Determining the cause of the erectile dysfunction

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MauvaisCoton

Hi everyone,

I've been dealing with mild to moderate erectile dysfunction issues for almost a year. While I respond well to Cialis, I'm scared of having permanent side effects such as vision or hearing loss and I also know that meds don't treat the cause of the erectile dysfunction. I'd like to start working on improving my erections so I can have a more satisfying, less stressful sex life. I need to have a plan.

Here are a few key facts:

  • My libido dropped after my ex girlfriend of 5 years broke up with me at the beginning of 2020. I'm in a new relationship now and it's slowly coming back, even though it's limited by my anxiety about erectile dysfunction and Peyronie's disease (I'm in the chronic phase but I'm almost always scared about it getting worse).
  • In the last few months, I became extremely anxious about my erections. I know my anxiety plays a huge role in making it difficult to achieve or maintain an erection. My therapist recommended I have sexual intercourse with my girlfriend without the pressure of getting an erection. He suggested I tell her in advance that no PIV is going to happen and that I'll be focusing on her pleasure only. I'll try that soon. I also meditate daily.
  • I have NTE's and, even though they are rare, erections in the morning. Most of the time, they don't feel full.
  • I eat a whole-foods, plant-based diet, I workout 3 to 4 times a week and my blood results are excellent. Testosterone levels are good too. No hormonal disbalance.
  • A Doppler exam hasn't been done by my urologist. Wait times in the public healthcare system are over a year. I could see a private urologist but the only one I can think of where I live is not specialized in Peyronie's disease.
  • I don't watch porn. I don't really feel the need to masturbate. My libido is still lower than it used to be.
  • I've been using RestoreX for 5 weeks now.
  • I take Cialis on demand (10mg) and it works well, even 24 hours after.

I want to know what is the cause of my erectile dysfunction. What do you suggest my next steps should be?

Thanks for your help.
30. Congenital curvature upward. Diagnosed with Peyronies Disease in 2017. Curvature near the base of the shaft (approx. 45° to the left). Still painful sometimes. Mild ED since summer 2020. Anxious.
Currently using RestoreX (since 04/21) and L-citrulline.

MauvaisCoton

I'd like to add a little more information. I've noticed that, when I try to get an erection but can't, the base of the shaft is harder than the rest of the penis. It's softer and more "spongy" after the location of the scar (dent on the left). Could it be the cause of my erectile dysfunction?
30. Congenital curvature upward. Diagnosed with Peyronies Disease in 2017. Curvature near the base of the shaft (approx. 45° to the left). Still painful sometimes. Mild ED since summer 2020. Anxious.
Currently using RestoreX (since 04/21) and L-citrulline.

MauvaisCoton

30. Congenital curvature upward. Diagnosed with Peyronies Disease in 2017. Curvature near the base of the shaft (approx. 45° to the left). Still painful sometimes. Mild ED since summer 2020. Anxious.
Currently using RestoreX (since 04/21) and L-citrulline.

Hawk

I appreciate the fact you would like to know the cause of your ED but since ED can be caused by a wide range of issues which require exam, tests, and diagnosis by trained medical personnel, how can non-medical guys who have never met you diagnose you?
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

MauvaisCoton

Hi Hawk, I appreciate your answer and you are right. I have another appointment coming with a urologist. Which exams or tests would you suggest I ask to help me get to the bottom of this? Blood tests have already been done and results are good. Would a Doppler be the only option left?
30. Congenital curvature upward. Diagnosed with Peyronies Disease in 2017. Curvature near the base of the shaft (approx. 45° to the left). Still painful sometimes. Mild ED since summer 2020. Anxious.
Currently using RestoreX (since 04/21) and L-citrulline.

Hawk

Do you know what blood tests were done and the specific results.  If you depend on him to decide on the blood tests with no consultation with you, then depend on him to just say " everything is good," then you are not taking an active role.  He should do at least a total AND a free testosterone, and your numbers should be in the middle or high range of normal, not the low side of normal.  Whenever I get a blood test, I ask for Vitamin D levels that are surely low for anyone in Canada.  It will not cause Erectile Dysfunction, but it is a critical hormone-like vitamin.

Next, I would get a Doppler Ultrasound on an ERECT penis.  If that reveals no venous leak, my next move would be to go to an endocrinologist for a total workup; estrogen, cortisol, etc.

If all of this checks out, you have to assume by elimination that it is psychogenic.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Mikel7

Quote from: Hawk on June 10, 2021, 09:33:03 PM
 He should do at least a total AND a free testosterone, and your numbers should be in the middle or high range of normal, not the low side of normal.

 This is so true.  Most Dr's will say you are normal just because it is within the suggested range. Ignorance is bliss.  Most men feel and perform much better at the higher end with their Testosterone levels anyway.
Lump 4/2020, age 62 , Dr Levine 6-26-20, Dors Curve 11/2020, Peyronies
Vit E400mg, COQ10, Heat Therapy, Penimaster, Pentox, Cialis, Restorex
SNHL 7/2020 - Stopped all Meds because ototoxicity  Heat/traction/VED are working. CPPS Diagnosis - Stable :)

porterrobinson

my uro said its enough dor a young man to be 300ng/dL or higher. totally nuts. male sexual health is being made a joke out of
single, mid 20
diagnosed early 2020
indentation 20 degree bent to left, recurrence with new indentation below glans
tried vacuum device with no success

Mikel7

That is so true.  There are very few Endos and Urologists who know how to treat male hypogonadism correctly.
Lump 4/2020, age 62 , Dr Levine 6-26-20, Dors Curve 11/2020, Peyronies
Vit E400mg, COQ10, Heat Therapy, Penimaster, Pentox, Cialis, Restorex
SNHL 7/2020 - Stopped all Meds because ototoxicity  Heat/traction/VED are working. CPPS Diagnosis - Stable :)