Erection Issues: Causes and Solutions for Young Men

Erectile dysfunction

Hello Doctor: I am 23 years old, a graduate student, and I have not engaged in sexual intercourse.
I occasionally work out, but I do very little aerobic exercise.
I have noticed a significant decrease in my libido over the past six months to a year (it's been quite a while, but I'm not sure of the exact time; it may have started in college).
I used to experience erections or arousal in response to watching adult films or other external stimuli, but I have found that my response to such stimuli has diminished over time.
It has become increasingly difficult to achieve an erection, and even when I do, the firmness and size are noticeably different from before.
My morning erections have also changed in terms of firmness and frequency.
After each episode of masturbation, I often feel a dull sensation in my bladder (which occasionally happens otherwise), a slight feeling of fullness, and a bit of dizziness.
I am unsure if this is normal.
During college, when I was younger and more impulsive, I frequently watched adult films and would masturbate every two to three days, and I also noticed that the time to ejaculation has gradually decreased.
I would like to know if my previous habits could be affecting my current situation, and whether my current condition leans more towards a physical issue, a psychological issue, or simply a matter of stress.
I would appreciate any advice you could provide.
Thank you.

home2005, 20~29 year old female. Ask Date: 2018/06/03

Dr. Du Mingyi reply Urology

Basically, your issues are caused by psychological factors, and there are no organ-related problems.
The first method for improvement is to stop watching adult films and masturbating.
When exercising, don't just focus on weight training; incorporate aerobic exercises as well.
Another key point is to learn how to make female friends and how to interact with women.
Having a basic understanding of social interactions is essential for developing subsequent romantic relationships.

Reply Date: 2018/06/03

More Info

Erection issues in young men can stem from a variety of factors, including psychological, physiological, and lifestyle influences. Your situation, as described, suggests a combination of these elements, and it’s important to approach this comprehensively.

Psychological Factors
One of the most common causes of erectile dysfunction (ED) in younger men is psychological. Stress, anxiety, and depression can significantly impact sexual desire and performance. Given that you mentioned a decrease in sexual desire and difficulty achieving erections, it’s possible that psychological factors are at play. The pressure to perform, especially in a society that often emphasizes sexual prowess, can lead to anxiety, which in turn can create a cycle of decreased sexual function.

Physiological Factors
Physiological issues can also contribute to erectile dysfunction. Hormonal imbalances, particularly low testosterone levels, can lead to decreased libido and erectile difficulties. It might be beneficial to have your hormone levels checked, especially since you’ve noticed a significant change in your sexual function. Additionally, conditions such as diabetes, cardiovascular issues, or even certain medications can affect blood flow and nerve function, leading to ED.

Lifestyle Influences
Your lifestyle choices can also play a crucial role in sexual health. You mentioned that you engage in occasional weight training but do not participate in aerobic exercise. Regular aerobic exercise is essential for maintaining cardiovascular health, which is directly linked to erectile function. Poor cardiovascular health can lead to reduced blood flow to the penis, making it difficult to achieve or maintain an erection. Incorporating regular aerobic activities, such as running, cycling, or swimming, can improve blood circulation and overall health.

Moreover, excessive consumption of pornography can lead to unrealistic expectations regarding sexual performance and body image. It can also desensitize you to sexual stimuli, making it harder to become aroused in real-life situations. If this has been a significant part of your sexual experience, it might be worth considering reducing your consumption of pornographic material.

Urinary Symptoms
The sensations you describe, such as a feeling of fullness in the bladder and slight dizziness after ejaculation, could be related to several factors. It’s not uncommon for men to experience some discomfort after ejaculation, especially if they have been tense or anxious. However, if these symptoms persist, it would be wise to consult a healthcare professional to rule out any underlying conditions, such as prostatitis or urinary tract infections.

Recommendations
1. Consult a Healthcare Professional: Given the complexity of your symptoms, it’s advisable to seek a thorough evaluation from a urologist or a healthcare provider specializing in sexual health. They can conduct necessary tests, including hormone levels and possibly a physical examination.

2. Mental Health Support: Consider speaking with a mental health professional if you suspect that anxiety or stress is contributing to your symptoms. Cognitive-behavioral therapy (CBT) can be particularly effective in addressing performance anxiety and improving sexual function.

3. Lifestyle Changes: Incorporate regular aerobic exercise into your routine, maintain a balanced diet, and ensure you are getting adequate sleep. These changes can improve your overall health and potentially enhance your sexual function.

4. Limit Pornography Use: Reducing your consumption of pornography may help in resetting your sexual responses and improving your arousal to real-life stimuli.

5. Practice Relaxation Techniques: Techniques such as mindfulness, meditation, or yoga can help reduce stress and improve your overall mental well-being, which can positively affect your sexual health.

In conclusion, your situation appears to be multifaceted, involving psychological, physiological, and lifestyle components. By addressing these areas holistically, you can work towards improving your sexual health and overall well-being. Remember, seeking professional help is a crucial step in understanding and resolving these issues effectively.

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