When dealing with impotence there’s also a psychological component to it, right? Let’s talk about how that plays into everything. > Absolutely. The psychological aspect of erectile dysfunction what we call psychogenic erectile dysfunction it’s actually something organic, when somebody gets nervous they produce hormones that help us survive stressful situations it’s our fight-or-flight hormones okay we’re talking about the core result in the epinephrine. These are the hormones that allow us to survive something that may be very dangerous for our overall health. The best way to describe it is the way is this way I tell guys imagine when we were cavemen having sex with our partners if a big furry man came up behind you what would you do you? Run right? okay and then I asked him: You ever trying to run with an erection? you can’t do it. — right — body prepares you for that, and that’s essentially what happens when somebody gets anxious right before they have intercourse. > okay are there certain medications that can make a man’s ability to perform difficult? > Yes. Unfortunately and unfortunately a lot of the medications that are given in order to treat patients for a lot of the medical problems do have as a side effect erectile dysfunction now that does not mean that that gives them a reason to be able to start to stop their high blood pressure medication because ultimately if they don’t treat their high blood pressure they can end up with a wrecked out dysfunction or even worse heart attack or stroke or even death. > Okay and how let’s talk about how E.D. is diagnosed so the first of all patient will come in — right — and they’ll say listen doctor I have this problem either cannot achieve I cannot achieve and/or sustain an erection that’s rigid enough for the entire sexual intercourse. Once that happens then of course I go over a little more history ensure that they’re safe enough it’s safe for them to have sexual intercourse and to take certain therapies, we include certain blood tests in order to check with a hormonal profile, some of them will also we will obtain an ultrasound just to check blood flow within the actual phallus but a lot of the actual diagnosis is done with the treatment if they respond well to treatment well it’s diagnostic and therapeutic at the sa