Psychological erectile dysfunction

Thanks. Here are my responses:

1. Age,sex,weight,body and face appearance, country, occupation.
ANS. 43, male, 68 kg, 178 cm. Living in New Zealand and in the lecturing line.

2. Main complaints and other associated troubles.
a)Where is the trouble; The exact locality of the complaint like hands,legs etc; duration of trouble.
ANS. General weakness in erection, both physical and psychologically caused that erection doesn't last long or lasts very often at the point of penetration.
2.
b)What exactly do you feel, Sensation as pain, how pain feels or burn etc.
ANS. Anxiety and stress during performance and a constant conscious awareness as to whether erection is maintained.
c)What are the factors that causes this trouble according to you.
ANS. Might have been the many years of masturbation that have weakened the erection. Psychologically, due to lack of confidence and the negative feedback I received from my ex wife during our sexual encounters of my performance. Once I suffered erectile dysfunction and that triggered fear of failure that perpetuates a negative cycle of thought. Erection dies at point of penetration or when fumbling with condoms.
d)Condition under which the complaint is reduced or you feel better like,cold or hot application,cold or hot weather,position as standing,walking,rest etc.
ANS. NA
e)Condition under which the complaint is increased like,cold or hot application,cold or hot weather,position as standing,walking,rest etc.
ANS. Condition worsens when I become more worried or fearful of failure.
f)Any other complaint any where in the body.
ANS. I also suffer from frequent urination problems. Otherwise health is good.
g)Onset time of troubles in detail, i.e which came first, after that what problem and so on.
ANS. About 7 years ago.
h)Treatment method adopted and its result.
ANS. I have tried ayurvedic and homeopathic medicine with varying levels of success. Usually Viagra seems to help.

3. History of diseases in family.
ANS. None of this sort of problem.

4. Personal History.
a)About childhood.
ANS. Dysfunctional upbringing where parents didn't have a harmonious relationship and sexual abuse was there for my mother.
b)Academic performance.
ANS. I was reasonably good in my studies.
c)Any major incidents in life and the effect of it on life.
ANS. Dysfunctional upbringing did have an emotional scar and made me feel negative about life. A failed marriage made it worse.
d)How you are satisfied with your sex life, friends, family members, company etc.
ANS. Not satisfied with sex life. Nothing great at home with family but now peace is there. A few but good friends.

5. Habits/Addiction.
a)Smoking, Alcohol,Sleeping pills, Laxative etc.
ANS. Social drinker. Nothing else.
b)Masturbation and frequency.
ANS. Used to be very frequent in the past – sometimes twice or thrice a day. Now drastically reduced as my libido level has gone down.

6. How is your Appetite and Thirst.
ANS. Generally good.

7. Likes and Dislikes.
a)Alcohol Bread Butter Bitter Salt Sweet Sour Fats Milk Mud Chalk Egg Spicy food Meat Fish Fruits Fried Food
Warm food-drink Cold food-drink Ice Ice cream Chocolates Tea Coffee.
ANS. I like sweets and spicy food. I like chocolates esp very much. I also like fried food.
b)Anything else about like and dislike of any activity with you or surrounding.
ANS. I like quietude, reading, meditation etc. I don't like overcrowded places, materialistic people.

8. Bowel movements.
a)Nature of stool, frequency, satisfactory or not.
ANS. All good now.
b)Any discomforts associated with stool.
ANS. None.

9. Urine.
a)Frequency, nature, volume.
ANS. More than frequent at times. The problem started three years ago but now is much better thogh there are period when I need to urinate and urinate a lot at 15 mins intervals.
b)Any discomfort before, during or after urination/odour
ANS. No pain or discomfirt. A check with urologist showed nothing was wrong.

10. For men.
a)Any difference in erection/want of erection/weak erection/Ejaculation early/late.
ANS. As above, libido levels have gone down. Erection happens but dies and cannot be sustained for long. If I am able to penetrate, ejaculation happens 1-2 mins later.
b)Any other trouble in sex.
ANS. As above.

11. For Females.
a)Menses, Regular, Irregular,Early, Late.
ANS.
b)Duration of menses.
ANS.
c)Nature of flow, Scanty, Blood colour, Consistency, Odour, Staining, itching/ when and what makes it worse/better.
ANS.

