Dr. Raveendran S R
Sexology
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Patient's Query
Hi doctor,
I am 32 years old, and my weight is 68 kg. I do not have BP or diabetes, and I do not smoke. I go for a walk and sometimes run three days a week. I do Intermittent fasting, so my cholesterol levels are normal. I have seen a local physician who did a few tests to check my LH, FSH, prolactin, and testosterone level, which are normal, so there are no hormonal issues.
Most of the time, I do get erections at night. I have observed that past 30 days, and mostly 23 days, I had erections at night. My doubt is I do not know how strong it was or how many minutes it lasted. So I am worried about the venous leak. My physician prescribed Cialis 10 mg, so when I masturbate with my hand, sometimes it works fine, like 20 to 25 minutes.
When Cialis does not work, I am pressured, and all my attention goes to why I am not getting it even after taking the tablet.
The doctor says it is psychological. I am unsure if it is a venous leak or a blood vein issue. Why is my flow not appropriate? Kindly help.
Hello,
Welcome to icliniq.com.
I understand your concern. I suggest you not worry.
Patient's Query
Hi doctor,
I have posted the query above. Can you please help me out with my problem?
Hello,
Welcome back to icliniq.com.
Yes, I can help you. So all your report is fine, and you are healthy. Morning erections are not mandatory. Increased stress and diet plan can change the morning erection type and duration. Did the leak you mentioned was you could not get a regular erection? I suggest you plan for the investigation to know the leak issue.
Patient's Query
Hi doctor,
How can we do that? Do you think the venous leak is the issue? Or is it mental? I get nighttime erections only during sex, and I am such a conscious and mental barrier that came into the picture due to previous episodes of not getting an erection.
Sometimes when I tried Cialis, it worked, as I said earlier, during masturbation or watching porn videos for 16 to 20 minutes. If it is a venous leak, it should also not work.
I am so confused right now, and I do not know if it is normal or a physiological issue. If it is normal, how come I get nighttime erections or some soft erections? When I talked to a urologist, they said it is more like a mental issue. Yesterday when I had Cialis, it did not work, but at night I got an erection. Kindly help.
Hello,
Welcome back to icliniq.com.
I suggest you confirm the leak by doing a penis Doppler study. If you are getting erections, naturally, you do not have an organic cause. The medication Cialis (Tadalafil) will increase the blood flow into the penis. But for a good erection, I suggest you have a good intention and a stimulus. Your partner plays a significant role in getting a good and soft erection. If porn you need to sync with particular porn to get a good erection rather than a random one.
Patient's Query
Hi doctor,
Thank you, doctor, I do get an erection the problem is sustaining it. So when I take Cialis it stays for 15 to 20 minutes if I use hand stimulation but as soon as I stop using my hand or stop watching porn it starts going down. So my assumption is it should stay erect at least for the next five to seven minutes. That is why I am thinking something is wrong with the veins or a venous leak issue. Sometimes when I do not take a Cialis tablet and masturbate I get soft erections. So I do not know what is the reason for that. Is it due to my mental attention going to that and I become less aroused? Also sometimes even after taking Cialis during intercourse sometimes I lose erections I do not know if it is due to not feeling aroused or what exactly? I am so confused what is going on? I went to a urologist and he said you have phimosis partial and can be treated by surgery waiting for the operation date now. Anyways main issue is as said above not sustaining while intercourse but can during masturbations' if I use hand stimulation if I stop watching porn and hand stimulation it goes down. I had the same issue a couple of years ago too but at that time I was single so did not pay much attention. I used to masturbate a lot so have fear it is damaged by veins or sensations. I have never done like a rough way but still. All these issues are making me so stressed nowadays.
Hello,
Welcome back to icliniq.com.
If you stop the stimulus maximum erection can stay for two to 10 seconds not minutes. You need to have continues stimulus for a sustained erection. You need a proper partner or a proper porn stimulus for a good erection even with medication. Masturbation is normal it would not harm you in any way regarding erection. I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
So what do you suggest should I continue taking Cialis 10 mg as needed? Why I am saying venous leak as I do get soft erections so it is difficult for me to sustain so kind of worried about what is going on. If the issue with venous blood flow is due to previous masturbation addiction that damaged the structure of the penis or its veins. Do you think it is more a mental issue being stressed like performance anxiety? Or am I used to porn so much that my brain is trained that way? If that is the case I may visit physiotherapy. It is way too long to even do a penile doppler test for a leak, my primary care doctor here does not recommend doing that as he is referring to a urologist whose wait list is till next year. So I do not know how to rule out the venous leak. What treatment options do you suggest, I do have an appointment scheduled this week with a sex therapist to see the mental physiological aspect.
Hello,
Welcome back to icliniq.com.
You can take the tablet when needed but regular exercise and diet will help you. Masturbation does not cause a leak. if you can get an erection normally you do not have a physical issue I can understand but you need to take medications for now.
Thank you.
Patient's Query
Hello doctor,
What do you refer to when you say getting an erection normally? Is it fine even if it is weak?
Hello,
Welcome back to icliniq.com.
You get an erection when you have an erotic feeling from porn or sex. A weak erection means you get an erection but are not able to insert your penis into the vagina. I hope you get it.
Thank you.
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Sexology
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