Erectile Dysfunction (no doc has had an answer)
Hi - I'll start by saying my problem has been going on for years, since I was a teen. I am now 39. After years of doctor visits, testing and different medications...nothing has changed my ED problems. But it's more complex than that. I have 2 kids, have generally been able to get a sufficient erection with my wife when we do have sex, but the erection is smaller than it should be and hard to explain, but there is a tightness sensation around the base and throughout the shaft. When my penis is flaccid and I squeeze it gently, it almost feels like there is no smooth muscle tissue inside. I can feel straight through to the urethra (if that's indeed what I feel inside). So my penis when flaccid is also shrunken/constricted and has a sort of uncomfortable tingling sensation. Here's the strange part though...the doctors I have all seen say everything "looks" normal and that it is likely psychological. I have used papaverine injections many times and they do give me erections - sometimes longer than I prefer. But with those erections, I still feel like the caverns on the side of my penis are not expanding as much as they should. I also should add that I do not get morning erections. My erections for masturbation are about a 6 out of 10 and I am able to ejaculate. But there have been a few instances - one when I traveled to the Bahamas with my wife where my penis all of a sudden was in a flaccid state that provided a lot more comfort, was more full (expanded but still flaccid) when flaccid and I had a much higher sex drive. When we came back home, it went back to the usual way. Another time it was more engorged (not hard, but just a more normal flaccid state and not so constricted) was when I first met my wife and was very excited about meeting her and the sex. That lasted a short time and then it went back down to the usual. And a third more recent time it went back to normal (and I also was getting rock hard nigh time and AM erections) was when I was working out a little more often and one morning I just woke up and my flaccid penis was about 3-4x larger (length and girth) than it has been and I was able to get 10 out of 10 erections on my own. That lasted about 2 weeks and then it just went down again and I can't seem to get it to stay the way it should be. I know that's the way it should be because I have normal sex drive, morning erections and no tingling sensation when it is fuller. I am on Clonazepam for anxiety, but the "normal" times have come and gone when I was on the clonazepam so I don't suspect that is the problem. It's not physical because there are the rare times when it becomes normal (full erections day and night and no tingling). I just had my testosterone test and it was 433 and my cortisol was 16 - both apparently normal. I tried rhodiola rhodesia for stress but it hasn't helped as I thought it was stress. But again, I don't get nightime erections or AM erections at all when I am in this state. So I have come to the conclusion that physically, I am fine. However, it must be a hormonal imbalance that is out of my control, but stress levels and testosterone seem fine. I often am somewhat irritable and feel kind of down, so thought it could be something with testosterone, but again, that is 433 and the doctor's assistant called and said it's normal. So what else can it be? I have a doctor appointment with my urologist on 3/15 but I know he'll just say use Cialis as it will help relax those constricted smooth muscles in the penis. That may possibly help, but Cialis doesn't fix the problem. Are there other hormones that can be tested where I might find out what causes my penis to constantly be in a state of what I would call "flaccid constriction" - almost like when you go in to fight or flight mode and the penis constricts...except mine seems to stay like that all of the time, including no AM erections. Does it have something to do with nitric oxide deficiency? Again, I suspect a hormone imbalance of some kind that is not allowing the caverns to relax and allow normal blood flow, including when I am sleeping. I also did the sleep test where they wrap a ring around the penis to see if it breaks during the night and and no erections was the result. So it can't just be plain stress since I'm calm when sleeping. That's why I think it is a chemical imbalance. Plus, when I went to the Bahamas, it went normal while there. And after working out (though that didn't last) it went normal...for a while anyway. Sorry for the long post but if anyone has any suggestions on a particular type of doctor, questions to ask, tests to request etc. I would greatly appreciate it. It's no fun living 24/7 with this constricted and tingling feeling in my penis and difficulty in getting decent erections. Thank you in advance for all help and suggestions.