What Causes Erectile Dysfunction?

Posted on Mon, 26 May 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 26 May 2014 Answered on

Tue, 17 Jun 2014 Last reviewed on

Question : I have Ed. And i Have met many doctors who would give me tablets to enhance my sex. It does work. But no one ever tried to find out the root cause. I do not want to take tablets , I want to be diagnosed and find out what the problem is and fix it permanent if possible.
Below points might be helpful for u
I do have very good libido. I get turned on by even looking at girls
I sometime get up from sleep with errection
I can get errectyion. But I am not able to maintain it
I am 31 years old
My testosterone level was 400. Which is marginally OK.
Cialis work good. Even if I do lose errection I can get it back in a second.
When I get aroused I can feel the blood running to penis

Is it because the tissues in penis I weak? Or the blood? Or psychological?

Answered by Dr. G.Srinivasan (4 hours later)

Brief Answer:
Usually psychological.

Detailed Answer:
Welcome to the forum.
I went through your detailed history.
The fact that you have interest for sex, erections at night and get stimulated easily are good signs.
Also i understand that you get enough erection to start the act of sex , but is not enough for the whole act.
More than 90 percent of ED is due to psychological cause.
A specific cause is found in only 10 percent of patients, which are usually related to poor blood supply to the organ due to arterial/ venous cause or neurological disease.

The following things should help you.
1. Regular exercise regimen to keep weight under control and to keep the blood vessels healthy.
2. Quit smoking - if you happen to be a smoker.
3. Get blood sugar checked and treat if the blood sugar is found to be high.
4. Early and light dinner - to keep the stomach empty in order to have enough blood supply to the area of interest ( penis) rather than stomach.

Hope this helps,
Kindly write back for doubts if any---
Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (2 hours later)

can the poor supply to the organ be diagnosed? how do I confirm 100% that I have Ed because of psychological?
I forgot to mention that I do not smoke... and I have quit drinking 2 months ago
I was 71 kg with 5 6" height. and I started to work out a month ago and now I am 67.5 kg
I had minor sugar earlier so I have re tested again yesterday to see the latest result. I'll let u know once I get the result
is 400 testerostone level good enough for my age guys? I was thinking of taking natural testerostone enhancers.

Answered by Dr. G.Srinivasan (9 hours later)

Brief Answer:
Penile doppler study.

Detailed Answer:
welcome back.
Penile doppler can be done to check if your erection status.
It is done by doing ultrasound of the penis to check for blood flow in normal and erectile state.
If the test shows good blood flow, then it is declared as mind-set related.
In my opinion, it is not necessary as you get spontaneous erection.

serum testosterone seems to be normal but there is lab to lab variation and so if the value fits within the given range, there should be no worry.
Cessation of smoking and weight reduction ,will do wonders for you.
Kindly get back for doubts if any,
Sincerely,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (6 hours later)

i will update u tomorrow regarding testosterone result
as I told u I do not smoke .
I am working on reducing some fat though I look average already.

I can get penile Doppler done if it can confirm 100% that I am physically OK

Answered by Dr. G.Srinivasan (4 hours later)

Brief Answer:
Doppler not a must.

Detailed Answer:
Welcome.
I explained about penile Doppler for discussion.
I don't think you need it.
Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar