Thanks for sharing such an intimate problem. It’s quite rare that men ask for advice concerning their sexual life. Well, let’s get down to your question. There are several possible causes of you losing sexual interest in your wife. In case you have not only arousal problems but also issues with getting an erection, then low testosterone levels may be to blame. In this case, you have to try to lose some extra pounds (if you are overweight) and add some testosterone production stimulating foods to your ration (e.g. tuna, beef, chili pepper, beans, ginger) or turn to testosterone therapy or use some ED pills (Viagra, Cialis and so on).

There’s also a possibility of psychological issues that make you avoid sex with your wife. Maybe your sex life just got boring after all this time being married? Try to bring new flavors and experiences to your bed. Experiment with sex toys, role-playing, the spectrum of things you can try in bed is huge. Another problem that may cause such a reaction is an unresolved conflict or offense. The inner psychological barrier is built then, and your sexual desire gets down.

Stress and tiredness also matter much for the way your libido works. Excessive workload or frequent stressful situations can reduce your desire to have sex. It is connected with the production of cortisol – a stress hormone, which also lowers sexual function. Try to avoid stress and have more time for rest, and it is very likely that your sexual life will get much better.

It is possible that you suffer from an initial form of premature ejaculation, a problem that affects at least 20-30 percent of American men. Of course the precise diagnosis must be made by a trusted uro-andrologist. The short of it, however, is this:

It is scientifically admitted that there is a genetic predisposition in conditioning the average times of the ejaculatory reflex after the introduction of the penis into the vagina. The speed with which the reflection can be activated depends on:

• genital factors, such as the sensitivity of the glans and the intensity of the erotic and sensorial stimulus;
• cortical factors, such as the level of mental excitement, the quality of the couple’s relationship, the exciting “charge” of the context, but also the anxiety that accompanies sexual intercourse.

There are also several biological, psychosexual and relational factors that can further shorten the ejaculatory latency time, “precipitating” the orgasm. At the biological level, ejaculation can be accelerated by pain caused by an underlying condition that should be diagnosed.

In addition to anxiety, the psychosexual factors that make it difficult to control for a reasonable seal are inexperience, guilt, shame (for example when the first sexual experiences take place with prostitutes), or the fear of being caught, especially in the very young. On the other hand, conflicts, tensions, and couple frustrations are of a relational nature; or, on a clinical level, any sexual problems of the partner, such as dyspareunia or vaginismus.

he fact that the erection varies is common. In your boyfriend’s case, just as you describe it can be a drug side effect, there are also a lot of other things that can interfere with the ability to develop an erection eg. stress, lack of sleep, performance anxiety, alcohol influence etc. Generally, one could say that some such factors are increasingly affecting age. The fact that he sometimes cannot get ejaculation is also the drug side effect that is described for medication with antidepressant action.

In most cases, the problem is the stress. Young men can feel anxiety when they are with a partner for the first time or feel fearful of making their sex partner pregnant. This kind of anxiety causes the body to start producing stress hormones, which in turn affects the ability to get an erection.

Young men are more often affected by problems with erectile dysfunction during periods and are more easily affected by factors such as stress and anxiety associated with intercourse. Poor experiences about sexuality and sex can cause nervousness and performance anxiety, which is also the most common cause of impotence among younger men.

Yes, this type of medication can lead to a decrease in sexual desire. To make a diagnosis of sexual dysfunction due to the use of substances and drugs, it is first of all necessary to evaluate, by history, physical examination or laboratory data, if the presence of symptoms is prior to the use of these substances and have a persistence of a fairly consistent duration, of at least a month, even after the interruption from the assumption, and above all if there are other factors that can bring back the dysfunction to psychological factors independent from the use of drugs.

Nifedipine that has been prescribed for you is not among those drugs that can cause erectile dysfunction, especially at your age. If this problem is present, you need to tell your cardiologist and ask them for their advice, for example, you might have to undergo an exercise ECG. The purpose is to rule out a coronary problem, which is hardly present at 32, unless you have a heavy cardiovascular disease genetically or other risk factors such as excess weight, smoking, high cholesterol.

Dear reader, morning erections depend very much on the healthiness of nocturnal sleep, since they are due to specific brain reflexes that occur during deep sleep hours. What matters are erections in the course of sexual activity, whatever it is. It is obvious that you will have to evaluate your erective function with his doctor in the light of the tests they will appoint. I suggest that you take some much needed rest, and then discuss the results with the specialist.

Dear reader, the symptoms you report seem to have a significant impact on your sex life, however, it is also useful to evaluate the ways in which the problem begins, any concomitant diseases, or lifestyle habits that can alter the efficiency of the erective process. Erectile dysfunction has several causes; in your case, given the absence of traumas and the sudden appearance I think we can exclude a vascular type problem, but an androgical visit should be made to verify the rest. Find an opportunity to make an andrological visit and talk to the specialist directly.

Dear Reader, I often repeat this on this site, but it is worthwhile reiterating: see this minor issue as an opportunity to book an appointment with your andrologist who will, after having evaluated his real clinical situation, to give you the correct indications to follow. In my opinion, you have no major causes to be concerned with, and if there is anything wrong at this stage, it stems from the psychological plane; however, it can only be confirmed after a physical examination and other kinds of tests done by a specialist. Cordial greetings.

Dear User, personally, I agree with those who say that the coexistence of erectile dysfunction with varicocele is only random. I ask you if a first-level diagnosis has been made to frame the sexual discomfort, evaluating the hormonal structure and, possibly, the vascular balance necessary for a good maintenance of erections. Best regards!

Hello, Javier! I believe it is better to re-evaluate the reasons for his erectile dysfunction with a good andrologist… the tests you report are not enough and they are probably incomplete and not very centered on the factors involved. The hormonal profile must be assessed in full and not only in testosterone and the relationships between hormones must be assessed. The oxidative metabolic profile and vascular status (FMD test) should be evaluated. The prostate quadror must be kept in mind and evaluated with the pelvic-prostatic doppler phase. Once the situation is well framed, the therapeutic route can then be adequately decided on. More importantly, any dose adjustment should be discussed with a medical specialist.

This said, there are reliable telemedicine services that exempt you from the necessity to appear physically at the doctor’s office. Or at least the telemedicine specialist will be able to tell you if you can skip another examination when you answer their questions. A new prescription for a bigger dose of Cialis will be issued for you remotely if the specialist considers this as the best course of actions. Hope I have outlined your prospects comprehensibly!