Implant for psychogenic ED

[Dile2709]

I'm 28 years old and have suffered from psychogenic erectile dysfunction for 10 years, since the beginning of my sex life. My problem is psychological; I've tried all possible alternatives: pills, sex therapy, injections. The injections work sometimes, but there have been anxious moments with such a large adrenaline surge that it ended up overpowering even the injections, which made me lose confidence in them. I've used Bimix in two different formulas and various titrations, I've tested Trimix, and so on. Besides not being consistent—not in relation to the injection itself, I've never missed a single injection, but rather due to variations in anxiety, which end up causing me even more anxiety—there's also the issue of practicality and lack of spontaneity, since I can only inject three times a week on alternate days. Not to mention that my girlfriend is young and sex can happen at any time. Traveling together is a nightmare because it can really happen in unexpected situations, and there's no point in trying to plan it; sometimes she's simply not in the mood. In short, it's not what I want for myself. We've already had a frank conversation about all of this; she's very supportive and understanding, but it's such a delicate and frustrating situation that I feel like garbage and frustrated. It's not a matter of libido; I want to have sex with her all day, but when the time comes, it's extremely inconsistent. My worry about "Is it hard? Will it stay hard?" haunts my mind and ends up taking away my pleasure, and with each failure, I sink deeper into depression and anxiety. I end up avoiding sex not because of a lack of libido, but because of the absurd fear of failing. It's a situation that has been happening for many years, since the beginning of my sex life, as I said before, and I've really exhausted all non-surgical alternatives. Since it's psychological, many will say: go to therapy, seek help! I've been doing that for 10 years, I've tried several different therapists, I've used various psychiatric medications, and I don't see any improvement.

Even when I achieve some success in sex and gain more intimacy with my partner, the next time is always uncertain. I recently consulted two of the best urologists in my country, specializing in ED in general, and with extensive experience in psychogenic problems, and both informed me that I am a candidate for the implant. I also consulted with a sex therapist who concluded that I am a candidate. I am aware of all the risks, I have aligned my expectations, and I haven't decided on this yet, but I would like to hear what you have to say. Sex isn't everything in life, but my inability to enjoy the moment and my partner, whom I am truly passionate about and with whom I want to build a future and a family, makes me apathetic, often lifeless, with a constant reminder and tension related to my situation.

[LetoMan]

First of all, your ED is not psychogenic. If you are taking trimix injections and not getting hard, it is because something is wrong with you physically. Anxiety may exacerbate whatever is wrong with you, but the cause is physical.

Yes, if you can’t get satisfactory erections even with Trimix, I would absolutely strongly consider an implant.

[Dile2709]

First of all, your ED is not psychogenic. If you are taking trimix injections and not getting hard, it is because something is wrong with you physically. Anxiety may exacerbate whatever is wrong with you, but the cause is physical.

Yes, if you can’t get satisfactory erections even with Trimix, I would absolutely strongly consider an implant.

I can get a 100% erection even without medication when I'm alone, for as long as I want, as long as I stimulate myself, of course. The issue with Trimix is ​​that, at home, alone, it works perfectly, sustaining an erection for hours, even without any stimulation. The problem arises during peaks of anxiety during sex; the erection starts to fluctuate, even with Trimix.

I am mentally exhausted after years and years of unsuccessfully searching for ways to solve this.

[LetoMan]

If you want to believe that it is all in your head, be my guest. What do I care? But the issue is that your corpora leaks blood, partícularly when you are under stress.

An implant is a solution to that.

[UpNorth]

I would guess that when you have sex with your SO your body moves a lot more than with masterbating thus the blood drains out of your pecker?
Towards the end of mine I was only able to do one position then once I changed it I was done.

I don’t think that a surgeon would suggest an implant if other options would work let alone two escpecially at your age. There is no doubt that your anxiety and depression will increase.

Good luck and read on using the use of a VED before implanting.

[little99]

I have psychogenic ED as well. I have used Trimix and found that it does not work well for psychogenic ED. If you get anxious, the fight or flight release of adrenaline can overpower the Trimix vasodilation. It happened to me. I have been on many forums where people who claim to be Trimix experts will profess that its imposbile. Trimix always works as long as you don't miss your injection. Well, they are wrong. I have studied Trimix and the fight-or-flight response. I take Propranolol for the anxiety, but it does not help with the blood flow reduction from the penis that results from adrenaline. I am on RE1 with some success. It is the second-strongest Trimix at 200 30 2. I wish it were not true.

[LetoMan]

I have psychogenic ED as well. I have used Trimix and found that it does not work well for psychogenic ED.

It doesn’t sound like purely psychogenic ED. If trimix doesn’t work, it sounds like you have a physical problem.

Very few cases of ED are purely psychological or purely physical. On the one hand you have guys that have prostatectomies or similar that have left them without function. That’s purely physical. On the other hand there are guys that have perfect erectile function, but have *sudden onset* situational ED. That is a key diagnostic criteria for purely psychological ED. But many, many guys have something between the two. They have a physical issue that can be aggravated (or partially alleviated) by stress levels.

In other words, if you consistently can’t get or keep an erection during sex, particularly if you use pills or injections, that is because you have physical deficiencies in getting or keeping blood in your penis. It doesn’t matter if you can get erections under less stressful conditions; there is a chronic physical condition that keeps you from normal erectile function.

What I hate about this psychogenic designation is that it implies that the *cause* is psychological. There are cases where the cause is psychological, but they are acute, sudden onset cases that can be fixed with psychological changes (and certainly can be addressed with pills or injections). But chronic ED that doesn’t respond to treatment is evidence of a physical deficiency… it’s not in your head.

[frank66665]

Try to find a high-level endocrinologist who treats erectile dysfunction. At 28, don't get an implant. Find a good doctor and spend the money you would have to spend on an implant there. You'll have a dysfunction that can most likely be treated with drugs.