Dear Halo, Do you really have a phsychological problem? If so, then it is likely that you get excellent erections from visual stimulation or mental stimulation even without masturbation. And with masturbaton, erections last a long time even if you stop physical stimultation before orgasm. Also, you probably get very firm morning erections that sometimes last long enough to give you trouble peeing. Basically, if it is psychological, then you get lasting erections under many circumstances, but just when you really need them, they fail. If this is not true, it is definately worth while to take the tests that can really rule out physical problems, if you have not done so already. Go to your regular doctor for a referral to a urologist. Do not tell either of them that you think it may be Psychological, or they will just tell you to use Viagra or injections, and they will maybe even make you feel foolish or somehow weird. Look at the list above and focus on the part that is not working up to expectation, eg., no morning erections, no complete erection anytime, good erections in the morning but short duration. Say that you want to find out what is causing this problem by taking tests to rule out physical causes: Rigiscan test, injection test and ultrasound. None of these tests is 100% fool-proof. Rigiscan is affected by how anxious you are, how distracted you are about having something on your penis while you sleep, and how serious your physical problems may be, if there are any. Do not let them just send you away with direction to do the "stamp test," The stamp test works like this: before you go to bed, you stick the ends of a strip of postage stamps together snuggly around your penis. Then in the morning you see if the strip is torn along the perforations. You already know you can get 75% erect, so you most likely will tear the stamps. Rigiscan will tell you not just that you got erect but also how erect you got, and how many minutes you were erect while you slept. The injection test is capable of identifying venous leakage pretty well but misses arterial insufficiency by as much as 20% of men with excellent erections after Caverject or phentolamine/papaverine (Bimix) injection. Injection test gives 68% false negative results for arterial insufficiency if the erections are incomplete but still good enough for intromission, (i.e., penetration etc.)(See Aversa et al., 2002. "Penile pharmacotesting in diagnosing male erectile dysfunction: evidence for lack of accuracy and specificity." Int J Androl. 25(1):6-10.) Many other researchers also found that the test is sometimes inconclusive, so dont let the urologist tell you it is proof positive. Ultrasound is the next test that can tell if you have arterial insufficiency or severe venous leakage. Venous leakage is when your penis does not expand enough to close off the veins draining the cavernous bodies that would normally fill with blood and become rigid with erection. Ultrasound can identify if the blood continues to flow excessively after erection should have shut it off. The actual proof of the degree of venous leakage is the cavernometry/cavernosography tests. Cavernosometry is really sufficient to tell if you have venous leakage, and cavernosography can show where the leaking veins are, but that is usually superfluous information. Ok so once they tell you you have some physical problem, what then? Well first you can stop beating yourself up for not getting an adiquate erection or for quickly losing your erection. Also if it is organic erectile dysfunction (ED) and you have insurance, they may help with the cost of meds. So if this is psychological, the best solution is to get married. Every study shows that men who are married are happier with and have more sex than unmarried men. This will also provide the environment to gain confidence and ease. If you are worried about performance, start with assistance from medications. When you are married, they wont be wasted. Don't be afraid of getting married without a "test drive." You are not buying and she is not a thing. In the end, a woman who isn't experienced even with you may also give you confidence. Find a woman who respects you, not your penile performance. You can work on that over the years. Practice makes perfect, and it is fun practicing. Really love grows if you are willing and your expectations are realistic. So dont get hung up on finding the absolute perfect match; none of us is all that perfect ourselves, are we? Sexual performance and satisfaction do get better in marriage, not worse as many would have you believe. Old fashioned morality actually has a practical side. Genesis 2:18 "the LORD God said, [It is] not good that the man should be alone..." and He is right. Best of luck. Mark

Thanks for all the info. Yes, it seems to be psychological from what I've read (and from your email, all the items in the first paragraph match what I experience). When I'm with a woman, it's basically in those few minutes (or even seconds) before penetration that I have the biggest issues. I really have to be in the right position and hope she doesn't need additional 'things'. For example, all I needed was a little lube for myself to penetrate one woman a month ago. She got a little upset about the lube (feeling it was saying something about her or whatever). When she said it, I lost it and wasn't able to get it back. Anyway, the lube is not the issue b/c it happends w/ other things all the time... the point is that everything has to be perfect for me to perform. If she says something silly, or if she decides she wants to wait another 10 minutes for me to kiss her body, or if I have to change positions, then the outcome is usually negative. I perform better on Viagra than nothing. Really, the best time I perform is if I wake up hard... my body is relaxed and I have good success at this time. But I was hoping for more of a guarantee at any time I need to achieve an erection, which is usually at night. Few people that used BMG trimix complained about the injections w/ regard to immediate performance (I appreciated the feedback on using other approaches of getting the trimix for less cost). And for a guy who doesn't get laid too often (being honest), I need something that is going to come through every time when I'm in the early stages of a relationship. After that, I think I'll be comfortable and also I'll be able to talk with her about it. But the initial stages are key. Of course trimix has its own issues... it needs to be refrigerated, so I'm out of luck if I'm at her house or out of town... when I have a new girl over, it take a good 10 minutes to inject the trimix and 'massage it', and she's going to wonder what's going on. And BMG says it's a 'cure', but most people who use it say it's good for immediate results, but not a 'cure' after 6 monts like the website says. Thanks!

