Erectile Dysfunction: Signs, Causes, and Solutions

Does this qualify as erectile dysfunction?

Hello doctor, I’m not sure if I have erectile dysfunction.
Since college, my erectile response while watching adult films has not been as quick as it was in high school; I need to use my hand to achieve an erection.
I didn’t think much of it until recently when I noticed difficulty achieving an erection during masturbation, or that my erection would quickly subside.
I realized my situation might not be normal, so I wanted to ask a few questions.

1.
I have been masturbating since elementary school, using friction on my penis until ejaculation rather than achieving ejaculation through an erection.
Could this method of masturbation affect my ability to achieve normal erections later on?
2.
Is masturbating once a day during college considered excessive? (I achieve erections through manual stimulation.)
3.
I have had girlfriends, but due to phimosis, I am afraid that penetration will be painful, so I am uncertain if I can complete intercourse.
Additionally, I recently observed that one night I woke up to find I had an erection, and it was quite firm.
I suspect that a long-term lack of exercise may have contributed to my sexual dysfunction, so I have been running every morning for the past few days.
After running, I noticed a slight improvement in the firmness of my erections, but the duration is still insufficient.
Can these symptoms be considered indicative of erectile issues? Thank you.

zero zero, 20~29 year old female. Ask Date: 2016/04/06

Dr. Fu Shizhang reply Urology

Erectile function is closely related to daily routines, diet, exercise, and life stress.
If there are normal erections during nighttime sleep or upon waking in the morning, erectile dysfunction is unlikely.
In young individuals, the most common cause of erectile issues is psychological.
Online consultations cannot replace an in-person evaluation and physical examination by a physician.
If there are underlying health issues, it is still recommended to seek medical care at a healthcare facility.

Reply Date: 2016/04/06

More Info

Erectile dysfunction (ED) is a condition that affects many men at various stages of life, and understanding its signs, causes, and potential solutions is crucial for addressing the issue effectively. Based on your description, it seems you are experiencing some difficulties with achieving and maintaining an erection, which can indeed be classified as erectile dysfunction. Let's break down your concerns and provide some insights.

Signs of Erectile Dysfunction
1. Difficulty Achieving an Erection: If you find that you require manual stimulation to achieve an erection, this can be an early sign of ED.

2. Difficulty Maintaining an Erection: If you experience an erection that does not last long enough for satisfactory sexual activity, this is also indicative of ED.

3. Changes Over Time: Noticing a decline in your erectile response compared to earlier years, such as during high school, can be a sign that something has changed, warranting further investigation.

Causes of Erectile Dysfunction
ED can stem from a variety of factors, including:
1. Physical Causes: Conditions such as diabetes, hypertension, cardiovascular diseases, and hormonal imbalances can affect blood flow and nerve function, leading to ED.

2. Psychological Causes: Stress, anxiety, depression, and relationship issues can also contribute to erectile difficulties.

3. Lifestyle Factors: Lack of physical activity, poor diet, smoking, and excessive alcohol consumption can negatively impact erectile function.

Addressing Your Concerns
1. Masturbation Techniques: Your method of masturbation, relying on friction rather than achieving an erection, is unlikely to cause long-term erectile dysfunction. However, it may condition your body to respond differently to sexual stimulation. It's essential to explore various forms of stimulation to maintain a healthy sexual response.

2. Frequency of Masturbation: Masturbating once a day is generally considered normal and not excessive for most men. However, if you feel that it is interfering with your sexual life or causing anxiety, it might be worth evaluating your habits.

3. Physical Health: Your observation of waking up with an erection indicates that your body is still capable of achieving an erection under certain conditions, which is a positive sign. This phenomenon, known as nocturnal penile tumescence, suggests that your erectile tissue is functioning correctly.
4. Impact of Physical Activity: Regular exercise, such as running, can improve blood circulation and overall health, which may positively influence erectile function. It’s great that you’ve started a routine, as physical fitness can enhance libido and erectile performance.

5. Concerns About Phimosis: If you have phimosis (a condition where the foreskin cannot be fully retracted), it can cause discomfort during sexual activity and may contribute to anxiety about penetration. Consulting a healthcare professional about this condition is advisable, as they can provide options for treatment or management.

Solutions and Recommendations
1. Consult a Healthcare Provider: It’s essential to discuss your symptoms with a healthcare provider who can evaluate your overall health, perform necessary tests, and provide tailored advice. They may suggest lifestyle changes, therapy, or medications if appropriate.

2. Psychological Support: If anxiety or stress is contributing to your ED, consider speaking with a mental health professional. Therapy can help address underlying psychological issues.

3. Healthy Lifestyle Choices: Continue with regular exercise, maintain a balanced diet, and avoid smoking and excessive alcohol. These changes can significantly improve your sexual health.

4. Open Communication: If you have a partner, discussing your concerns openly can help alleviate anxiety and improve intimacy.

In conclusion, while your symptoms may indicate erectile dysfunction, there are various factors at play, and many solutions are available. Seeking professional advice is the best course of action to address your concerns comprehensively. Remember, you are not alone in this, and many men experience similar issues at different stages of life.

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