Hello
Thanks for using Doctor Spring for posting for posting your query.
I have gone through your question in details and I can understand what you are going through.
However I would require a couple of more details to help you in answering your query in a better justified way.
1. When you wake up in the morning, is there a penile erection?
2. How is the erection on masturbation? Is it weak there as well?
3. Since how long have you noticed the problem?
4.By erectile problem do you mean to say that "your penile erection is less even before ejaculation " or you mean to say that "ejaculation occurs early and then the erection is lost."?
Hope to hear from you at your earliest convenience.
Regards and wish you good health,

Dr. Srikanth Reddy MD
Neuro-Psychiatrist and Sexologist

Hello, thankyou for the reply,
These complains are very common and I see many such patients in my clinic. The fact that you are able to attain an erection in the morning rules out the organic causes for the erectile disorder. Its unfortunate that you are not able to get the same erection during the sexual act or masturtabtion but you can be sure that your genitals are perfectly fine. The reason is psychological and the problem is in the mind. It has to do something with your early sexual acts/trauma or the way you think about sex. Probably there is some urgency or concern or pressure to perform or some problem with the way you think about sex. And this disturbing thought is basically making you loose erection. You will need intensive sex therapy and cognitive therapy to overcome this problem.
Also possible is the relationship issue. Many times there is a problem in the relationship among the partners which finally reflects as difficulty to have an erection and do sex. For this illness sensate focus therapy is a very good option. In this therapy sessions for the first 2 weeks, partners take turn to stimulate each other without touching the genitals. Some may use perfumes or creams or oils as well. In the next two weeks genitals can be used for stimulation but the actual sex is still prohibited. This 4 weeks session is done without the pressure for performance on the man and instills lot of confidence in him. then after 4 weeks, regular sex is started.
You need to see a sexologist or a psychiatrist for this purpose who will evaluate you in detail face to face and identify the exact problem with your thinking or relationship with your partner and try to correct it.
Believe me, this problem is not going to correct itself with time or even with medicines. So the ones which are available over the counter like viagra for erectile dysfunction may not be useful for you.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.

Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.

Hello
Thanks for the add on information. I guess the sexologist you saw is not an allopathic or modern medicine doctor. He has prescribed you so many herbal preparations.
Your low testosterone levels and high triglycericed need to be teated but they are not related to the erectile dysfunction. Low testosterone levels will have effect on the sexual desire and not on the penile erection.
I have suggested that your erectile dysfunction is not organic and use of viagra may not help you.
As I said before rather than medications its the sensate focus therapy done by both the partners can help in improving your problem. It will take some time but believe me there is no quick fix solution for your problem.
The medications which can work are basically bupropion or venlafaxine if the erectile dysfunction is due to underlying depression or anxiety.
Viagra may help you temporarily but its not a permanent solution. You may take 25 mg or 50mg per day 1 hour before sex but try avoiding the herbal preparations as there are not many randomazed controlled trial showcasing their benefit.
Regards
Dr. Srikanth Reddy MD