Is it erectile dysfunction (ED)?

Posted by kleinbottle @kleinbottle, Feb 12, 2023

So, things start off fine. Foreplay exciting. But, shortly after beginning intercourse erection is gone. ED or some sort of psychological issue?

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What is your age? .. Are you overweight? .... what medications do you take? ..all these are factors ..sounds like you have venous leakage .. meaning the blood goes into the penis and you get an erection but then it leaks out which the position you are in ...effort etc .. have you tried any ED medications?

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73, not overweight. Take metoprolol and lisinopril for bp management. Have not tried any ED meds. Thanks for your reply.

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Get checked out by your PCP or see a urologist.

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Hi @kleinbottle, as this article from Mayo Clinic states: https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776
"Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction."

I agree with @jenatsky that you should talk with your doctor to rule out physical causes and/or possible medication factors and to look into what's going on.

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@kleinbottle
I read 32% of men who took metoprolol reported having ED however I can't speak to the accuracy of this number.
I have Epilepsy and a large number of men with epilepsy have ED. Mine is believed to be caused by long-term seizure medication use which caused Neuropathy.
You need to discuss this issue with your physician.
Jake

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I have a number of spine issues and now I need to use catheters and now I have started ED issues. My urologist believes it all caused by my spinal issues; I am 65 and I keep having problems with spinal problems that surgeries can fix it is the scar tissue’s from past (8 surgeries) operations. I feel like I just keep waiting for the next problem as the years go by.

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ED causation is complex to diagnose and many PCPs and "regular" urologists are ill-equipped to work through the required detailed diagnostic regimen. I ended up with both a quality diagnosis (they used an ultrasound to identify blood flow issues) and a successful treatment plan after visiting a urologist with an ED focus at a high-quality medical facility.

Along my multi-year process, I gained the impression that some providers call themselves ED experts while what they only really can do is write you a Rx for one of the usual ED drugs. There are so many options beyond the blue pills...

I am not a conspiracy theorist in any fashion - but I do think there can be an element of "snake oil" salesmen in some ED practices. For me, when the supposed ED specialist urologist suggested a penile implant was the next best step - I knew I needed a different approach.

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Uncertain as to how to proceed....tried to discuss my concerns with likely ED issues to my urologist. His response was that ED is the "Canary in the Coal Mine" with regards to potential cardiovascular issues. He stated that my ED concerns were more related to my use of BP meds (Losartan + HCTZ) and Cholesterol -lowering meds. I also take Gabapentin (400 mgs) only at night for chronic but moderate back pain following Fusion of L4 L5. He just wrote a script for Viagra. Discussed same issue with my PCP, and his response was nothing more than a script for Viagra. When I suggested various tests to explore diagnosing cardiovascular issues, his response was along the lines of "Well we can obtain various test results, but not certain these results are in and of themselves, all that helpful". I don't think that is a satisfactory answer. Not certain which medical provider I should believe or where to proceed? kugrad1975

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@kugrad1975

Uncertain as to how to proceed....tried to discuss my concerns with likely ED issues to my urologist. His response was that ED is the "Canary in the Coal Mine" with regards to potential cardiovascular issues. He stated that my ED concerns were more related to my use of BP meds (Losartan + HCTZ) and Cholesterol -lowering meds. I also take Gabapentin (400 mgs) only at night for chronic but moderate back pain following Fusion of L4 L5. He just wrote a script for Viagra. Discussed same issue with my PCP, and his response was nothing more than a script for Viagra. When I suggested various tests to explore diagnosing cardiovascular issues, his response was along the lines of "Well we can obtain various test results, but not certain these results are in and of themselves, all that helpful". I don't think that is a satisfactory answer. Not certain which medical provider I should believe or where to proceed? kugrad1975

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Go to a urologist that ED is his specialty... when you look up drs in your plan you will find some that treat ED as part of their practice .. I went through the same thing for years before they start putting stents in my heart ... then found out 6 of my meds could cause sexual issues .. if you end up needing an implant don't wait too long like I did.

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@kugrad1975

Uncertain as to how to proceed....tried to discuss my concerns with likely ED issues to my urologist. His response was that ED is the "Canary in the Coal Mine" with regards to potential cardiovascular issues. He stated that my ED concerns were more related to my use of BP meds (Losartan + HCTZ) and Cholesterol -lowering meds. I also take Gabapentin (400 mgs) only at night for chronic but moderate back pain following Fusion of L4 L5. He just wrote a script for Viagra. Discussed same issue with my PCP, and his response was nothing more than a script for Viagra. When I suggested various tests to explore diagnosing cardiovascular issues, his response was along the lines of "Well we can obtain various test results, but not certain these results are in and of themselves, all that helpful". I don't think that is a satisfactory answer. Not certain which medical provider I should believe or where to proceed? kugrad1975

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I recently went to a highly qualified urologist, and he was equally unhelpful. He immediately went to the only options for me were 1.) Injections (probably Trimix), and 2.) Penile implant.
nothing else. Then he rushed out of the room and that was it for my appt. He dismissed my claim that free testosterone should be looked at. I do take losartan 50 mg and 200 mg of gabapentin, and I showed him my meds list and he barely glanced at the list, saying none of those are responsible. I'm trying another urologist soon as well as a surgeon who specializes in the penile implants. Still gotta press on with the doctors. Most act like they could care less. Read the blogs on this Mayo Clinic website, you must be ab advocate for yourself. Read up. If you go online, look at anecdotal videos of men of all ages and what they went thru before getting to get a penile implant.

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