Hello,
Thank you for your query at DoctorSpring.com
Most men, at some stage in their life can have an occasional, temporary episode of being unable to get and keep an erection. Common reasons for this can be due to stress, tiredness, anxiety or drinking too much alcohol.
Your condition, is what is called erectile dysfunction and it can have physical or psychological causes or a combination of both.
Examples of some physical causes include: narrowing of the blood vessels in the penis (usually in patients with cardiovascular disease, high blood pressure or diabetes) OR hormonal condition such as thyroid dysfunction OR use of certain medications.
Psychological causes include depression, anxiety, fear of failing at sex, relationship problems with your partner.
One way to differentiate between physical and psychological causes is to know whether you still have nighttime erections. Men usually have between 3 to 5 spontaneous erections during sleep or when waking up. If you continue to have erections in your sleep, it is more likely that the cause of your problem can be due to psychological cause such as stress, tiredness or anxiety.
Also it would be helpful that should you decide to send a follow up question if you could attach reports of the blood work that you mentioned so that I get an indea of the tests that you got done.
Regards

Hello,
I have gone through your question in detail 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. Kindly answer these questions. It seems more like a psychological issue, however these questions specific reply will help me asses the situation better.

1. Do you get early morning erection when you wake up in the morning?
2. What happend when you masturbate? Do you get an erection?
3. Do you get erection these days when you see any sexually explicit material?
4. Any h/o hypertension or diabetes? Or any regular meds?
Hope to hear from you at your earliest convenience.
Regards and wish you good health,
Dr. Srikanth Reddy MD

Hello,
Its definetly an erectile dysfunction and the cause is psychological. At your age and the fact that some time erection is there and some times it is not suggests that organic causes can be ruled out.
Normally the patients who visit my clinic have had past traumatic experiences with sexuality or they feel that sex is a bad thing in life. 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 tehrapy 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 cumpulsion 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.
Hope this helps,
In case if you have any further query, do let me know.
Kind regards