How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Elliott, LPCC, NCC Your Own Question

Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
40019946
Type Your Mental Health Question Here...
Elliott, LPCC, NCC is online now
A new question is answered every 9 seconds

at the age of 23 im having 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: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year 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 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Customer: replied 1 year 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 1 year 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 ***** ***** 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 1 year 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 1 year 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 1 year 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 1 year 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 ***** ***** 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: 7662
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and other Mental Health Specialists are ready to help you
Customer: replied 1 year 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 1 year ago.
Dear *****,

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 1 year 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 1 year ago.
Dear *****,

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 1 year 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 1 year 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

Customer: replied 3 months ago.

hello counselor,

 

Im thinking about taking viagra for psychological E.D.

 

is viagra a good drug to take for my psychological E.D? are viagra generics good? how large do you recommend the doses? 25mg?

 

I sure im healthy enough for viagra. my doctor recommended it a year ago. but i dont want to go to him since i dont have medical insurance yet. im 24 and i have high triglycerides and moderate to high blood pressure (on occasion).

 

 

Customer: replied 3 months ago.
Relist: Answer came too late.
didnt answere
Expert:  Dr. Kaushik replied 3 months ago.
Greetings.

Welcome to the site.

I am Dr. Kaushik and i am a psychiatrist and i believe i can help you with your problem.

Well, i have read the entire conversation that you had with the previous expert who on his part very well defined your condition as Performance anxiety which is associated with an underlying fear of not being able to perform sex up to the desired level thereby this thought process keeps on playing like a record in one's mind when one is about to have sex and eventually it leads to the dreaded outcome of poor performance due to either total or partial loss of erection.

Now in your case you have high triglycerides and blood pressure which at your age may not be causing the poor erection but they eventually shall cause the same if they continue remain out of control. So basically what i am trying to tell you here is that at the moment your problem with inability to have erection is psychological and is best described as Performance anxiety and can be managed effectively by taking propanolol at dose of 20 mg / day for 8-12 weeks at least and in addition to this you may take erection boosting drug like cialis ( tadalafil) at dose of 5 mg but only occasionally half to 1 hour before sex, this will bring you erection to have a satisfactory sex which will in turn boost your confidence and next time you may not require this drug to assist you once your confidence is up. Also cialis aka tadalafil is safer as compared to viagra in terms of the latter's side effects on heart.

So to summarize you may take cialis / tadalafil at dose of 5 mg as and when required before sex but do check with your doctor if your overall health condition and vitals make you eligible to take. And on a regular basis you may take propanolol at dose of 20 mg / day which will take care of your blood pressure as well your performance anxiety as this drugs finds use in both of them. In addition you shall ask your doctor to put you on lipid lowering drug to manage your deranged lipid levels and some good drugs in this category are statins.

I hope this helps and answers your queries.

Please make sure that you discuss all of these options with your doctor before taking any drug mentioned above.

Please kindly leave a Positive rating if you are satisfied with the answer.

If there is any further assistance needed please feel free to ask using the reply button.

Regards
Customer: replied 3 months ago.

I really dont want to get on a regimen for occasional sex. It also sounds expensive. Could viagra at 25 mg be better solution? Or at least give me the same results as your regimen?

Expert:  Dr. Kaushik replied 3 months ago.
Viagra 25 mg can give you the same results although cialis has better side effect profile because nausea, vomiting are common side effects of viagra which otherwise are rarely seen with cialis.

And as far as propanolol is concerned it give you permanent relief in terms of taking care of your nervousness and anxiety preceding sexual encounter thus bypassing the very need to take viagra for sex.

I hope this makes sense and gives you some perspective about your options.

Wish you all the best.

Regards
Customer: replied 3 months ago.

Do you think i should start with 25 mg or 50 mg of viagra?


 


Do you recommend taking a probonolol with viagra before sex?

Expert:  Dr. Kaushik replied 3 months ago.
Please try to understand that propanolol is a medication which works when taken regularly since it has to maintain it's levels in the body so as to provide the benefits that you are seeking. So it has to be taken every day in the morning with or after breakfast and viagra on the other hand shall be started at 25 mg dose and to be taken 1 hour before sex so it is for as and when required usage.

I hope this makes it clear.

Regards

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education