Premature Ejaculation and Erectile Issues: A Guide

Premature ejaculation and erectile dysfunction?

The doctor would like to ask a few questions.
I have read that frequent masturbation can lead to temporary premature ejaculation.
If that is the case, how long should I abstain to return to normal? I used to have normal ejaculation times, but since six months ago, I sometimes ejaculate very quickly after masturbation, and my glans is very sensitive.
It feels like I ejaculate as soon as I feel the urge.
Will this affect my future sexual performance? This really worries me.
After masturbating at night, I sometimes do not experience morning erections the next day, which makes me concerned.
There are times when I don’t have morning erections, and I worry that when I wake up at night to urinate, I still don’t have an erection.

Another question is whether it is normal to sometimes have difficulty achieving an erection.
If it is difficult to get an erection, should I avoid trying to achieve one? Could this affect the engorgement of the penis, making it feel smaller? Recently, my erections do not feel thicker than before.
If I let my penis rest properly, will it return to its previous size? Am I describing symptoms of erectile dysfunction, or is it more related to psychological factors as others have suggested? I plan to abstain from sexual activity for three months to see if I can return to normal.
Could you please provide detailed guidance on this?

xuesheng, 10~19 year old female. Ask Date: 2019/05/26

Dr. Du Mingyi reply Urology

Young people typically do not experience erectile dysfunction; it is usually related to psychological factors.
They can consult a urologist for further evaluation.

Reply Date: 2019/05/26

More Info

Understanding premature ejaculation (PE) and erectile issues can be complex, as they often intertwine with psychological, physiological, and lifestyle factors. Let's break down your concerns and provide some guidance.

Premature Ejaculation (PE)
Premature ejaculation is defined as ejaculation that occurs with minimal sexual stimulation and before the individual wishes it to happen. It can be classified as lifelong (primary) or acquired (secondary). Your experience of experiencing PE after a period of normal ejaculation could be linked to several factors, including anxiety, sensitivity, and even frequency of masturbation.

1. Masturbation and Sensitivity: Frequent masturbation can lead to increased sensitivity of the glans (the head of the penis), which may contribute to quicker ejaculation. If you have noticed a change in your ejaculation timing, it might be beneficial to reduce the frequency of masturbation. However, the time required for recovery varies among individuals. A period of abstinence, such as three months, may help in desensitizing the glans and restoring normal function.

2. Psychological Factors: Anxiety about performance can exacerbate PE. If you are worried about your sexual performance, this anxiety can create a cycle that perpetuates the issue. It is essential to address these psychological factors, possibly through relaxation techniques, counseling, or therapy.

Erectile Dysfunction (ED)
Erectile dysfunction is characterized by the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. It can be influenced by both physical and psychological factors.

1. Morning Erections: The absence of morning erections (nocturnal penile tumescence) can be concerning but is not always indicative of a problem. Various factors, including stress, fatigue, and hormonal changes, can affect morning erections. If you notice a consistent lack of morning erections, it may warrant further evaluation.

2. Difficulty Achieving Erection: Experiencing occasional difficulty in achieving an erection is common and can happen to anyone. However, if this becomes frequent, it may indicate underlying issues such as anxiety, depression, or even physical health problems. It is advisable not to force an erection if it does not occur naturally, as this can lead to further anxiety and performance issues.

3. Size and Sensation: Concerns about the size of the penis during erection can be linked to psychological factors. It is essential to understand that size does not determine sexual satisfaction for most partners. If you feel that your penis appears smaller or less firm, it may be related to anxiety or decreased blood flow. Taking breaks from sexual activity can help in restoring confidence and function.

Recommendations
1. Abstinence Period: As you suggested, taking a break from sexual activities, including masturbation, for a few months may help in restoring your sensitivity and control over ejaculation.
2. Consultation with a Specialist: If your concerns persist, consider consulting a urologist or a sexual health specialist. They can provide a thorough evaluation and discuss treatment options, which may include behavioral techniques, medications, or therapy.

3. Lifestyle Changes: Incorporating healthy lifestyle changes, such as regular exercise, a balanced diet, and stress management techniques, can significantly improve sexual health.

4. Open Communication: If you are in a relationship, communicate openly with your partner about your concerns. This can alleviate some of the performance anxiety and create a supportive environment.

5. Mental Health: Consider speaking with a mental health professional if you feel that anxiety or stress is significantly impacting your sexual health. Cognitive-behavioral therapy (CBT) can be particularly effective in addressing performance anxiety.

In conclusion, while your concerns about premature ejaculation and erectile dysfunction are valid, they are also common and often manageable. Taking proactive steps, including a period of abstinence, seeking professional advice, and addressing psychological factors, can lead to improvements in your sexual health and overall well-being.

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