Question:
Dear Doctor,
I got married recently. From the start of my youth I had good firm erections including strong nocturnal erections. During the early years I did masturbate, although not very excessively. However, I haven't been masturbating for the last couple of years and have been busy with my job. Now nothing turns me on. I have slight orgasmic pleasure and weak erections during sex. I have completely lost my libido and am facing some sort of erectile dysfunction. I am physically fit with a muscular body (go to the gym) and don't smoke or drink. Moreover, I ejaculate too early and have been unable to give my wife an orgasm. Tribulus terrestritis has helped me to some extent that I've been able to copulate but without pleasure. Please help and oblige.
Thanks,
Zaheer
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Answer:
by Larry Siegel: (05/19/2004)
Thanks for taking the time to write in with your question. There are a few points I would like to address. First, I would suggest having an evaluation done by a urologist to make sure that there's nothing physical going on with your reproductive system. Before addressing any type of sexual dysfunction or disorder, physical issues need to be ruled out. It might also be helpful to see an endocrinologist in order to test the status of your pituitary and thyroid glands (the urologist may be able to order those tests as well).
I also want to address the fact that you are taking testosterone and testosterone-enhancing products when you don't seem to have any deficiency (571 ng/dL is well within normal ranges). It's not suprising that you haven't found much relief with the supplements you've been taking. A 1999 study, published in the Journal of Urology, says the physiological relationship between testosterone and male sexual behavior hasn’t been well understood. It’s also true that past research on this subject has been inconsistent or not significant at all. While there is evidence of a link between low testosterone and sexual dysfunctions, the solution to increasing sexual drive and performance is far more complicated than just increasing the amount of hormone.
Tribulus Terrestris is an herb that is claimed to elevate testosterone levels. Most researchers and scientists believe it works by positively affecting levels of luteinizing hormone, which in turn positively affects levels of testosterone. Many companies market and sell various tribulus formations, but very few harvest the right parts of the plant at the right time of the year (certain parts of the plants, at certain times of the year, contain higher levels of saponins, the active ingredient).
There is certainly no shortage of substances that either claim or have been shown to increase sexual function in men. Among the more common are avena sativa, saw palmetto, nettles extract, vitamin A, zinc, selenium, ginseng, horny goat weed, and muira puama. However, given what you describe, I would suggest looking more into the psychological and emotional aspects of what you're experiencing.
What you describe may very well have a basis in stress and anxiety; whether a result of work, marriage, past relationships, or life. It may be helpful to find a trained sex therapist or counselor to explore this with. It might also be helpful if you put less emphasis on penile performance and more on other ways of pleasuring your wife. As a man, you are far more than just a penis. This is true as a lover as well. The fact that you are experiencing both erection problems and rapid ejaculation tells me there might be a basis in anxiety. Talking with a qualified sex professional may help work thru this.
I hope this was of some help to you. I wish you good luck and much success. Take care and be well. Peace.
Larry Siegel, MA, CST, AASECT
Reviewed by Sexual Health Editorial Team
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