12. Sleep.
a)The quality of sleep, the quietness or restlessness of sleep,
position of sleep, times of waking and reasons for waking,
need for cover over various parts of the body,
whether the window must be open or closed etc.
common dreams, peculiar sounds or gestures during sleep, etc.
ANS. I sleep generally ok though there are periods when I suffer from insomnia, esp if I am stressed out.

13. Sweat
a)How much, what parts, staining, Odour.
ANS. I sweat normally and I sweat a lot under my armpits. No unusual odour.

14. Weather
a)Tolerance to heat and cold, dryness, humidity, weather changes, sun,
foggy weather, wind drafts, closed rooms, etc.
ANS. I am ok with hot weather but struggle in cold weather, be it air con or winter. I need layers and dislike cold weather.

15. Mental Status
a)The quality of the patient's life in relationship to loved ones, family, friends and colleagues. Overall quality of energy available to function in daily life, and under various circumstances.
ANS. Generally mentally not at peace. Not much family love and few friends.
b)Any mental/emotional shocks occurring in the patient's life-grief, major financial losses separation from loved ones, death, identity crisis and other stress in life.
ANS. Dysfunctional upbringing where my parents weren’t harmonious together, poor relationship with sibling and failed marriage and relationships with women.
c)Memory,ability to concentrate/comprehend.
ANS. Usually all good.
d)Are you fearful of anything eg: Animals, people, being alone, darkness, death, disease, robbers, thunder, storm, high places.
ANS. Nothing really. Fear of sex nowadays.
e)Are you anxious about anything: if yes, give details.
ANS. Whenever I think of sex. There is a desire to mingle with women but when it comes to actual sex, I do get fears, nervousness and lack of confidence.
f)Are you impatient.
ANS. Usually no.
g)Are you doubtful or suspicious.
ANS. Yes sometimes of people I meet.
h)Are you hurt easily (emotionally)how do you react. Does it cause hatred/revenge.
ANS. I don't get hurt that easily and if I do, I just try to forget and move on. Rarely any feelings of revenge though at times a dislike for the person might persist for a while and then that too disappears.
i)Does your pride get hurt easily.
ANS. Not really.
j)Are you depressed, if so, reason/circumstances.
ANS. Yes often nowadays. Over sex and life in general and the direction in which it is going.
k)Do you like to share your problems.
ANS. Yes with a select few people whom I am comfortable with.
l)Effect of consolation.
ANS. Usually there is temporary relief.
m)Do you ever become suicidal when? How.
ANS. No but chronic depression has happened.
n)Memory- quality if poor, for what ( eg. Names, places, people, what you read).
ANS. No such problems
o)Do you weep easily, effect of weeping, ie, does it make you worse or better.
ANS. No I don't weep.
p)Are you easily irritated. What makes you angry, how do you express it.
ANS. Not really though nowadays that seems to be on the rise.
q)Are you destructive.
ANS. No
r)How good are you in making decisions.
ANS.
s)Do you like company or like to remain alone.
ANS. Usually alone or with a few people I am comfortable with.
t)How seriously are you affected by disorder and uncleanness in your surroundings.
ANS. To a limited extent but not too drastically.
u)How does failure appear to you?
ANS. It might be disappointing
v)Are there any matters that you deeply dislike?
ANS. Dishonesty, betrayal of trust
w)What activities you deeply like? How does it affect your mood?
ANS. Meditation, being with nature and like minded people
x)Are you affectionate? How does others sorrow affect you?
ANS. Yes quite affectionate and I express it though I can restrain my feelings too. Others sorrows can make me emotional and tear up at times.
y)Any present fears in your life or future.
ANS. As to whether I can find a good life partner.
z)Any present life or future life desires.
ANS. To do something meaningful for orphans, to feed poor and help the under priviledged.

Thanks. Will try and revert back dr.

Hi doc,

I have taken the two day course. I still have more dosage of the medicine. Should I just wait and see to examine effects?

Sleep, fatigue, urinatio etc seem better. But cant see much in terms of erection but then I have not been involved in the act. What I dont see a difference and would like to see significant improvement is sexual desire - in fact I see it going down. Pls advise. Thanks.