Wow, Halo...if I didn't know any better, I'd say your post came from me. I can get hard right away during foreplay, but if I don't get junior down to business, he goes limp pretty quick. Needless to say, I'm not a big fan of condoms. For some reason he doesn't respond well to being touched by my girlfriend. But, if I masterbate while going down on her, I can usually bring him back...usually. Even then, changing positions or not getting the right penetration will make it go away. On the flip side, the right position makes me ejaculate very early...what a frustrating conundrum. I too find that I excel at morning sex or wake-up-in-the-middle-of- the-night-sex than normal situations. I know it's all in my head, and it pisses me off, which only makes it worse. Luckily my girlfriend is very supportive and willing to try anything to help me. Does Viagra help you at all in those situations? How about the others? Josh

Yes Josh, it sounds like we’re in the same boat (except I don’t experience premature ejaculation). Like you said, each time I have sex, I feel like it’s the first time. That’s likely part of the problem because that extra anxiety may be all it takes to cause the problem. Yes, when I go down on a girl I usually have to masturbate as well to make sure it doesn’t go away. The change in position and lack of attention on myself causes an issue. And in the morning everything work better b/c the body is rested and also we haven’t had time to psych overselves out of it. The difference b/w a full erection and 75% is just a little blood… which makes all the difference. I think Viagra (or Cialis, etc) is a good next step for you. Do you have insurance to see a doc? Just go see your doctor and get a sample. The first time I tried I took Viagra 50mg, which did nothing. 100mg works much better. Really, I think like 150mg is what I need, but I’ll check with my doctor first b/c I think 100mg of Viagra is the most someone is supposed to take in a day. But for me, Viagra is a great improvement, but still not a guarantee. That’s why I also joined the Boston Medical Group Yahoo group to find out more info about something that works every time. At the bottom of this email, I copied and pasted the post I made to that group. Josh, the main thing I’m interested in is what you say in your email regarding your ex-wife. I haven’t had a wife or even a long-term girlfriend. So it sounds like even when you were married (sex with the same person over and over), you still had these issues? I was really hoping it wouldn’t be an issue after being with the same person, which allows us to be more comfortable and perform better (at least I thought). Do you have better results after you’re with the same person several times? Please elaborate on your experiences with your wife, long-term girlfriends, and first few times with a new girl. I’ve found the more I’m with a girl, the better the results.. usually. Thanks!

Well, you would think being with the same person would make things more comfortable, but that's part of the reason for the "ex" in front of wife. She was never supportive of me, and made me feel like shit every time it happened. Also (and what I think is part of the problem), she was kinda selfish/lazy in bed. I had to do everything every time, and after a while, you get used to having to get yourself hard and get her ready. She wasn't willing to help. Ever. Sex was more work than it was worth and after a while my body kind of adjusted to that. So once it started going downhill, it only got worse. Current girlfriend = much better. I brought it up the first time we tried it...and it didn't work. She went through the whole "it must be me" speech, so of course I had to go through my history right there. But, she's been very supportive since then, and said she would go to the doctor with me. She even said if I wake up in the middle of the night with a hard-on to wake her up so we don't waste it. hahaha We've had sex many times, and almost every time it's only worked because I played with myself to get it there. I just get too excited and nervous. The other night it just wouldn't work again. I was ready to go (75%), but she didn't have her diaphram. So I pull out a condom and pfft, that was the end of it. Like you said, the difference between 75% and full is huge. If I'm 75%, I can get to 100% by penetration. You can't put a condom on at 75% though. :( I shouldn't say I'm a premature ejaculator. What I was getting at was how odd it is that some positions can make me lose my erection and others just drive me over the limit. It's just funny I can go from one extreme to the other in a matter of seconds. What a silly little organ... Josh