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Question:
i would like to ask i have been unable to keep an erection for over a yr now but i still have a high sex drive and i get pleasure with my girlfriend but the minuite i have sexual intercourse i cant keep an erection i am still able to get erections but i cant stay like that for very long im not always able to experience ejaculation aswell

Answer:
by Hussein Ghanem: (06/14/2004)
You need to visit an Andrologist / Sex therapist to determine the nature of your problem whether psychcogenic or organic. Generally the most important causes of erectile dysfunction include: PSYCHOGENIC FACTORS: Most important factors are performance anxiety (fear of failure during intercourse) & depression. ORGANIC FACTORS: - Vascular: Example athersclerosis & related risk factors (Diabetes, Hypertension, high cholesterol and smoking. - Neurogenic: Example multiple sclerosis, spinal cord injury, neuropathies, and radical pelvic surgery. - - Endocrine: Mainly Diabetes, decreased male hormone levels or elevated Prolactin, or disturbed thyroid hormone levels. - - Drugs: Medications: e.g. some antihypertensives, antidepressants, antiandrogens & major tranquilizers Cigarette smoking Alcoholism Recreational drugs: e.g. Marijuana & Heroin - - Other diseases: Erectile dysfunction might be associated with liver, renal & heart disease.. For general information purposes, I am enclosing this general classification of therapy for erectile dysfunction. Therapy is generally classified into first line, second line, and third line treatments options. In persistent cases, It may be helpful to get the man to obtain erections through medication in order to overcome the psychogenic factors. Please check my recent article on this subject http://www.sexualhealth.com/fullstory.cfm?id=33 Treatment decision-making . 1st line therapy (Oral erectogenic agents): e.g. Viagra and new medications in clinical trials Vardenafil & Cialis; Vacuum devices; Couples/sexual therapy . 2nd line therapy (Local treatments): Intraurethral alprostadil; Intracavernosal self injections . 3rd line therapy (Surgery): Mainly for persistent physical problems. Best wishes, Hussein Ghanem, MD

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