Penile Pain After Prolonged Erection: Causes and Solutions - Urology

Pain after penile erection?

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Hello Doctor: Due to increased stress in April, I have slightly increased the frequency of masturbation.
Recently, around May 10th, during masturbation, it seemed that I experienced prolonged erection (about 1-2 hours; I checked my search history for that day from 8:17-9:00 and 9:35-11:20, during which I touched my penis, browsed Twitter for nude photos, watched adult films, looked at women's breasts, and engaged in sexual chat.
I also consumed about 1 liter of beer around 9:00).
Later, around 11:00, I suddenly could not maintain an erection through the aforementioned methods, and I ejaculated while in a flaccid state.
The next day, I was unable to achieve an erection through any stimulation, and even if I could, the blood flow to the penis felt weak.
I was concerned about erectile dysfunction, so I sought medical attention at a clinic and a hospital on the following Monday and Thursday (Note: I experienced morning erections from May 11-13, with hardness rated between 3-4, but slightly less than before).
The doctor, after hearing my account, believed there was no organic disorder and suggested that it was due to penile fatigue.
He recommended that I increase my exercise intensity and jog daily.
Following the doctor's advice, I began to exercise more and took a prescription for Circulatory Enhancer tablets to improve peripheral blood circulation and alleviate the symptoms of erectile dysfunction.
After about 4-5 days of medication, my erectile function slightly improved.
After continuing the medication for about 2 weeks (by May 27), I was able to achieve an erection through sexual fantasies, with hardness reaching level 4.
However, I found that the glans was less responsive to stimulation, although I gradually regained some sensation, but it was not as intense as before (the duration of erections through sexual fantasies lasted about 1-3 minutes, while looking at nude photos, breast pictures, and engaging in sexual chat could maintain an erection for about 7-17 minutes, all with hardness at level 4).
However, after a period of erection, I began to experience tightness and soreness in the groin area near the penis, as well as in the pubic region, and the muscles on both sides of the base and midsection of the penis would start to tense up.
I could relieve this somewhat by massaging with my fingers.
After a while, the hardness would drop to level 3, and the duration of erections through visual stimulation would shorten to 1-3 minutes.
However, applying heat could slightly improve discomfort and hardness, and my urination function was normal, with a strong stream.
Recently, starting around May 26, I began to experience some insomnia symptoms, going to bed around 11:30-12:00 but remaining awake until about 3:30-4:00 AM.
I attempted to use alcohol to aid sleep (on May 28 and May 30-31), but there was not much improvement.
Consequently, with poor sleep quality from May 31 to June 1, my hardness and endurance seemed to decline.
On June 2, I visited the hospital again to discuss this situation, and the doctor prescribed some anti-inflammatory medication, muscle relaxants, and sleep aids.
My sleep has improved recently, but it seems that due to muscle weakness, my blood flow and erection hardness have decreased (to level 3), or I am only achieving a semi-erection.
Since I am quite concerned, I am here to ask again.
Summary of the patient's physical condition: 1.
BMI: 17.9-18.1, 170 cm/53 kg, with no history of heart or cardiovascular diseases.
2.
Masturbation frequency is about 3 times a week; sometimes, when stressed, I achieve pleasure through touching the penis and glans, leading to direct ejaculation.
The week I experienced flaccid ejaculation, I masturbated once a day.
3.
I exercise regularly, 3-5 times a week, with 2-3 days of weight training, 1 day of fencing, and I also jog (5 kilometers in 31 minutes) and do aerobic warm-ups.
4.
My diet is normal; I occasionally eat fast food, but in April, to stay alert and finish assignments, I drank a bit more cola, about once a week for 4-5 days.
5.
Since May 10, I have not masturbated, only massaged the tense areas of the penis and touched the glans to test sensitivity.
6.
I have no bad lifestyle habits, going to bed around 11:00-12:00, and I have recently abstained from alcohol for a while (3 months), with occasional drinking.
7.
In recent weeks, I have experienced morning erections 3-4 days a week (hardness rated 3-4), but if I feel mentally fatigued or if the previous erection lasted too long, I do not experience morning erections.
8.
Even if I do not have morning erections, I can maintain an erection through visual stimulation or sexual fantasies.
The above is a summary of my recent medical history, and the following are my questions: 1.
Is it normal to experience prolonged erection and masturbation for a certain period (one month, one week) as described, and could this lead to organic changes? 2.
Could taking muscle relaxants affect erectile function? 3.
Is the cause of the above situation due to excessive penile exertion leading to fatigue of the erectile tissue or penile muscles, resulting in a psychological state of reduced sexual desire, thus making it difficult to achieve an erection through sexual fantasies, visual stimulation, or touching the penis? 4.
Does lack of sleep hinder the recovery process of erectile function due to penile soreness, or could it indirectly cause erectile dysfunction? 5.
Did excessive friction of the glans and stimulation of the penis on May 10 lead to decreased sensitivity of the glans? 6.
Could my recent poor mental state due to taking muscle relaxants affect erectile function? 7.
How can I improve this situation and restore normal erectile function?

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K Zai, 20~29 year old female. Ask Date: 2020/06/05