Prostate Pain and Erectile Issues: A Urology Perspective

Special Symptoms and Functions

I would like to ask the doctor a few questions: I am currently 23 years old.
Since high school, I have noticed that whenever I am stimulated by women (through words, texts, or physical actions) and experience the secretion of pre-seminal fluid (which may not be related to prostate secretion), if I do not ejaculate, I will have a vague pain in my left abdomen after a while, and sometimes my testicles also hurt.
However, if I do ejaculate, it can alleviate or even resolve the pain; if not, the discomfort may persist.
During my senior year of high school (before I had any sexual experiences), I consulted a urologist, but at that time, I did not explain the above situation in detail as I was accompanied by family members.
I was only diagnosed with kidney stones.
In general sexual activities, since ejaculation occurs, I do not experience the aforementioned issues.
This phenomenon still persists, and while I understand how to avoid it, I still cannot find an answer.

I would like to ask the doctor another question: When I have sex with my girlfriend, I experience a high likelihood of erectile dysfunction both with and without a condom.
Changing positions causes my erection to gradually soften, and I must quickly reinsert to regain firmness.
Additionally, after thrusting for several minutes, my erection tends to soften during the process, which severely impacts our sexual experience.
I have a very low level of physical activity; are there specific dietary changes or exercises that could effectively improve this situation?

Xiao Wu, 20~29 year old female. Ask Date: 2017/09/10

Dr. Li Xinyi reply Urology

If there is no ejaculation, after a period of time, there may be a vague pain in the left abdomen or pain in the testicles.
In some cases, even after ejaculation, individuals may still feel discomfort in the pelvic area.
This does not appear to be indicative of a pathological issue.
The second concern relates to health and personal interests.
The aspects you mentioned also do not seem to suggest a pathological problem, as there is a wealth of information available on diet and exercise through Google.
Maintaining physical health is also essential for sexual health.
If there are any concerns, it is advisable to consult a urologist for an examination and to discuss with the physician.

Reply Date: 2017/09/10

More Info

Understanding prostate pain and erectile issues can be complex, especially for younger individuals like yourself. At 23, experiencing discomfort in the lower abdomen and testicular pain related to sexual arousal without ejaculation is not uncommon, but it can be concerning. Let’s break down your symptoms and explore potential causes and solutions.

Prostate Pain and Related Symptoms
The discomfort you describe in your left abdomen and testicles after sexual arousal without ejaculation may be linked to a few factors, primarily involving the prostate and pelvic floor muscles. The prostate gland produces prostatic fluid, which is a component of semen. When you are sexually aroused, the prostate becomes engorged with blood and may produce fluid. If ejaculation does not occur, this buildup can lead to a sensation of fullness or discomfort, often referred to as "prostatitis" or pelvic pain syndrome.

Chronic pelvic pain syndrome (CPPS) is a common diagnosis that can manifest as pain in the pelvic region, including the lower abdomen and testicles. This condition can be exacerbated by stress, anxiety, and even prolonged periods of sexual arousal without release. The relief you experience after ejaculation is likely due to the release of built-up pressure and tension in the prostate and surrounding muscles.

Erectile Dysfunction and Soft Erection Issues
Regarding your concerns about erectile dysfunction (ED) during sexual activity, this can be influenced by several factors. Psychological factors, such as anxiety about performance, can significantly impact erectile function. Additionally, physical factors, including reduced blood flow or nerve function, can also contribute to difficulties in maintaining an erection.

You mentioned that you have a low level of physical activity. Regular exercise can improve overall blood circulation, enhance mood, and reduce anxiety, all of which are beneficial for sexual health. Incorporating cardiovascular exercises, such as running, swimming, or cycling, can improve blood flow and potentially enhance erectile function. Strength training can also be beneficial, as it helps build muscle and improve testosterone levels, which can influence libido and erectile function.

Dietary Considerations
Diet plays a crucial role in sexual health. A balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats can improve overall health and potentially enhance sexual function. Foods high in antioxidants, such as berries and leafy greens, can improve blood circulation. Omega-3 fatty acids found in fish, nuts, and seeds can also support cardiovascular health. Additionally, staying hydrated is essential, as dehydration can affect blood volume and circulation.

Recommendations
1. Consult a Urologist: Given your symptoms, it may be beneficial to consult a urologist who specializes in pelvic pain and erectile dysfunction. They can perform a thorough evaluation, including physical examinations and possibly imaging studies, to rule out any underlying conditions.

2. Pelvic Floor Exercises: Consider pelvic floor exercises (Kegel exercises) to strengthen the muscles around the prostate and bladder. These exercises can help improve control over urination and ejaculation, potentially alleviating some discomfort.

3. Manage Anxiety: If anxiety about sexual performance is contributing to your erectile issues, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) can be effective in addressing performance anxiety.

4. Lifestyle Changes: Increase your physical activity level and adopt a healthier diet. Regular exercise and a balanced diet can improve your overall health and sexual function.

5. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur and any potential triggers. This information can be helpful for your healthcare provider in diagnosing and treating your condition.

In conclusion, while your symptoms may be concerning, they are not uncommon among young men. With appropriate medical guidance, lifestyle changes, and possibly some therapeutic interventions, you can manage your symptoms effectively and improve your sexual health.

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