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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7661
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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at the age of 23 im having erection problems. last night i

Customer Question

at the age of 23 im having erection problems. last night i met with a girl to have sex. however, i coudnt get an erection. I get extremely nervous about sex. i feel like my heart is going to explode. this is weird because I can have an erection anyday and anytime I want. in fact, i watch porn regularly (too much at times) and get erections. my doc says i have HBP and high tryglecides. however, those conditions dont stop me from having erections on daily basis. only when i get ready to have sex I cant get it up. Im currently take buspirone on occasion as a sleeping agent. can you help me solve this problem. I dont want to go through this again.
Submitted: 10 months ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 10 months ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help.

Elliott, LPCC, NCC :

There are several reason that you are having ED problems.

Elliott, LPCC, NCC :

High blood pressure could be a cause, and if you are taking a blood pressure pill it could affect your sexual function.

Elliott, LPCC, NCC :

Buspirone is known to have sexual side effects and disturbs sexual function in some users, including delayed ejaculation and erectile dysfunction.

Elliott, LPCC, NCC :

Finally, heavy users of pornography find that it can interfere with their real sex life.

Elliott, LPCC, NCC :

It is making you more nervous about having sex.

Elliott, LPCC, NCC :

You are already prone to anxiety, for that is what buspirone is for - and not a sleep aid.

Elliott, LPCC, NCC :

What is happening to you when you have sex and then cannot perform properly is that you become so anxious that you have a panic attack which is characterized by your heart pumping so quickly (tachycadia) that it feels as if it is going to burst. This is a panic attack.

Elliott, LPCC, NCC :

Your doctor should rethink your medication and perhaps switch you to from buspirone to buproprion (Wellbutrin) which can control your anxiety without causing additional sexual problems.

Elliott, LPCC, NCC :

Your doctor may even consider giving you a beta blocker known as propranolol, or an antianxiety medication known as alprazolam.

Elliott, LPCC, NCC :

Speak to your doctor about these suggestions.

Elliott, LPCC, NCC :

I have given you some excellent suggestions and I recommend that you follow up on them.

Elliott, LPCC, NCC :

Warm regards,

Elliott, LPCC, NCC :

Elliott, MAE, LPCC, NCC, CCMHC

Elliott, LPCC, NCC :

Please remember to give me positive feedback for my effort and concern.

Elliott, LPCC, NCC :

Warm regards,

Elliott, LPCC, NCC :

Elliott, MAE, LPCC, NCC, CCMHC

Expert:  Elliott, LPCC, NCC replied 10 months ago.
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Customer: replied 10 months ago.


I can have an erection virtually any time i want to. except when i really need it. I dont think its physical problem. however, during these periods, my heart beats fast like its going to burst out, and chest pain.


 


if these episodes are truely panic attacks, what is the best medication and how should i take it and much should i take it?

Expert:  Elliott, LPCC, NCC replied 10 months ago.
Dear friend,

You are quite right. This is NOT a physical problem, but purely anxiety. Panic attack is one of the forms of anxiety. The possible symptoms are rapid heartbeat, thinking you are going to have a heart attack, chest-pains, shortness of breath, sweating, fear of death, and a general terrible feeling that you want to stop.

You do not have to have all the symptoms, but you are having a panic attack in regards XXXXX XXXXX inability to perform up to standards.

Talk to your physician about possible medications. Do NOT let him give you antidepressants because they can interfere with sexual performance. One exception is bupropion (Wellbutrin) which helps depression and anxiety.

For fastest relief alprazolam is the most effective but should ONLY be taken AS NEEDED, for otherwise it can be habit forming.

One other medication that is used for performance anxiety and is not addictive, but still should be taken only as needed is propranolol.

Discuss this with your physician as to what the best solution is for you. You will overcome this.

Warm regards,

Elliott
Customer: replied 10 months ago.


out the 3 possible treatments, which woud be more successful?


bupropion taken daily?


alprazolam taken before sex?


or propanol taken before sex?

Expert:  Elliott, LPCC, NCC replied 10 months ago.
This is something only your physician could recommend for sure, as he or she will be writing the prescription.

The most immediate relieve would probably come from a low dose (0.25 mg) or alprazolam (Xanax) but this can be addictive if abused. It is the most effective.

Propranolol is known as a performance drug and is often used by actors, speakers, performers, and in general for anxiety and make work well for you. It is not addictive as alprazolam is.

