Sexual Dysfunction: Causes and Solutions for Young Men

Sexual function

My boyfriend is currently 28 years old and was a premature baby born at 9 months, having spent time in an incubator.
He has a fondness for ice and has always had issues with his bronchial health, experiencing dry coughs, especially when consuming cold foods.
Around the sixth grade, he underwent a varicocelectomy due to venous valve insufficiency, which caused swelling and pain in both groin areas.
At that time, the doctor mentioned that if the veins were not ligated, it could compress the testicles and lead to infertility in the future.

We have been sexually active for about six months, and during intercourse, he often struggles to maintain an erection, becoming flaccid at critical moments, which prevents penetration.
I have heard that premature babies may have poorer health, which could affect sexual function later in life.
Could this issue be related to his premature birth or the varicocelectomy? Or could it be due to daytime fatigue from work and psychological stress? What methods can be employed to improve this situation?

Ms. Chen, 20~29 year old female. Ask Date: 2000/09/29

Dr. Liu Jianting reply Urology

There are many factors contributing to sexual dysfunction, but they are not related to your stated medical history, including premature birth and varicocele surgery.
Sexual activity is an expression of mutual understanding, empathy, respect, and care.
Therefore, experiencing setbacks can often be very distressing.
I recommend that both of you visit a urology clinic or a sexual health clinic for further evaluation.

Reply Date: 2000/09/29

More Info

Sexual dysfunction, particularly erectile dysfunction (ED), can be a complex issue for young men, often influenced by a combination of psychological, physiological, and lifestyle factors. In the case of your boyfriend, several elements may contribute to his difficulties with maintaining an erection during sexual activity.

1. Psychological Factors:
Stress and anxiety are significant contributors to erectile dysfunction, especially in younger men. Performance anxiety, fear of failure, or concerns about sexual performance can create a cycle of stress that exacerbates the problem. This is particularly relevant if your boyfriend has experienced difficulties in the past, as these experiences can lead to increased anxiety during future encounters. Encouraging open communication about sexual experiences and feelings can help alleviate some of this pressure.

2. Physical Health and Medical History:
Your boyfriend's medical history, including being a premature infant and having undergone surgery for varicocele (a condition that can affect blood flow and hormone levels), may play a role in his current sexual function. Varicocele can lead to reduced testosterone levels and impaired sperm production, which might affect libido and erectile function. While being a premature infant does not directly correlate with sexual dysfunction, it can sometimes be associated with other health issues that may indirectly affect sexual health.

3. Lifestyle Factors:
Lifestyle choices, such as diet, exercise, and sleep patterns, significantly impact sexual health. A diet high in processed foods and low in nutrients can affect overall health, including sexual function. Regular physical activity is crucial, as it improves blood circulation, reduces stress, and boosts testosterone levels. If your boyfriend has a sedentary lifestyle or is not engaging in regular exercise, this could be a contributing factor to his erectile difficulties.

4. Hormonal Factors:
Testosterone levels naturally decline with age, but they can also be affected by various factors, including stress, obesity, and certain medical conditions. If your boyfriend has low testosterone levels, this could lead to decreased libido and erectile dysfunction. A healthcare provider can evaluate hormone levels through blood tests and recommend appropriate interventions if necessary.

5. Medical Evaluation:
Given your boyfriend's history of varicocele and other health issues, it would be prudent for him to consult a healthcare professional for a thorough evaluation. This may include a physical examination, blood tests to check hormone levels, and possibly imaging studies to assess blood flow to the penis. Understanding the underlying causes of his erectile dysfunction is essential for determining the most effective treatment options.

6. Treatment Options:
Treatment for erectile dysfunction can vary based on the underlying causes. Psychological counseling or sex therapy can be beneficial for addressing anxiety and performance issues. If physical factors are identified, treatments may include lifestyle modifications, medications (such as PDE5 inhibitors like Viagra), or other medical interventions.
7. Communication and Support:
It's crucial for you to support your boyfriend emotionally. Encourage him to talk about his feelings and experiences, and reassure him that sexual dysfunction is a common issue that many men face. Building intimacy and trust in your relationship can help reduce performance anxiety and improve sexual experiences.

In conclusion, your boyfriend's erectile dysfunction may stem from a combination of psychological stress, physical health issues, and lifestyle factors. A comprehensive approach that includes medical evaluation, lifestyle changes, and emotional support can significantly improve his sexual health and overall well-being. Encourage him to seek professional help to address these concerns effectively.

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