Erectile Dysfunction and Lower Abdominal Pain: Causes and Solutions

Q: Erectile Dysfunction and Lower Abdominal Pain: Causes and Solutions

Hello： If the examination and consultation are conducted by a clinic or a non-urologist, please visit a hospital's urology department for further evaluation. <br>Many urological symptoms may still indicate underlying issues. <br>Avoid vigorous physical activity temporarily, refra

Erectile dysfunction, lower abdominal pain?

Hello Doctor, about six months ago I started experiencing erectile difficulties.
During intercourse, I often lack sufficient rigidity, and I can only occasionally achieve penetration.
Additionally, I have a slight aching sensation in my lower abdomen (pubic area).
The pain becomes more intense when I have a full bladder, during ejaculation, after an erection, or when pressure is applied.
Sometimes, I feel a sensation of incomplete bladder emptying when urinating, and occasionally, when squatting or performing certain movements that put pressure on the bladder, I leak a drop or two of urine.

Over the past six months, I have consulted several doctors:
1.
Doctor A mentioned that I have a mild hernia (X-ray and urinalysis were normal).
2.
Doctor B suggested that it might be due to stress and holding in urine (based on a verbal consultation) and monitored my urinary output and frequency for two weeks, which were both normal.
He prescribed muscle relaxants for me.
3.
Doctor C conducted urinalysis, semen analysis, bacterial cultures, and a testicular ultrasound, all of which were normal.
He suspected prostatitis and prescribed antibiotics for two weeks, but the pain persists.
Recently, my libido has noticeably decreased.
I still experience morning erections, but they are not as firm as before; they are semi-rigid.
I have always maintained a regular exercise routine (playing sports, running), and I only have a fixed partner.
This situation is really troubling me.
Thank you for your response.

Tom, 20~29 year old female. Ask Date: 2017/04/23

Dr. Du Shixi reply Urology

Hello: If the examination and consultation are conducted by a clinic or a non-urologist, please visit a hospital's urology department for further evaluation.
Many urological symptoms may still indicate underlying issues.
Avoid vigorous physical activity temporarily, refrain from masturbation, and do not take over-the-counter medications.
Minimize activities that put pressure on the perineum and abdomen.
If it is indeed prostatitis, medication may need to be taken for several weeks or more.
However, it is important to continue monitoring your lifestyle.

Reply Date: 2017/04/23

More Info

Erectile dysfunction (ED) and lower abdominal pain can be interconnected issues that significantly affect a person's quality of life. Based on your description, it seems you have been experiencing a combination of symptoms, including difficulty achieving and maintaining an erection, lower abdominal discomfort, and urinary issues. Understanding the potential causes and solutions for these symptoms is crucial.

Possible Causes
1. Psychological Factors: Anxiety and stress are common contributors to erectile dysfunction. The pressure to perform sexually can create a cycle of anxiety that exacerbates the problem. Since you mentioned experiencing stress, this could be a significant factor in your situation.

2. Physical Conditions:
- Prostatitis: Inflammation of the prostate can lead to pain in the lower abdomen and pelvic area, as well as erectile dysfunction. Your previous consultations with doctors regarding prostatitis and the prescribed antibiotics suggest this could be a contributing factor.

- Hernia: A mild hernia can cause discomfort in the lower abdomen and may affect sexual function. However, since imaging and urinalysis have returned normal results, this may not be the primary issue.

- Urinary Tract Issues: The sensation of incomplete urination and pain during urination can indicate a urinary tract infection or bladder issues, which could also contribute to erectile dysfunction.

- Hormonal Imbalances: Low testosterone levels can lead to decreased libido and erectile difficulties. Hormonal evaluations may be warranted if this is suspected.

3. Lifestyle Factors: Regular exercise is beneficial for overall health, including sexual health. However, if you are experiencing significant stress or anxiety, it may impact your physical performance and sexual function.

Solutions and Recommendations
1. Consult a Urologist: Since you've already seen multiple doctors, it may be beneficial to return to a urologist for a comprehensive evaluation. They can perform further tests, including hormonal assessments, to rule out underlying conditions that may be affecting your sexual health.

2. Psychological Counseling: If anxiety is a significant factor, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) can help address performance anxiety and improve sexual function.

3. Medication Review: Discuss with your healthcare provider the medications you are currently taking. Muscle relaxants and other medications may have side effects that impact sexual performance. A review of your medications may lead to adjustments that could alleviate some of your symptoms.

4. Lifestyle Modifications: Continue engaging in regular physical activity, as it can improve blood flow and reduce anxiety. Additionally, consider incorporating relaxation techniques such as yoga or meditation to help manage stress levels.

5. Pelvic Floor Exercises: Strengthening the pelvic floor muscles through Kegel exercises can improve urinary control and may enhance erectile function. These exercises can be beneficial for both men and women.

6. Follow-Up: Keep track of your symptoms and maintain open communication with your healthcare providers. Regular follow-ups can help monitor your condition and adjust treatment plans as necessary.

Conclusion
Erectile dysfunction and lower abdominal pain can stem from a variety of physical and psychological factors. A comprehensive approach that includes medical evaluation, psychological support, and lifestyle changes can help address these issues effectively. It’s essential to remain proactive in seeking solutions and to communicate openly with your healthcare providers about your symptoms and concerns.

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