.