Hello
Thanks for using DoctorSpring.com for posting your query.
I have gone through your question in detail and I can understand what you are going through.
Firstly we need to differentiate whether the erectile dysfunction is organic (physical) or psychological. From the description that you have given it appears more to be psychological. Abrupt onset of dysfunction with occasional improvement in functioning and the age you are in suggests that physical causes are not very important. However still to ascertain, it would be wise to do a penile dopler study to look for the penile vascularity. This can be done with artificial penile stimulation through phentolamine ( Pharmacological induced penile erection). If there is a good erection by PIPE then probably the cause is psychological. Mostly psychological causes are not treated with medicines. ormally the patients who visit my clinic have had past traumatic experiences with sexuality or they feel that sex is a bad thing in life or have unexplored subconscious emotional conflicts with their partner which manifests as sexual dysfunction . Occasioanlly even work stress can also lead to this problem. Manytimes the cause cannot be unfolded. Now this illness cannot be helped with medicine and will require psychological help. This is done by a sexologist or a psychiatrist who would like to explore your thoughts about sex and correct them where they are wrong with the cognitive behavioural therapy. Also a therapy called sensate focus therapy is also useful in such cases. In this therapy person should not make insertion as a part of sex and instead have only foreplay with no compulsion for sex for 1-2 weeks so that the patient becomes comfortable with the sex. During this phase the female partner should not touch the genitals of the patient. Now that the compulsion to have sex is solved and hence the confidence improves. I suggest some of my patients to even use aromatic oils for increasing the pleasure. After 2 weeks, you may begin with permission to touch the genitals but still not the actual intercourse. Then after 2 weeks, intercourse may be initiated.
This will take time but things will settle down with time...
Kind regards
Dr. Srikanth Reddy MD