fucked0ne wrote:
I’m pretty sure some guys here have gotten implants for psychogenic ED.
I think we are learning that persistent ED where the patient can *sometimes* get an erection is largely correlated with a physical deficiency, venous leakage. Guys with venous leakage can often get and keep erections when under little to no stress, lying on their backs, no partner, looking at porn, etc. but the venous leakage makes it easy to lose that erection, and the effect of that compounds psychologically into what we have historically called “performance anxiety.” I’m not sure there is actually purely psychogenic persistent ED, I suspect it is always hand in hand with some sort of physical cause.
Regardless, whether it is always the case or often the case that “psychogenic” ED has a contributing physical cause, the bottom line is that it is not useful to use the evidence of whether one can get an erection *under certain circumstances* as an inference for whether the cause of the ED is “all in your head.” Instead, the relevant question should simply be whether the intervention is working to give the patient the desired result (a satisfactory sex life).
I’m not a doctor or a sex therapist. But I think if the OP is not getting satisfactory erections from pills and injections, that suggests that therapy is not going to work. When pills first came out, the docs used to say that you WILL get an erection as long as you are excited. If he is still not getting satisfactory erections with those interventions, I doubt it’s a psychological issue.
On the other hand, it could be that he really is not turned on by his girlfriend, so even with medication he is not getting an erection. Maybe therapy could help with that, but probably not.
Either way, seeing a therapist can’t hurt, and it sounds like Macoza has a number of things he might want to discuss with a therapist, so I can get behind that advice!
I just wanted to point out that being able to sometimes get an erection is no longer seen as evidence that the cause is psychological. Our modern understanding of ED is that for persistent ED the psychological effects accompany the physical causes. There may be purely psychogenic ED, but most of the guys we once described as having that actually have venous leakage.
Born 1974. Implanted 5/21/2024. AMS 700 CX 21cm, 3cm RTE. Penoscrotal. Venous leak my whole life. Pills helped, but hated the side effects; worked less as I aged. Skipped injections. Grateful to bionic brotherhood that helped me make this decision.
