Erectile Dysfunction: Causes, Treatments, and Concerns

Erectile dysfunction

Hello Doctor: A couple of months ago, I suddenly experienced erectile difficulties.
Initially, I could achieve an erection, but often pre-ejaculate fluid would come out first, and then within a minute, I would lose my erection, accompanied by a feeling of rapid heartbeat.
Previously, the doctor only prescribed me 5mg of Cialis to try, which worked normally, but it seems that without it, I can't perform.
I'm very worried and don't dare to let my family know because most articles say that young men often have psychogenic issues.
I maintain a regular schedule, but despite my continuous exercise and going to bed early, there seems to be only slight improvement.
A few weeks ago, I suddenly had an episode of epididymitis, but after taking medication, the doctor said it was okay.
However, I still occasionally experience sharp pain in the groin area, and morning erections have almost ceased.
Now, I don't even dare to masturbate, and this has been going on for over a month.
I hope the doctor can give me some advice.

as, 20~29 year old female. Ask Date: 2016/11/03

Dr. Du Shixi reply Urology

Hello, I understand your concerns.
It might be helpful to relax a bit.
Consider whether your weight is too high, maintain a balanced diet (minimize fried foods), ensure you have adequate sleep, and engage in moderate exercise (like walking or running).
Try to avoid sitting for long periods or spending excessive time online; if you do go online, limit exposure to stimulating content.
If relaxation is difficult, it may be beneficial to consult a urologist for medication assistance to help rebuild your confidence.
Additionally, using medications like Viagra occasionally is a temporary solution; it's important to focus on regaining your confidence first.
Thank you for your inquiry.

Reply Date: 2016/11/03

More Info

Erectile dysfunction (ED) is a common condition that can affect men of all ages, though it is often more prevalent in older individuals. Understanding the causes, treatments, and concerns surrounding ED is essential for effective management and improvement of quality of life.

Causes of Erectile Dysfunction
ED can be caused by a variety of factors, which can be broadly categorized into physical and psychological causes:
1. Physical Causes:
- Cardiovascular Issues: Conditions such as hypertension, atherosclerosis, and heart disease can impede blood flow to the penis, making it difficult to achieve or maintain an erection.

- Diabetes: High blood sugar levels can damage blood vessels and nerves, leading to ED.

- Hormonal Imbalances: Low testosterone levels can contribute to erectile difficulties.

- Neurological Disorders: Conditions like multiple sclerosis, Parkinson's disease, and spinal cord injuries can affect nerve signals that are necessary for an erection.

- Medications: Some medications, including those for high blood pressure, depression, and anxiety, can have side effects that include ED.

2. Psychological Causes:
- Anxiety and Stress: Performance anxiety, stress from work or relationships, and general anxiety can interfere with sexual arousal.

- Depression: Mental health issues can significantly impact libido and sexual function.

- Relationship Problems: Issues with a partner can lead to emotional distress that affects sexual performance.

Treatments for Erectile Dysfunction
The treatment for ED often depends on the underlying cause. Here are some common approaches:
1. Medications: Phosphodiesterase type 5 inhibitors (PDE5 inhibitors) like sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) are commonly prescribed. These medications enhance blood flow to the penis, facilitating an erection in response to sexual stimulation. It’s important to note that these medications do not work without sexual arousal.

2. Lifestyle Changes: Improving overall health can have a positive impact on erectile function. This includes:
- Regular exercise
- A balanced diet
- Quitting smoking
- Reducing alcohol consumption
- Managing stress through relaxation techniques or therapy
3. Counseling: If psychological factors are contributing to ED, therapy with a mental health professional can be beneficial. This may involve cognitive-behavioral therapy (CBT) or couples therapy.

4. Hormone Therapy: If low testosterone levels are identified, hormone replacement therapy may be considered.

5. Vacuum Erection Devices: These devices create a vacuum that pulls blood into the penis, helping to achieve an erection.

6. Surgery: In cases where other treatments are ineffective, surgical options such as penile implants may be considered.

Concerns and Considerations
It’s understandable to feel anxious about experiencing ED, especially at a younger age. The concerns about being perceived as having a psychological issue are common, but it’s important to remember that ED can have multiple causes, and seeking help is a positive step.

Your experience with pre-ejaculatory fluid and rapid loss of erection could indicate a combination of physical and psychological factors at play. The fact that you have had a recent episode of epididymitis (inflammation of the epididymis) could also contribute to discomfort and anxiety regarding sexual performance.

It’s crucial to have open communication with your healthcare provider about your symptoms, concerns, and any medications you are taking. If you find that the medication prescribed (like sildenafil) is effective but you are concerned about dependency, discuss this with your doctor. They may suggest a treatment plan that includes both medication and lifestyle modifications.

Additionally, if you are experiencing ongoing pain in the groin area or any other concerning symptoms, it is important to follow up with your healthcare provider for further evaluation.

In summary, ED is a multifaceted condition that can often be treated effectively. Addressing both the physical and psychological aspects of the issue is key to finding a solution that works for you. Don’t hesitate to seek support from healthcare professionals who can guide you through this process.

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