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ERECTILE DYSFUNCTION QUESTION:

I am 23 years old and I am suffering getting hard and staying hard problem since last 2 months, not so much erection as before so very difficult to intercourse..what are the causes and suggest remedies or supplement, please

DOCTOR ALSAYES ANSWER:

Let me first point out to you that erectile dysfunction has many factors and underlying causes, one of these aspects are the psychological aspect.
A psychological aspect can in form of anxiety or pressure to perform under heightened anxiety, or acute stress disorder, or Low sex drive due to underlying cause (as a bad memory from a previous relationship).

Watching pornography and masturbation more frequently can also lead to erectile dysfunction during actual sex relation. Some studies have found that frequently masturbating to porn can contribute to ED by desensitizing you to certain imagery and physical intimacy. We must first identify the cause and then treat it accordingly, in your case, I advise you first to visit your doctor and make some evaluation tests to exclude any medical/physical cause, and if all tests came up negative then your doctor will advise you on how to deal with your stress and performance anxiety or he may refer you to a psychotherapist.

In the meanwhile, I advise you to establish a healthy lifestyle by exercising regularly, eating healthy food (low cholesterol), and stop or avoid alcohol and tobacco as they both contribute to ED. These steps will help you regain your normal erection faster.

I hope this answers your question.

Thanks, Dr. Alsayes

ERECTILE DYSFUNCTION QUESTION:

My partner is 47 going on 48 and I am about 15 years his junior. The last 2 times that we have been intimate, he was unable to keep his erection. The most recent occurrence, he needed to take a couple of breaks. He would be inside of me then he would go soft.

We then took a break and cuddled for a while and then he got hard again and went back in but then got soft again. After the third time of this, he was able to ejaculate. And I am totally fine with that! I enjoy lovemaking with him just as much. Why does h need to do that (i.e. Stop in the middle)?

Is it me? Do I simply not appeal to him anymore :*(. I do want to talk to him about it but I don’t know how without upsetting him. All I can say is, without saying anything, he knows I know he is having difficulty maintaining an erection. What I do say is just that it’s ok and we do whatever feels natural or good at the moment.

I don’t know what else to do or say. Help!

DOCTOR ALSAYES ANSWER:

First of all, you must know how important it is for you both to communicate about this. It’s your intimate life and you must communicate about it freely and more often ensure a healthy relationship sexually and emotionally.

What your partner is going through is most probably an erectile dysfunction (ED) case. And ED has many factors and underlying causes, one of these aspects are the psychological aspect.

A psychological aspect can in form of anxiety or pressure to perform under heightened anxiety, or acute stress disorder, or Low sex drive due to an underlying cause.
Watching pornography and masturbation more frequently can also lead to erectile dysfunction during actual sex relation. Some studies have found that frequently masturbating to porn can contribute to ED by desensitizing you to certain imagery and physical intimacy

Alcohol drinking and tobacco or any smoking can also contribute to ED.
Health issues like high sugar level and high cholesterol can also lead to ED.

We must first identify the cause and then treat it accordingly. I advise your partner first to visit a doctor and make some evaluation tests to exclude any medical/physical causes, and if all tests came up negative then his doctor will advise him on how to deal with his stress and performance anxiety or he may refer him to a psychotherapist.

In the meanwhile, I advise him and you to establish a healthy lifestyle by exercising regularly, eating healthy food (low cholesterol), and stop or avoid alcohol and tobacco as they both contribute to ED. These steps will help him regain his normal erection faster.

I hope this answers your question.

Thanks, Dr. Alsayes

ERECTILE DYSFUNCTION QUESTION:

I have been using 36 hour Cialis for almost 15 years. I have noticed it has not been effective the past month or so. Can Cialis lose its effectiveness after using it for that long?

DOCTOR ALSAYES ANSWER:

First of all, it’s very important to point out that none of ED medication would ever work without a sexual stimulation. These medications are designed to increase the blood flow in the penile tissue leading to the erection in the presence of sexual desires. So if you are “not in the mood” or stressful or out of focus, you will find these medications useless at these moments.

On the other hand, these medications can be affected by food or alcohol. For instance, fatty meals are the enemy of Cialis, they can make it harder for the medicine to reach the bloodstream. So make sure you avoid them just before taking the Cialis. Make sure you at least have 2 hours after last meal and before taking Cialis.

Also, It’s common for the human body to build up a tolerance to drugs. And since you have been using Cialis for a long time and frequently then your body may have built some level of tolerance to the medication and that’s why it’s not effective as it once it was for you.

In this case, you may change to a different type, such as Viagra, or you may increase the dose, let’s say if you are taking 5 mg then shift to 10 mg (which actually the recommended dose) and see how your body will react. Also remember to take it on an empty stomach or two hours after eating the last meal, and 1 hours before the intercourse. Let’s see how that would work.

I hope this answers your question.

Thanks, Dr. Alsayes

ERECTILE DYSFUNCTION QUESTION:

I started using creatine monohydrate powder about a week ago. The instructions read that l must take a measurement of 5ml 5 times a day for One week and after that take 2 times a day until it’s finished.

Since I started using it my sex drive has gone completely to zero. Sometimes l don’t even feel my 4-5.

May it because of creatine or intensive working out.

DOCTOR ALSAYES ANSWER:

Yes, it’s most probably due to the creatine powder.

Actually, some recent studies found that daily long-term usage of creatine can lead to a lesser sex drive and a decreased production of testosterone hormone, which eventually means erectile dysfunction.

I’d suggest you use creatine sparingly or at the very least lower your dosages.

I hope this answers your question.

Thanks, Dr. Alsayes

ERECTILE DYSFUNCTION QUESTION:

I am 20 years old and have never ejaculated nor have I ever had a wet dream. Twice I woke up with pain while having an erotic dream. I’ve never finished masturbating because either I lose focus or feel start to feel pain. I’ve been to a couple urologists, but none seem to help.

I’m sure there might be a psychological factor like all the urologists suggested, but I’m almost sure there is a biological factor as well. I get frequent Balanitis, and pain when I urinate. I also have an autoimmune disease that involves streptococcus infections.

My testosterone is 552, SHBG 15 (range is 10-50). I had an abdominal CT scan (showed small phlebolith), and abdominal ultrasound, testicular ultrasound (showed varicocele). I was wondering if anyone knew what could cause this other than it being psychological.

DOCTOR ALSAYES ANSWER:

I’m, sorry? You said a couple of urologists said it ’s psychological? How is that possible when you say U/S showed a Varicocele?
Most probably that could be the causes of your problem.

It must be evaluated because moderate to severe Varicocele can lead to such complaint.

Also, a frequent Balanitis is not a something that should be missed or underestimated by a urologist. There should be tests and evaluation to identify the cause and prescribe the proper treatment.

You need to see an experienced urologist for evaluation.

Thanks, Dr. Alsayes