15 Months and counting

This is your problem: age.

Most of the physical changes you're going through are perfectly normal. Men's sexual peak is around 19. From there it's a long, gradual downward slide. The slowdown includes reducing testosterone levels, less morning erections, poorer erection performance during masturbation and sex, needing more direct physical stimulation to keep an erection, and losing erections quicker when stimulation is stopped.

>But my penis goes flaccid within 20 seconds after I "let go".

This is totally normal. The penis needs direct physical stimulation to stay hard (this could be from self, partner or even bedsheets). All that's changed is you lose your erection quicker, which is simply a product of age.

Your problem certainly has a psychological component. We'll get to that in a moment. First you have to realise that being horny all day long and erect at the drop of a hat is for those with the most hormones - men in their early 20s and younger. In your case it may seem that your body suddenly changed on Nov 7 2008. After that, anxiety played a significant part. But the Urologist told you you were fine, and that's because you can get erections during masturbation, which means there is no physical problem. Physically, it purely comes down to the amount of direct stimulation your penis receives. If you take your time and recreate this stimulation during sex, you'll have the same erection performance as during masturbation.

For the physical side of things, and the effect of diet and exercis, there is a great book called the Hardness Factor by Dr. Steven Lamm (no affiliation).

Psychology and mental attitude does play a significant part. Particularly if you are worried about erection performance, this worry / stress / tension / nervousness will trigger your sympathetic nervous system (fight or flight) and manifest itself in poor erections.

>I have tried to relax, but it gets harder as time goes on. Are there any other "relaxtion" techniques to try?

Relaxing certainly helps, but the worry and performance anxiety can be much more powerful. Meditation may help. But make sure to maintain continuous direct contact with your erection.

>Before I move onto the question, I do not smoke, do not drink often, do not take meds, and excerise everyday.

This is good. Also, it's believed that weightlifting (with heavy weights and low reps) boosts testosterone production which helps erection performance.

>I wonder if anyone has been not able to get an erection for this long period of time like me?

You can get an erection. You've just had some trouble maintaining it during sex.

>So I received a few samples of Cailis, tried it, and it didnt work.

I would spend a few weeks / months continue seeing your psychotherapist as this will certainly help get over the performance anxiety. Just a note that there are two other brands of erectile dysfunction drugs, levitra and viagra, these may work better for you. However at your age, and since you can get an erection during masturbation, you should not come to depend on these drugs.

>Best way to describe the sexual experiences within the last 15 months is spacing out, not concentrating, heart races, and constantly hoping that "it" would work again.

The high heart rate is caused by tension. This is your SNS (fight or flight) in action.

>What can I do to bring back my sexual desire?

Not much. Horniness is likely a product of hormones, mostly testosterone for men. Erectile dysfunction drugs may increase the performance, usually not the desire.

>Any other tips, because I do not want to be stuck like this during the prime of my life,

Unfortunately, the sexual prime of your life was 7 years ago!!!

>This is constantly on my mind, every single day, every hour of the day in the back of my mind, so any words of wisdom would be extremely helpful.

This constant worry is quite likely to be compounding the problem. It's stress, no different to other stressors in life: job, relationship, kids, legal issues etc.

>I feel I cannot make new relations in life without "it" working again!

You can make new relations. "It" is not broken. Find the right person and they'll have no problem with you taking your time, talking to you about it and helping you with it.

Here is the best attitude to have: sex is not the only thing in life. It's certainly not the only thing in a relationship. Tell yourself you just. don't. care. whether you can or can't get an erection. If it happens, it happens, if not, fine. When you meet someone, concentrate on having fun with them. Concentrate on enjoying life. Laugh at life, and more important, laugh at yourself. Laugh at your own failure. Laugh at how worried you were (past tense).

If you go to bed, don't have penetrative sex the first few times. Have lots of foreplay, oral, and spend time on her clitoris (I'll go out on a limb here and presume you're hetero...). Now notice how, during most of that time, especially if she's touching your penis, that you've got an erection. The times you lose the erection will be when there's no direct contact. However, if, during all this time, you are constantly thinking about having penetrative sex and worrying that you won't be able to keep the erection, then as mentioned earlier, the worry will actually kill the erection. It's a weird catch-22 / vicious circle of performance anxiety causing erection failure which causes performance anxiety which causes ...

So a combination of not caring about it, not worrying about it, not thinking about it and seeing your psychotherapist would probably be the best course of action.

>Now do you suggest giving up masturbation for a long period of time, as it has been a month now that I have stopped masturbating.

No, don't stop masturbating. There is a common misperception that if you masturbate too much you will "use up" your sexual energy and won't be able to perform. Masturbation is not the issue but orgasm/ejaculation. If you ejaculate 5 times every day for three days (whether through sex or masturbation), then yes on day 4 you won't be in the mood and erection quality will suffer. But even after many ejaculations, the body recovers usually in a day or two. Abstaining for a month is pointless. You could develop medical problems if you don't ejaculate for a long time (ie a good few months). There are 8 structures in the lower urinary tract that contribute to ejaculation - epididymus, vas deferens, seminal vesicle, prostate, ejaculatory duct, cowper's gland etc. Like any other part of your body, regular use keeps everything functioning and healthy. If you keep abstaining from ejaculation, you'll eventually have a wet dream. This is your body 'flushing the system' and keeping you in check.

>I am worried I will only respond to the touch of my hand, especially when my penis has been touched by lovely females it has felt non-existent. I think if I can i overcome the "feeling" of my hand...

Your penis cannot tell the difference between the touch from your hand or anyone else's. All it knows is location of stimulation (glans, base, shaft), intensity, speed and rhythm of stimulation. Any problems you have with a lover are purely psychological, based on, as mentioned, the vicious circle of performance anxiety.

Keep masturbating as normal. Do it when ever you feel like it. Ejaculate as often as you feel like. Then notice how, in the immediate aftermath of ejaculation, getting an erection is very difficult. This is your recovery phase. When you were 19, you might have been able to get an erection 10 minutes later. At 26 it might be an hour later. Or it might take a day to recover full sexual energy. You can actually measure this - simply time how long it takes you to get an erection. Make a note of this time and compare say 10 mins after ejaculation, 1 hour after, 1 day after etc.

Now, if you know you're meeting someone on friday night you might be having sex with, maybe don't cum for say 2 days beforehand, just to be sure. But 1 month is pointless!!

Here is a good tip that will help identify and separate your problem into its physical and psychological components. Buy an artificial vagina (aka male masturbator) - you can get one from any local or online sex shop. A fleshlight is not great, because it has a hard outer shell which gets in the way when you're trying to simulate some sex positions like man on top. There are hundreds of other brands / types.

So get an erection and start "having sex" into this sex toy. Try different positions including on a bed with you on top, like the missionary position. Don't move the toy with your hand but actually thrust into it with your hips to simulate sex. If you can keep the erection like this, it further proves your problem is not physical. Try not to go straight to orgasm, try to last for 20 minutes or longer if you can. Using a sex toy like this is very good for practicing orgasm control (premature ejaculation).

Further, and perhaps most importantly, put on a condom and have sex into the sex toy. A lot of guys complain that condoms ruin their erection. So if you can keep your erection now, this proves that using a condom is not causing a problem and could save you an STI and some child support.

So if you've got possible sex coming up on friday night, you could in fact try out the sex toy before you leave the house (with no orgasm/ejaculation). It's still fully possible that your erection will fail during sex later that night, but this last minute sex toy test will give you one last push of confidence and further establish that, literally, it's all in your mind.