Straker said:
Thank you for your reply. Despite what I said in my previous post I am really having problems accepting that my libido and ED problems are psychological. This is not due to misplaced pride or embarrassment but because of the timing of the onset of my difficulties (coincided with cycle) and also because I do not get any spontaneous erections (morning woody or any other time). I am prepared to entertain any possibility of the root of my problem because i am so desperate to sort it out. Is there any way to definitely tell whether my problem is physical or psychological?
I see you are also in the UK. Could you recommend any specialists that might be able to help, if this is a psychological problem?
thanks.
If you're not getting morning wood - then that often indicates low levels of circulating free testosterone. It could be that your estradiol (E2) is high - this would have the knock on effect of increasing SHBG, so your free-test (which drives libido) could be low... I'm speculating here so what you really need is a full range of hormonal blood work.
I would guess you may be shut down to some degree and in addition the stress / anxiety of the situation is making matters worse.
If you would like me to recommend a hypnotherapist let me know your location via PM and I'll try to advise someone who is local to you.
As for a specific recommended specialist (London based) check your PM.
Alternatively (to save money) you could ask to be referred out to your local endocrinologist / therapist via your GP.
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From:
http://www.regentsparkclinic.com
What are the commonest causes of erection problems?
Erection problems can be caused by:
1. Physical factors
2. Psychological factors
Or 3. A mixture of physical and psychological factors - (Sig) NOTE: Which may possibly be your situation.
Physical Causes
There are many physical causes, which tend to occur in the older man (over 50 years old) and tend to start gradually and slowly get worse. Examples of physical causes are:
1. Damage to the nerve supply to the penis such as in diabetes and multiple sclerosis.
2. Damage to the blood supply to the penis such as with high blood pressure, atherosclerosis, and diabetes.
3. A lack of hormones required for such as testosterone or thyroxine.
4. Prescribed drugs can effect erections such as those for high blood pressure, depression, schizophrenia, and epilepsy.
5. A high intakes of substances such as smoking, alcohol, cannabis, heroin, and cocaine.
Psychological Causes
It is surprising how one episode of being unable to get or keep an erection can lead to such anxiety which then leads to further episodes of erection problems and so on in a vicious cycle. When psychological factors predominate the problems is often of a sudden onset and is variable over time and in different situations. Some factors include:
1. Stress, anxiety, and tiredness
2. Relationship problems such as poor communication, poor understanding and habitual conflict.
3. Decline in sexual interest
4. Depression
Regents Park Clinic will carry out a full assessment by taking a medical history and asking questions about the problem, about your sexual relationship/s, and about stresses such as work or money problems.
After that they will do an examination, which includes taking a blood pressure, and examining the heart, abdomen, and genitals. They check the nervous system by doing your reflexes and the blood supply by checking the leg pulses.
Finally they will check the urine for glucose to rule out diabetes, and do a blood test to check kidney function (U&E’s), liver function (LFT’s), thyroid function (TFT’s), and a testosterone level.
(Sig) Note: You may want to go in prepared and have a list of what you want back from the blood test - i.e.
Testosterone: (10.4-40.6) nmol/L
LH: (1.7-10.5) IU/L
FSH: (1.55-11.74) IU/L
SHBG: (7-50) nmol/L
- Free Testosterone ratio -
TSH: (0.49 - 5.0) mU/l
E2: (12 to 46) pg/ml - (5.37-65.9) nmol/L
Prolactin: (58-416) mU/l
DHT: (36-573) pg/ml
Free T4: 1.0 (0.7-1.9) nmol/L
Cortisol: (4.5-22.7) nmol/L
DHEA (180-1250) ng/dl
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