ABSTRACT
This chapter presents a case of a 30-year-old man who comes to see psychiatrist in the general practitioner surgery. He is embarrassed and explains that he was married last year and is having problems with his sex life. In particular he mentions that since he was married he has had problems maintaining an erection when he is with his wife. He says that when he has been able to get an erection he often has a premature ejaculation. His wife has not been able to achieve orgasm. He still occasionally masturbates in private and can sustain an erection for at least 5 minutes. His erections are normal and not painful. Brief systemic enquiry is normal. He has no polydipsia, polyuria, frequency, other urological symptoms or cardiovascular symptoms. There are no penile, testicular or scrotal abnormalities, and he has normal muscle and hair distribution. Neurological examination is also normal including reflexes, fundi, visual fields and motor power.
