Talk to General Physician on Sexual Anorexia, ED

Severe Sexual dysfunction with real partner. Details are as 1-Life long preoccupation with fetishist and masochistic fantasies and related compulsive masturbatory addiction lasting for over a decade 2- Diminished interest in vanilla sex to the point of severe sexual anorexia. 3- PDE5 inhibitor (cilias) has been ineffective. 3- No anamoly in blood CP LFT, RFT, CRP, ESR 4- The nature of ED was diagnosed as psychogenic by a sexologist after an initial physical examination of the genitals. 5- Persistent shoulder and back muscle aching and gastrointestinal troubles. 6- Prescription of SSRI (cipralex10mg) by a psychiatrist after noticing signs of depression in the initial session. That line of action was not pursued further after a month fearing probable adverse side effects on the libido. Any insight into the matter enlightening warranted course of action would be really appreciated.