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Dr. David
Dr. David, MD
Category: Urology
Satisfied Customers: 45602
Experience:  Experienced physican in Urology
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I've had all blood test ran this year with my cholesterol,

Customer Question

I've had all blood test ran this year with my cholesterol, blood sugar and hormones being normal. I have suffered from impotence over the last 2 decades. I've taken Cialis for a very long time and it's always worked, but this year it started to fail. Have I reached resistance. I've taken 20mg over the last 5 years. Could my problem be more mental than physical. I do suffer from a lot of stress and anxiety. I'm only 47. One uro told me I might have Atherosclerosis, but I've been suffering with this for a long time. My heart is fine according to my GP. This problem is frustrating to all because I don't what the true problem is and my uro would not run any test to rule anything out.
Submitted: 9 months ago.
Category: Urology
Expert:  Dr. David replied 9 months ago.

Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 9 months ago.

yes, severe anxiety and stress can kill an erection.

do you have morning erections in the morning?

are you able to masturbate and have an erection on your own?

if you can, then most likely your blood testosterone levels are normal and you don't have atherosclerosis causing your erection problems.

regular exercise and eating healthy can help improve your health and can help decrease your anxiety symptoms which can help your erections.

Customer: replied 9 months ago.
Have erectu in problems with masturbation as well but not always. I did experience a couple of morning erections and that's without medications. My body has not responded normally for over 15 years, but the ed meds always worked well, until this year. I've had this problem ever since my nasty divorce 20 years ago. Can you have performance anxiety even. with cialis. It worked when I was alone.
Expert:  Dr. David replied 9 months ago.

yes, if you have bad anxiety symptoms, this can cause performance anxiety and poor erections.

if you are taking certain anti-depression or anti-anxiety medications, they can affect your erections as well.

Customer: replied 9 months ago.
I'm currently not on any medications accept for the one I mentioned. So you think my problem is more mental then? I was less stressed last year. One last thing, can you reach a tolerance with ed meds?
Expert:  Dr. David replied 9 months ago.

I think your symptoms are a combination of both mental and physical.

as we get older, erections can become more difficult, specially if we haven't taken good care of our bodies and have not eaten healthy and exercised regularly.

bad anxiety symptoms don't help either.

you have to be very relaxed to be able to have an erection for the nerves that cause an erection to fire properly.

the cialis not working is not because you are reaching a tolerance, it is because your anxiety symptoms and your age and nerves are at a level that the cialis is not enough to help

cialis helps reduce the action potential of the nerves which lead to erections. but if you have bad anxiety symptoms and poor functioning nerves, then cialis may not be enough.

let me know if you have other questions.

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Customer: replied 9 months ago.
in other words I can fix this problem. Like I said I have functioned well not too long ago like last November. This year I've been under an extra amount of stress. I went through bouts of this when I was young, but was able to recover. I also have a long distance relationship, which doesn't make things any easier with the gaps in time. Thanks for your input.
Expert:  Dr. David replied 9 months ago.

you can fix it by eating healthier, drinking more water, avoiding alcohol and smoking which can kill erections, and exercising regularly and loosing weight

and working on stress reducing exercises, deep breathing exercises, meditation, yoga, stretching which can help decrease anxiety.

let me know if you have other questions.

if done for now, please leave positive rating of 3-5 stars so I can get credit for helping you today

we only get credit for helping clients after positive feedback

you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

here is my website if you need to reach me:

http://www.justanswer.com/medical/expert-dr-david/

Thanks for using JustAnswers.com

Customer: replied 9 months ago.
I quit smoking back in December 2014 and I rarely drink. Did smoking damage my arteries? I was functioning back then properly with meds in spite of me smoking. Only this year things got bad but also there were emotional circumstances in my current long distance relationship. I was more depressed this year as well. In the past I dealt with this and have usually recovered from this. I'm just trying to remedy the situation.
Expert:  Dr. David replied 9 months ago.

smoking over many years can damage the arteries.

I'm glad you quit smoking.

you may need to talk to a counselor or therapist

or take antidepression medications if you are still depressed.

let me know if you have other questions.

if done for now, please leave positive rating of 3-5 stars so I can get credit for helping you today

we only get credit for helping clients after positive feedback

you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

here is my website if you need to reach me:

http://www.justanswer.com/medical/expert-dr-david/

Thanks for using JustAnswers.com

Customer: replied 9 months ago.
If you are leaning towards mental than physical that will make it easier to go forward and fix myself. I do talk to a counselor about this btw. Also I'm not obese, I weigh 197 lbs and about 5-11. Would additional weight loss help as well. Let me know. Thank you!
Expert:  Dr. David replied 9 months ago.

yes, additional weight loss and exercise can help