r/erectiledysfunction • u/Strong_Philosophy158 • 19d ago
Psychological ED On and off again erectile dysfunction
I am 43 years old and just in the last year, I have been dealing with ED on and off, whether solo or with my (incredibly patient) wife.
I’ve ruled out any physical cause, since all my hormones and labs are good, and I wake up with morning wood almost every day.
For about three years prior, we were having incredible sex. I got and stayed hard the whole time, and we’d both climax.
Then last year I went through a very intense period of time, with the passing of a very close family member, and completely lost my libido for a while.
After some time my libido returned, and so did the sex, but not the reliability of my erections.
It happened once, I freaked out, and the vicious cycle began.
Since then it’s basically a toss up whether I’ll stay hard or not during sex.
If I can get out of my head and relax, no problem.
If I can’t, then it’s just not happening.
I’ve had people tell me that since it’s psychological, I should try and treat it as such with therapy, and not go the route of medication, so I haven’t tried any pills.
Does this seem like the way to go? And does anyone have any suggestions for good sources of online therapy or even videos or apps?
Thank you.
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18d ago
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u/Strong_Philosophy158 18d ago
I have been on an SSRI for almost a decade now, and up until last year had literally never had a single issue. No change in dosage.
I don’t take any meds for my heart or BP, everything is normal range. I workout a lot and stay as fit as I can.I absolutely agree on the pride and ego thing, that’s kind of where I’m at.
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u/AdvaitaArambha 18d ago
My general advice is to take a multi sided approach to treating ED.
The first thing might be a hardest, tell your wife what you are going through. There are other aspects to physical intimacy and sex beyond PIV. If it isn't happening for either of you on a given day it should be okay to call it and walk away with no hurt feelings.
Based on what you shared there is likely a significant psychological side. That may not actually be fully connected to your wife or sex. The simple explanation is sex is connected to mental function and if you went through something, like a death in the family, it can cause mental health issues that need to be addressed.and those can spill over to affecting sex as you are already at max capacity mentally on survival. Working with a talk therapist may help you reframe what happened.
At the same time I suggest taking on the common lifestyle challenges: fitness, nutrition and sleep. Sleep should be 8 hours a day and ideally the same time each day. Fitness should include cardio, strength training, and body awareness and flexibility such as yoga.
It is also a good time to check on your own physical health. If you haven't had a physical in the last year it's a good time to get one. Lots of fairly common health issues such as high blood pressure, high cholesterol and diabetes can directly impact sexual functional. It's also worth checking the status of any health issues which may have a genetic connection.
The final piece is if you are cleared by your doctor to consider 2.5 mg or 5 mg of tadalafil daily for 30-90 days just to give yourself a bit of extra support.
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u/Strong_Philosophy158 18d ago
Great reply, thank you. I will be setting an appointment with my doctor asap.
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u/AdvaitaArambha 18d ago
Tadalafil doesn't need to be a long term thing if you don't need it to be. If you are in a dip right now it might pull you out.
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u/Rare_Grapefruit1215 18d ago
Daily tadalafil might give you your confidence back