Bupropion is more of a long-term treatment and could be used in conjunction with one or the other of the above antianxiety meds.

Alprazolam is the best for a "quick fix" but if the propranolol works it is safer in the long run.

You could also consider talking to a counselor or therapist to see what may be going on in your life to cause this.

I hope that I have covered the field for you and answered your questions.

I wish you great success and shall keep you in my prayers.

Warm regards,

Elliott
Customer: replied 10 months ago.

do you have any suggestions on self help?


do you think i should go cold turkey on porn?


do you think i should stop excessive masturbating? if so, in your opinion, how often should i masturbate?


 

Expert:  Elliott, LPCC, NCC replied 10 months ago.
Dear friend,

I believe that you should quit the porn cold turkey.

Try to wean yourself off of masturbation. Start with once per day for a week then go to once every other day for a week, then go to once a week, and then try to quit altogether.

Here is a great book for self-help:

Product Details

Breaking the Cycle: Free Yourself from Sex Addiction, Porn Obsession, and Shame by XXXXX XXXXX MA and Andrew Adleman MA

Porn is America's numbe one addiction andis destroying marriages and relationships, perhaps by design.

 

Try to be part of the solution and not part of the problem anyo more.

 

The book will tell you how.

 

May God grant you strength.

 

Warm regards,

 

Elliott

 

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7661
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and 4 other Mental Health Specialists are ready to help you
Customer: replied 8 months ago.

looks like my anxiety is manifesting into my test taking abilities. I had previously taken a standardized test for graduate school. I did moderate, however, it wasn't enough for admission. so I decided to take it again.


on my practice tests, I was receiving great scores.


 


however, on the actual test day of my second exam I felt anxious and couldn't concentrate on the test. instead of scoring better, I scored lower than I ever had. I attribute this because of anxiety.


 


what medication would you recommend for this? I don't want any drugs that would alter my concentration or cognitive abilities.


 

Expert:  Elliott, LPCC, NCC replied 8 months ago.
Dear XXXX,

The absolutely best medication you can take is a safe medication called propranolol.

It is specifically used for performance anxiety and is taken to prevent anxiety that interferew with performance in test-taking, giving a speech, perform in public in theater or as a musician or singer, or in athletic games where it is not prohibited.

It is a mild blood pressure medication in larger doses but in smaller doses is safe and effective for just the purpose you have described.

You are freezing up with anxiety and this medication will help without lowering your ability to think and come up with the right answers.

You will succeed next time around.

Warm regards,

Elliott
Customer: replied 8 months ago.



 


I forgot to tell you the medications I took before the test. the night before I couldn't sleep. so I took 5mg of Xanax. but I still coudnt go to sleep. so I took another 5mg of Xanax. in the morning my legs left wobbley. that same morning I took atenol (beta blocker for anxiety) and 5mg of buspar.


 


I still coudnt do well on the test. could the series of medication do me harm when it comes to taking tests?


 


what is your opinion and advice on this?

Expert:  Elliott, LPCC, NCC replied 8 months ago.
Dear XXXX,

I think that you were affected by this combination of drugs. Atenolol combines with either Xanax or BuSpar to cause additive effects in lowering your blood pressure. You may have experienced headache, dizziness, lightheadedness, fainting, and/or changes in pulse or your heart rate.

Combining all three would slow you down and lower your effectiveness in my estimation.

The drug I suggested, propranolol, is closely related to the atenolol but may be more effective and should be taken in moderate dose without those other two so as NOT to lower your heart rate.

Warm regards,

Elliott
Customer: replied 8 months ago.

I see. But a beta blocker would only effect my physical symptoms not my emotional symptoms?


would a low dosage of buspar with atenol be effective or distructive to my exam?


 


I remember taking buspar alone on first test and I did ok. Does buspar effect someones cognitive ability?

Expert:  Elliott, LPCC, NCC replied 8 months ago.
Buspar is slow acting.

It can have the following side effects that might affect your test results:

  • drowsiness
  • headache
  • fatigue
  • nervousness
  • weakness
  • depression
  • excitement
  • insomnia
  • lightheadedness

 

If it were me taking the test I would have propranolo or otherwise atenolol.

 

The choice however, is up to you.

 

I hope that I have helped you with this second question.

 

Warm regards,

 

Elliott

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