Erectile Dysfunction: Symptoms, Causes, and Treatment Options

Am I experiencing erectile dysfunction?

About two years ago, when I had intercourse for the first time with my ex-girlfriend, I found that I couldn't achieve an erection.
However, after resting for about a week, I was able to engage in sexual activity again, but the firmness was significantly less than before.
Sometimes, I needed to use my hand to assist with the erection, and I no longer felt the same level of engorgement as I did previously.
Four months ago, after breaking up with my ex-girlfriend, I began to masturbate almost every day, but there were a few instances where I couldn't complete the act, which has caused me a lot of concern.
Recently, I can achieve an erection, but I still need to use my hand to help.
I masturbate about once a week, but the firmness is still inadequate.
Even when I do get hard, it doesn't last long and can easily become soft.
Could this be a sign of erectile dysfunction? Is it treatable?

Eric, 30~39 year old female. Ask Date: 2018/12/27

Dr. Lin Wenxu reply Urology

Please visit the urology outpatient clinic for a detailed examination and diagnosis in order to receive a more accurate answer.

Reply Date: 2018/12/27

More Info

Erectile dysfunction (ED) is a common condition that affects many men at various stages of their lives. It is characterized by the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Based on your description, it seems you are experiencing symptoms consistent with ED, particularly the difficulty in achieving a firm erection and the need for manual stimulation to achieve an erection.

Symptoms of Erectile Dysfunction
The symptoms of ED can vary but typically include:
1. Difficulty achieving an erection: This can be occasional or persistent.

2. Difficulty maintaining an erection: This may involve losing an erection during sexual activity.

3. Reduced sexual desire: Some men may also experience a decrease in libido.

4. Erections that are not firm enough: As you mentioned, the hardness of your erections has diminished, which is a common complaint among men with ED.

Causes of Erectile Dysfunction
ED can arise from a variety of physical and psychological factors. Some common causes include:
1. Physical Causes:
- Cardiovascular issues: Conditions that affect blood flow, such as atherosclerosis (hardening of the arteries), can lead to ED.

- Diabetes: This condition can damage nerves and blood vessels, leading to erectile difficulties.

- Hormonal imbalances: Low testosterone levels can contribute to ED.

- Neurological disorders: Conditions like multiple sclerosis or Parkinson’s disease can affect nerve signals involved in erections.

- Medications: Some medications can have side effects that include ED.

2. Psychological Causes:
- Stress and anxiety: Performance anxiety or stress from personal relationships can lead to ED.

- Depression: Mental health issues can significantly impact sexual function.

- Relationship problems: Issues with a partner can also contribute to erectile difficulties.

Treatment Options
The good news is that ED is often treatable. Here are some common treatment options:
1. Lifestyle Changes: Improving diet, exercising regularly, quitting smoking, and reducing alcohol consumption can enhance erectile function.

2. Medications:
- Phosphodiesterase type 5 inhibitors (PDE5 inhibitors) such as Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil) are commonly prescribed. These medications increase blood flow to the penis and help achieve an erection when sexually stimulated.

- Hormone therapy: If low testosterone is identified, hormone replacement therapy may be an option.

3. Psychological Counseling: If psychological factors are contributing to ED, therapy with a psychologist or counselor can be beneficial.

4. Vacuum Erection Devices: These devices create a vacuum around the penis, drawing blood into it and causing an erection.

5. Penile Injections or Implants: In more severe cases, injections directly into the penis or surgical implants may be considered.

Conclusion
Given your situation, it is advisable to consult with a healthcare provider who specializes in sexual health. They can conduct a thorough evaluation to determine the underlying causes of your ED and recommend appropriate treatment options tailored to your needs. It’s important to address both the physical and psychological aspects of ED, as they can often be interconnected. Remember, you are not alone in this, and many men experience similar issues. With the right support and treatment, it is possible to regain confidence and improve sexual function.

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