My ED seems mental but I dont know if I should get an implant.. What do I do?

[macoza]

I think my ED seems to be becoming more mental/stress related - although the cause was physical from a medication I was forced to take years ago. Anyway, during the week when I return home from work and I wake up to go to work, I dont get any nocturnal or morning wood. But when the weekend comes when I'm not working, I get respectable nocturnal and morning wood. Very confusing.

I've tried trimix which created painful issues and blood swelling, and pills which arent enough to give me rigidity. But when I'm not stressed, pills seem to work and I dont need them to an extent. For example, this past July I was able to get erect without pills. But when I traveled to see my gf and used pills, the pills gave me 50% erection only (even after trying to manually excite myself) cuz I was stressed from my expectancy to perform for my gf.

Given all this I'm still thinking of getting an implant. I'm doing this cuz my gf and I want intimacy on demand. But I still get this nocturnal and morning work when I'm not stressed. What do you guys think I should do?

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[JohnnyBorg]

Hey man - it’s very much a “chicken or the egg” scenario with these things sometimes. Often times there’s something physical going on that causes us to struggle to get an erection - but that creates a mental feedback loop (worry about not being able to get it up!) and that makes things even worse!

For me - this was very much the case. I always had a gut feeling my ED was physical, not mental. But because of my age (I’m younger) I was told over the years that it was all performance anxiety.

Have you had an ultrasound performed? This was the test that made it very clear for me that my ED’s root cause was physiologic in nature, not mental. If you can, I’d have a urologist perform one to get you that info.

[principles]

For whatever reason, your erections are not reliable. You can play Dr. House as much as you want, blame a hundred different reasons, speculate as much as you want, and still not get close to solving your issue.

I'll be completely partial for a moment. Knowing anecdotally what I now know, and having been through 5 surgeries in 5 years, if I were to start over, wanting to solve my issue most reliably without second-guessing my decision because of all the reports you hear in this forum, I’d get a hydrophilic malleable with a round tip. Schedule your surgery a couple of months from now, do a strict VED protocol leading up to the surgery, and get the biggest malleable you can get in. Your chances of infection are basically nil, as are your chances of requiring a revision due to IPP component failure and/or malpositioning. It’s a very simple surgery that WILL solve your issue with a very slim chance of complications, statistically speaking.

You will have to change many things in your daily life to accommodate your malleable, but you will be able to enjoy a thrilling sex life without worrying about surgical outcomes for most of your life moving forward. The biggest thing you want to avoid is an infection. Your chances of infection for a virgin implant surgery are very low. The chances of needing a revision for an IPP in 5–10 years is a coin toss, you may need one in 5 years, or you may need 3, and at each revision, your exposure to infection increases dramatically. Eventually, since we are all here for the long run, the chances of an infection are way greater than a coin toss. The less you need a revision for whatever reason, the better.

[Stevie Reno]

Ditto what Johnny and principles said..

I always felt like anxiety and stress was a big contributor to my ED….but after many years of pills and then injections, I’m pretty sure my primary problem was physiological. See, the pill usually worked but didn’t always work and I got to where I had to exceed the max dosage to get them to work more than they didn’t…even with the pills, I was always anxious about losing my erection. See, I always got erections but the longer between getting the erection and starting intercourse, the more likely I’d lose my erection…when it got to the point that the pills rarely worked - that is, didn’t get me an erection strong enough for intercourse - I went the injection route. And to my dismay, the injection at max dosage just made me a little stiff - not firm enough for intercourse.

I had a good long talk with my doctor and gave him a much more detailed summary of my struggles and he said that he was 99% sure my issue was venous leakage…when I was young I could get an erection but would lose it if I didn’t use it quickly. The pills helped because they amplify the signal to increase blood flow and for the veins/arteries to dilate/expand…but I always had some level of leakage so while they helped, they didn’t fix the problem. By the time I went to the injection it just didn’t mater - my leakage was too great to get and keep a good, hard erection…

I did counseling, meditation, drugs, alcohol - everything I could to combat my anxiety- but my root cause was a physical issue. I got my implant at 66 and wish I had done it 20 years ago…I think the reality is that my physical condition is what caused most of the mental struggles I had with anxiety and depression.

[macoza]

Hey man - it’s very much a “chicken or the egg” scenario with these things sometimes. Often times there’s something physical going on that causes us to struggle to get an erection - but that creates a mental feedback loop (worry about not being able to get it up!) and that makes things even worse!
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Exactly! In my case, a fuckin medication that a fuckin idiot doc forced me to take years ago caused my ED. Compounding that is the mental anguish from it that makes it worse and confused the hell out of me.

Have you had an ultrasound performed? This was the test that made it very clear for me that my ED’s root cause was physiologic in nature, not mental. If you can, I’d have a urologist perform one to get you that info.

Thanks for the feedback! Yes I had an ultrasound done 13 years ago and they found nothing wrong. But an ultrasound does NOT find all the possible root causes. It specifically searches for plaque, nothing more subtle like nerve damage, sadly. But the ultrasound does help nonetheless.

[macoza]

For whatever reason, your erections are not reliable. You can play Dr. House as much as you want, blame a hundred different reasons, speculate as much as you want, and still not get close to solving your issue.

Very true!!!

You will have to change many things in your daily life to accommodate your malleable, but you will be able to enjoy a thrilling sex life without worrying about surgical outcomes for most of your life moving forward. The biggest thing you want to avoid is an infection. Your chances of infection for a virgin implant surgery are very low. The chances of needing a revision for an IPP in 5–10 years is a coin toss, you may need one in 5 years, or you may need 3, and at each revision, your exposure to infection increases dramatically. Eventually, since we are all here for the long run, the chances of an infection are way greater than a coin toss. The less you need a revision for whatever reason, the better.

But you make it sound like revisions and infections are very routine. The majority of inflatable implants dont result in infection or revisions. I appreciate your warnings but I dont want a malleable since it can be noticeable when going to the beach. And from what the doc told me, revisions dont happen a lot.

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[macoza]

I always felt like anxiety and stress was a big contributor to my ED….but after many years of pills and then injections, I’m pretty sure my primary problem was physiological. See, the pill usually worked but didn’t always work and I got to where I had to exceed the max dosage to get them to work more than they didn’t…even with the pills, I was always anxious about losing my erection.

This is exactly my situation but with trimix injections. When I waited for the trimix to kick in after 10 minutes I got so worried that I injected myself again in the hopes that another does would force an erection. In several cases I overdosed which I fuckin regret.

I got my implant at 66 and wish I had done it 20 years ago…I think the reality is that my physical condition is what caused most of the mental struggles I had with anxiety and depression.

Your case mirrors mine to a tee. My ED was purely physical but was impacted far more by the mental stress it caused. Many stupid docs think that mental issues cause ED when in fact its the opposite.

Good for you that you went for the plastic. I'm going to get mine, no doubt!