Frequent Urination and Erectile Dysfunction in Young Men

Frequent urination and erectile dysfunction?

Hello Dr.
Chen! My name is Lin, and I am 25 years old.
I have some symptoms I would like to consult you about.
Recently, I have been troubled by frequent urination, going more than eight times a day.
I drink a lot of water, but what confuses me is that 1 to 2 years ago, even when I drank this much water, I did not have to go to the bathroom so often.
Now, it has become more severe; after drinking just a sip of water, I feel the urge to urinate in about 20 minutes.
Additionally, at night, I have to get up to urinate, sometimes once and sometimes twice.
I used to experience nocturia but could still sleep well.
Recently, it has been harder for me to fall asleep, and sometimes the thought of needing to urinate at night interrupts my sleep, which is quite bothersome.

In May of this year, I visited a urologist who tested my urine and said I had autonomic nervous system dysfunction.
I was prescribed medication, but after finishing the course, the frequent urination phenomenon still occurred a few weeks later.
I wonder if you could assess what might be causing these symptoms.

Another issue is related to masturbation...
I know that masturbation can stimulate the prostate and lead to frequent urination.
I typically masturbate every 3 to 7 days.
I have noticed that my erectile function seems to be affected; although I experience morning erections, the hardness during masturbation is not as firm as it is in the morning (I can feel a noticeable difference).
It seems that the engorgement of the corpora cavernosa is not as strong as before, and the erection is less pronounced.
This phenomenon has been occurring over the past 1 to 2 years, and I feel that the quality of my masturbation has also been affected.

I hope Dr.
Chen can help me diagnose these conditions so that I can receive appropriate treatment.
My main concerns are the frequent urination issue and the erectile difficulties related to masturbation.
Thank you, doctor!

Xiao Lin, 20~29 year old female. Ask Date: 2018/10/17

Dr. Chen Jiansheng reply Urology

Urination and erections can sometimes be influenced by emotions, along with age-related factors.
Therefore, frequent urination may occur.
It is generally recommended to consider pharmacological treatment in conjunction with adjustments to a normal lifestyle and daily routine.

Reply Date: 2018/10/17

More Info

Frequent urination and erectile dysfunction can be concerning symptoms for young men, and understanding their potential causes is crucial for effective management. Based on the information provided, it seems that you are experiencing two main issues: increased frequency of urination and changes in erectile function.

Frequent Urination
Frequent urination, defined as needing to urinate more than eight times a day, can be caused by a variety of factors. In your case, it appears that this symptom has developed over the past couple of years, despite maintaining a similar fluid intake. Here are some potential causes:
1. Overactive Bladder: This condition is characterized by a sudden urge to urinate, often leading to increased frequency and nocturia (waking up at night to urinate). It can be caused by various factors, including bladder irritation, neurological conditions, or even stress.

2. Diabetes: Both type 1 and type 2 diabetes can lead to increased urination due to high blood sugar levels, which cause the kidneys to excrete more glucose and water.

3. Prostate Issues: In younger men, conditions like prostatitis (inflammation of the prostate) can lead to urinary symptoms. Although less common in your age group, it’s worth considering.

4. Medication Side Effects: Some medications, especially diuretics or those affecting the autonomic nervous system, can increase urination frequency.

5. Psychogenic Factors: Anxiety and stress can also manifest as increased urinary frequency, sometimes referred to as "nervous bladder."
Since you mentioned that a urologist previously diagnosed you with autonomic nervous system dysregulation, it’s possible that stress or anxiety is contributing to your symptoms. If the medication prescribed did not alleviate your symptoms, it may be beneficial to follow up with your healthcare provider to explore other treatment options or further evaluations.

Erectile Dysfunction
Regarding your concerns about erectile function, it’s important to recognize that various factors can contribute to changes in erectile quality, especially in young men. Here are some considerations:
1. Psychological Factors: Anxiety, stress, and performance pressure can significantly impact erectile function. If you are concerned about your frequency of urination or other health issues, this could lead to anxiety that affects your sexual performance.

2. Physical Health: Conditions such as obesity, diabetes, or cardiovascular issues can affect blood flow and nerve function, leading to erectile difficulties. It’s essential to maintain a healthy lifestyle, including regular exercise and a balanced diet.

3. Hormonal Factors: Testosterone levels can influence libido and erectile function. If you suspect hormonal imbalances, a healthcare provider can perform tests to evaluate your hormone levels.

4. Substance Use: Alcohol and recreational drugs can impair erectile function. If you consume these substances, consider moderating your intake.

5. Masturbation Frequency: While masturbation is a normal activity, excessive frequency can lead to temporary changes in erectile function. However, your reported frequency (every 3-7 days) seems within a normal range.

Recommendations
1. Follow-Up with a Urologist: Given your symptoms, it would be beneficial to revisit a urologist for a comprehensive evaluation. They may recommend additional tests, such as a bladder diary, urine flow studies, or imaging studies, to assess your urinary function.

2. Lifestyle Modifications: Focus on maintaining a healthy lifestyle, including regular physical activity, a balanced diet, and adequate hydration. Reducing stress through mindfulness or relaxation techniques may also help.

3. Consider Psychological Support: If anxiety or stress is a significant factor, speaking with a mental health professional can provide strategies to manage these feelings and improve your overall well-being.

4. Monitor Symptoms: Keep track of your urinary patterns, erectile function, and any other symptoms. This information can be valuable for your healthcare provider in diagnosing and managing your conditions.

In conclusion, frequent urination and erectile dysfunction can be interconnected and influenced by various physical and psychological factors. A thorough evaluation by a healthcare professional is essential to determine the underlying causes and appropriate treatment options.

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