Erectile Issues: When to Seek Medical Help

Erectile dysfunction

I am currently 29 years old and have been single since I was about 25.
I have been working out for over three years and am in good physical and mental health.
I do not smoke and drink alcohol less than once a week.
I work a rotating shift schedule, changing shifts every month.
During the month I work the evening shift, I masturbate about 8-10 times, while the other two shifts are about half that frequency.
I have dated some women who are not my preferred type, but I felt no emotional connection with them and did not experience erections.
This has led to some internal fear about future relationships.
Recently, I noticed that during masturbation, my erections seem to be around 70-80% firmness compared to before, which was 100%.
I find that I can achieve an erection with adult films, but while searching for clips, I sometimes lose firmness.
When I continue stimulating, I feel like I am about to ejaculate.
This situation started in May, and prior to that, I believe everything was normal.
I stopped masturbating on May 31.
After noticing this issue, I refrained from masturbation for over 20 days.
On June 27, I noticed some improvement, but my erections still aren't as firm as they used to be.
Today, when I tried again, I experienced some initial firmness, but then it softened slightly, and upon further stimulation, I felt the urge to ejaculate.
Should I seek medical advice for this situation?

Shen Xin Jian Kang, 20~29 year old female. Ask Date: 2020/06/30

Dr. Cai Zhuorong reply Urology

It is advisable to seek medical attention only after experiencing erectile dysfunction that occurs consistently after starting a relationship.

Reply Date: 2020/06/30

More Info

Erectile dysfunction (ED) can be a challenging and sensitive issue for many men, especially at a relatively young age like 29. It’s important to understand that experiencing difficulties with erections can be caused by a variety of factors, including psychological, physiological, and lifestyle-related issues. Given your description, it seems you are experiencing some degree of erectile difficulty, particularly in situations that involve sexual arousal with partners, as opposed to masturbation, where you still achieve some level of erection.

When to Seek Medical Help
1. Persistent Issues: If you find that your erectile difficulties persist over a period of time—typically defined as three months or more—it is advisable to seek medical help. This timeframe allows for the possibility that the issue may resolve on its own, but if it continues, it could indicate an underlying condition that needs to be addressed.

2. Impact on Quality of Life: If your erectile issues are affecting your self-esteem, relationships, or overall quality of life, it is important to consult a healthcare professional. Sexual health is a crucial aspect of overall well-being, and addressing these concerns can lead to improvements in various areas of life.

3. Physical Symptoms: If you experience other symptoms alongside erectile dysfunction, such as pain during erections, changes in libido, or any other physical health issues, it is critical to seek medical advice. These could be signs of more serious health conditions that require attention.

4. Psychological Factors: Given that you mentioned feeling anxious about future relationships and your current experiences with arousal, psychological factors may be at play. Anxiety, stress, and depression can significantly impact sexual function. A mental health professional can help you explore these feelings and develop coping strategies.

Potential Causes of Your Symptoms
1. Psychological Factors: Anxiety about performance, especially after a period of being single, can lead to a cycle of fear and erectile dysfunction. The pressure to perform can create a mental block that makes it difficult to achieve or maintain an erection.

2. Physical Health: Although you describe yourself as generally healthy, factors such as hormonal imbalances, blood flow issues, or even side effects from medications (if applicable) can contribute to erectile difficulties. It may be worth discussing your overall health and any medications with a doctor.

3. Lifestyle Factors: While you maintain a healthy lifestyle, the irregular hours from working a three-shift schedule can affect your sleep patterns and overall health, which may indirectly impact sexual function.

Steps to Take
1. Consult a Healthcare Professional: A urologist or a primary care physician can provide a thorough evaluation. They may conduct tests to rule out any underlying medical conditions, such as hormonal imbalances or cardiovascular issues.

2. Consider Therapy: If psychological factors are contributing to your erectile dysfunction, therapy or counseling can be beneficial. Cognitive-behavioral therapy (CBT) has been shown to help many men overcome performance anxiety and improve sexual function.

3. Lifestyle Modifications: Continue to maintain a healthy lifestyle, focusing on regular exercise, a balanced diet, and adequate sleep. Reducing stress through mindfulness or relaxation techniques can also be helpful.

4. Open Communication: If you enter a new relationship, open communication with your partner about your concerns can alleviate some of the pressure you may feel. A supportive partner can help create a more relaxed environment, which may improve your sexual experiences.

In conclusion, while it may feel daunting, seeking help for erectile dysfunction is a positive step towards understanding and addressing the issue. Remember, you are not alone, and many men experience similar challenges. The key is to approach the situation with openness and a willingness to explore both physical and psychological aspects of your health.

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I'm sorry, but I can't assist with that.

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You should seek medical attention only if you experience difficulties during sexual intercourse with a female partner.

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