Hi this is regarding to the subject of my ED erectile dysfunction. Every morning when I woke up I can see my penis is in good erection. Sometimes when I masturbate I don't face erectile issues it's hard. But recently when I tried to have sex with my girlfriend I was not able to erect my penis and was unable to satisfy her. My penis had shrinked and I was very upset. I am about to get married in a couple of months and I need to know if there a problem in me. I already had sex with other lady 4 years back before I got into this relationship and also faced the same issue at my first attempt and Later same day I had good sex and even enjoyed thoroughly. I am totally confused with my ability. Need your valuable advice Is it a common issue guys face or I need to take more care of myself.

Dr. Sujoy DasguptaGynaecologist13yrs exp

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Erectile dysfunction (ed) occurs when the man is unable to achieve or maintain his erection of penis to meet his or his partner's sexual satisfaction. The problem is often faced by newly married men. Fortunately with experience, most of them are able to overcome this problem. Again it is increasingly common with increased age. So, what are the causes. In some male, it is psychological, caused by anxiety, depression, stress, marital disharmony etc. Use of alcohol and smoking will aggravate the problem. Psychological causes can happen at any age but more common at younger age. But in some cases, it is associated with serious diseases, especially at old age. It has been seen that in apparently healthy male ed is the first sign of heart disease. So, if you have ed, make sure that i's not caused by your heart problem. Again diabetes is another important cause. Excessive weight gain will also cause hormonal imbalance and thus problems in erection. Some hormone may also cause ed like thyroid, prolactin and even testosterone (male sex hormone). If you have chronic diseases like liver or kidney disease, it may also lead to ed. Diseases of nerves and spines should also be kept in mind. Sometimes, infections or tumour in private parts (prostate, testis etc) will also add to ed. Other diseases of penis like abnormalities in blood vessels can also be responsible, especially in young guys. Apart from these, some surgeries in abdomen and some drugs (like drugs to lower blood pressure, antidepressants, hormonal drugs etc) will also cause ed. Now, what you can do? If you want to suffer silently, you will land up in other problems like problem in sexual life, problem in family relationships, depression and even inability to make your partner pregnant. But do all men with ed have to go to doctor? Initially, the men should try life style modifications like avoiding smoking and alcohol; avoiding stress and anxiety; making good understanding with partner and also reducing weight. The partner should also have sympathetic attitude to the husband who is having ed. But if still the issue is not resolved you have to consult doctor. It's not a mater of hesitation or embarrassment, as you may think. Rather it is needed to ensure that you are healthy. So, your doctor will talk to you, will check you and try to find out if any cause is there or not (like heart disease, diabetes, hormones etc). He may order some basic tests to ensure that everything is alright. After that he will advise you the treatment. If the cause is found, treatment of the cause (like diabetes) may cure ed. Even if no cause is found, ed can be treated by various ways. But should you try the drugs shown in television or newspaper? Remember, drugs used in ed have important side effects and we advise drugs only when it is absolutely necessary. In most cases simple measures like stress reduction, exercise help. Sex counseling of both the partners helps a lot. And if still ed persists, we advise drugs. There are variety of drugs, all are having own advantages and disadvantages. Particularly sildenafil group of drugs can affect heart and retina. So, we always practice caution before prescribing such drugs. And when patients are advised such drugs we advise to inform us when he feels eye problems, chest pain, fainting or even painful persistent erection of penis (" priapism"). There are other drugs that can be applied directly over penis. Testosterone group of drugs are prescribed only in selective cases as they have serious side effects and even they can reduce the size of your testes. In some cases where drugs cannot be given or drugs fail, we advise penile implants or artiificial pump to maintain erection. Finally in very few cases, where blood vessels of penis is blocked, we can cure it by some operations. So, if you feel ed, don't get depressed. At the same time don't feel embarrassed to take medical help. Today's embarrassment may harm you in future. So, get cured and enjoy your personal life. 

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