Erectile Dysfunction: Causes and Solutions for Men

Q: Erectile Dysfunction: Causes and Solutions for Men

Hello： This platform cannot provide a diagnosis, but based on your symptoms, it sounds like there may be a prostate issue. <br>Complete abstinence is not necessary; moderate and gentle exercise is recommended, but avoid cycling (especially for extended periods) to prevent excessi

Morning erections have disappeared, and the hardness of erections is insufficient, leading to them quickly becoming soft?

Hello, I have been experiencing long-term excessive sexual activity, almost daily masturbation for many years.
Recently, I have noticed that my morning erections have almost completely disappeared, and I am experiencing slow erections, insufficient hardness, and a tendency for my erections to soften easily.
This is in contrast to the past when I could achieve morning erections daily, respond quickly to stimulation, and maintain sufficient hardness and duration.
I have also had experiences of prolonged erections that led to pain in my lower abdomen and testicles, but this resolved after resting.

A while ago, I experienced hematospermia followed by a condition where my semen did not liquefy (even after waiting 30 minutes, it still did not liquefy).
Additionally, I felt a foreign body sensation and slight pain when expelling semen.
I have also had issues with urination, where I felt that I could not fully empty my bladder, and I had to exert myself to squeeze out a little more urine, with a sensation of urine remaining in my urethra, especially when lying down.

Recently, I visited a urologist for urine and semen tests, and the doctor said everything was fine.
Since the tests showed no issues, I am seeking further advice.
I have started abstaining and exercising daily for about 1-2 weeks.
I am unsure if my urination problems are related to prostate issues or something else, and I would like to know what further tests I should undergo.
The consulting physician said there were no problems and did not prescribe any medication, so I am uncertain whether I should continue seeking medical advice.

I appreciate your assistance in addressing my concerns.
Thank you.

Mr. Li, 20~29 year old female. Ask Date: 2018/11/08

Dr. Du Shixi reply Urology

Hello: This platform cannot provide a diagnosis, but based on your symptoms, it sounds like there may be a prostate issue.
Complete abstinence is not necessary; moderate and gentle exercise is recommended, but avoid cycling (especially for extended periods) to prevent excessive pressure on the perineum.
Occasional warm sitz baths may be beneficial.
If you have had any unsafe sexual encounters, please seek medical evaluation.
As for your diet, it should be light.
Drink water instead of beverages; plain water is sufficient.
Wishing you good health.

Reply Date: 2018/11/08

More Info

Erectile dysfunction (ED) is a complex condition that can stem from various physical, psychological, and lifestyle factors. Your situation, characterized by a history of excessive masturbation, diminished morning erections, and issues with erection hardness and duration, suggests that several interconnected factors may be at play.

Causes of Erectile Dysfunction
1. Physical Factors: Chronic excessive masturbation can lead to temporary fatigue of the erectile tissues. The penis relies on a healthy blood flow and nerve function to achieve and maintain an erection. Overstimulation can desensitize the nerves and blood vessels involved in the erection process, leading to difficulties in achieving a firm erection. Additionally, your experience of pain in the lower abdomen and testicles during prolonged erections indicates that there may be physical strain on the pelvic muscles and nerves.

2. Psychological Factors: Anxiety, stress, and performance pressure can significantly impact sexual function. If you have been preoccupied with your sexual performance or worried about your erectile capabilities, this can create a cycle of anxiety that exacerbates the problem. The mind plays a crucial role in sexual arousal; thus, any psychological distress can hinder the physiological processes necessary for an erection.

3. Hormonal Issues: Hormonal imbalances, particularly low testosterone levels, can also contribute to erectile dysfunction. If you have not had your hormone levels checked, it may be worth discussing this with your healthcare provider.

4. Lifestyle Factors: Factors such as poor diet, lack of exercise, smoking, and excessive alcohol consumption can negatively affect erectile function. You mentioned that you have started exercising regularly, which is a positive step. Regular physical activity can improve blood circulation, reduce stress, and enhance overall well-being.

5. Medical Conditions: Conditions such as diabetes, hypertension, and prostate issues can also lead to erectile dysfunction. Your mention of urinary difficulties and discomfort during ejaculation may indicate a potential issue with the prostate or urinary tract, which could be contributing to your erectile difficulties.

Solutions and Recommendations
1. Lifestyle Modifications: Continuing with regular exercise and adopting a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can improve overall health and potentially enhance erectile function. Reducing alcohol intake and quitting smoking, if applicable, are also beneficial.

2. Psychological Support: If anxiety or stress is a concern, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) can be particularly effective in addressing performance anxiety and other psychological barriers to sexual function.

3. Medical Evaluation: Since you have experienced symptoms like blood in the semen and difficulty with urination, it is essential to follow up with a urologist. Even if initial tests came back normal, further evaluation may be warranted, including hormone level testing and imaging studies to rule out any underlying conditions.

4. Gradual Reintroduction of Sexual Activity: After a period of abstinence, gradually reintroducing sexual activity can help retrain your body and mind. Focus on intimacy and connection rather than performance, which may alleviate some pressure and improve your experience.

5. Medication: If lifestyle changes and psychological support do not yield improvements, discussing the possibility of medications such as phosphodiesterase type 5 inhibitors (e.g., Viagra, Cialis) with your healthcare provider may be beneficial. These medications can enhance blood flow to the penis and help achieve an erection when sexually stimulated.

6. Regular Follow-Up: Continue to monitor your symptoms and maintain open communication with your healthcare provider. If symptoms persist or worsen, further investigation may be necessary.

In conclusion, erectile dysfunction can be multifactorial, and addressing it often requires a comprehensive approach that includes lifestyle changes, psychological support, and medical evaluation. By taking proactive steps and seeking appropriate care, you can work towards improving your sexual health and overall well-being.

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