Erectile Dysfunction: Causes, Symptoms, and Solutions

Is it erectile dysfunction?

Hello Doctor, I have been in a relationship with my partner for over ten years and we have been married for almost two years.
After some issues arose post-marriage, we managed to resolve them.
However, since then, I have been experiencing difficulties during intercourse.
If I get distracted during the act, I find it hard to maintain an erection, and it takes a short time to regain it.
This has been happening more frequently over the past year, and it has become increasingly severe in the last two to three months.
Now, when I try to achieve an erection intentionally (as my partner and I are currently tracking ovulation to conceive), I find it even harder to respond.

On the other hand, in more stimulating situations, such as suddenly surprising my partner or being in a quieter room outside, I do not experience erectile issues.
However, when I do achieve an erection, it seems to lack full hardness, reaching only about 70-80%.
I have also tried Viagra, which worked well and boosted my confidence for a while, but eventually, the same issues returned.

I would like to ask the doctor if this qualifies as erectile dysfunction or if it is more psychological in nature.
Do I need to undergo any specific tests?

Mr. Jiang, 30~39 year old female. Ask Date: 2020/08/19

Dr. Cai Zhuorong reply Urology

Both psychological and physiological factors significantly influence erectile function.
It is recommended that you consult a urologist for an evaluation, which will allow for the arrangement of various tests.

Reply Date: 2020/08/19

More Info

Erectile dysfunction (ED) is a common issue that affects many men at various stages of life. It can be caused by a combination of physical, psychological, and relational factors. Based on your description, it seems that your situation may involve both psychological and possibly physiological components.

Understanding Erectile Dysfunction
Causes:
1. Psychological Factors: Stress, anxiety, depression, and relationship issues can significantly impact sexual performance. In your case, it appears that the stress from past events in your relationship may have contributed to your current difficulties. The fact that you experience erectile issues when you are distracted or anxious suggests a psychological component.

2. Physiological Factors: Conditions such as diabetes, heart disease, obesity, and hormonal imbalances can lead to ED. While you have not mentioned any underlying health conditions, it is essential to consider these factors, especially if you are experiencing a decline in erectile function over time.

3. Lifestyle Factors: Smoking, excessive alcohol consumption, and lack of physical activity can also contribute to ED. Evaluating your lifestyle choices can be beneficial in understanding your condition.

Symptoms:
The symptoms of ED can vary but typically include:
- Difficulty achieving or maintaining an erection sufficient for sexual intercourse.

- Reduced sexual desire.

- Erection that is not firm enough for penetration.

In your case, it seems you are experiencing difficulty maintaining an erection, especially when you are not in a stimulating environment, which aligns with the symptoms of ED.

Solutions:
1. Consultation with a Healthcare Provider: It is crucial to discuss your symptoms with a healthcare professional. They can conduct a thorough evaluation, including a physical examination and possibly blood tests to check for underlying health issues such as hormonal imbalances or cardiovascular problems.

2. Psychological Counseling: Since psychological factors seem to play a significant role in your situation, speaking with a therapist or counselor who specializes in sexual health may help. They can assist you in addressing any anxiety or stress related to sexual performance.

3. Medication: You mentioned that Viagra (sildenafil) has been effective for you. This medication can help improve blood flow to the penis and facilitate an erection. However, it is essential to use it under the guidance of a healthcare provider, as they can help determine the appropriate dosage and frequency.

4. Lifestyle Modifications: Improving your overall health can have a positive impact on erectile function. This includes regular exercise, a balanced diet, quitting smoking, and moderating alcohol intake.

5. Communication with Your Partner: Open communication with your partner about your feelings and concerns can help alleviate some of the pressure you may be feeling during intimate moments. This can foster a more supportive environment for both of you.

Conclusion:
Based on your description, it does appear that you are experiencing erectile dysfunction, likely influenced by both psychological and possibly physiological factors. It is essential to seek a comprehensive evaluation from a healthcare provider to explore the underlying causes and discuss appropriate treatment options. Remember, ED is a common issue, and addressing it can lead to improved sexual health and overall well-being.

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