Sexual Dysfunction in Young Men: Causes and Solutions

At 19 years old, experiencing a decrease in libido and erectile function compared to before?

Hello doctor, I am 19 years old and have a strong sex drive.
I often find myself getting an erection when I see girls (a very firm one).
Due to my strong libido, I started frequently engaging in masturbation around September of last year, doing it out of boredom once, and again before sleeping, averaging about twice a day.
Each time, I felt it was just to relieve a physiological need, so it was very quick.
However, starting in April of this year, I noticed a decrease in my libido, and the duration and firmness of my erections are not what they used to be.
I experience premature ejaculation during masturbation and intercourse (although taking maca has improved the premature ejaculation issue a bit).
This condition has persisted for six months now.
I currently have no sex drive, and even when watching adult videos, I need constant stimulation to maintain an erection (which is also insufficient in firmness).
During intercourse, my erection lasts for a short time and lacks firmness.
I experience about five instances of morning erections per week (but again, the firmness is insufficient).
I also feel easily fatigued and lack motivation in my activities.
I used to be a very confident person, but now I feel somewhat insecure.
I have tried abstaining from sex and masturbation, but the situation has not improved.
Last month, I went to the hospital for a blood test, and the doctor said my hormone levels are normal and diagnosed me with psychogenic erectile dysfunction, referring me to a psychiatrist.
I would like to ask the doctor: 1.
Is it possible that my symptoms are organic? 2.
Could excessive and rapid masturbation cause nerve damage or other issues related to erections? 3.
Can psychogenic erectile dysfunction lead to a decrease in libido? 4.
Can psychogenic erectile dysfunction contribute to poor mental health? I hope the doctor can help me with these questions.
Thank you! 🙏

Xuefu, 10~19 year old female. Ask Date: 2020/11/22

Dr. Cai Zhuorong reply Urology

1.
Is it possible that my symptoms are organic? If hormone levels are normal, the likelihood is lower, but it cannot be completely ruled out.

2.
Can excessive masturbation (deliberately ejaculating quickly) cause erectile nerve damage or other issues? There is no clear medical evidence linking the two, but there are cases where frequent masturbation has been reported to lead to decreased libido.

3.
Can psychogenic erectile dysfunction lead to decreased libido? A more plausible explanation is that decreased libido can be one of the causes of psychogenic erectile dysfunction.

4.
Can psychogenic erectile dysfunction cause poor mental health? No, poor mental health may lead to erectile dysfunction.

Reply Date: 2020/11/22

More Info

Understanding sexual dysfunction in young men is a multifaceted issue that often intertwines psychological, physiological, and lifestyle factors. Your situation, as you described, reflects a common pattern seen in many young men today, where sexual performance and desire can fluctuate significantly due to various influences.

Causes of Sexual Dysfunction in Young Men
1. Psychological Factors: Anxiety, stress, and depression are significant contributors to sexual dysfunction. In your case, the pressure to perform, especially after experiencing some difficulties, can lead to a cycle of anxiety that further exacerbates the problem. The fear of not being able to perform can create a mental block, making it even harder to achieve and maintain an erection.

2. Lifestyle Choices: Frequent masturbation, especially if done quickly and without proper arousal, can lead to desensitization. This means that over time, your body may require more intense stimulation to achieve the same level of arousal, which can contribute to erectile dysfunction (ED) and decreased libido. Additionally, irregular sleep patterns, poor diet, and lack of exercise can negatively impact your overall health and sexual function.

3. Hormonal Factors: Although you mentioned that your hormone levels were normal, it’s essential to recognize that hormonal imbalances can still occur, particularly in young men. Testosterone plays a crucial role in libido and erectile function, and fluctuations can lead to changes in sexual desire and performance.

4. Physical Health: While your symptoms appear to be primarily psychological, it’s important to rule out any underlying physical issues. Conditions such as diabetes, cardiovascular diseases, or neurological disorders can also lead to sexual dysfunction. Regular check-ups and discussions with your healthcare provider can help monitor your physical health.

Solutions and Recommendations
1. Psychological Counseling: Since your doctor has referred you to a psychiatrist, this is a positive step. Cognitive-behavioral therapy (CBT) can be particularly effective in addressing performance anxiety and other psychological barriers to sexual function. Therapy can help you develop coping strategies and reduce anxiety related to sexual performance.

2. Lifestyle Modifications: Consider adopting a healthier lifestyle. This includes regular exercise, which can improve blood flow and overall health, and a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Reducing the frequency of masturbation and focusing on quality rather than quantity can also help restore sensitivity and improve sexual function.

3. Mindfulness and Relaxation Techniques: Practices such as mindfulness meditation, yoga, or deep-breathing exercises can help reduce anxiety and improve your mental state. These techniques can also enhance your sexual experience by helping you stay present and focused during intimate moments.

4. Open Communication: If you are in a relationship, communicating openly with your partner about your feelings and experiences can alleviate some of the pressure you may feel. Understanding and support from your partner can be incredibly beneficial.

5. Gradual Exposure: If you find that certain situations trigger anxiety, consider gradually exposing yourself to these situations in a controlled manner. This could involve intimate moments without the pressure of intercourse, allowing you to build confidence over time.

Addressing Your Specific Questions
1. Could your symptoms be organic? While your symptoms seem primarily psychological, it’s always wise to keep an open line of communication with your healthcare provider to monitor any potential physical issues.

2. Can frequent masturbation cause nerve damage? While excessive masturbation itself is unlikely to cause nerve damage, it can lead to desensitization and altered sexual response. Moderation is key.

3. Can psychological ED cause decreased libido? Yes, psychological factors can significantly impact libido. Anxiety and stress can lead to a reduced interest in sexual activity.

4. Can psychological ED affect mental health? Absolutely. The stress and anxiety surrounding sexual performance can lead to broader mental health issues, including depression and low self-esteem.

In conclusion, addressing sexual dysfunction in young men often requires a holistic approach that considers psychological, physical, and lifestyle factors. By working closely with healthcare professionals and making positive lifestyle changes, you can improve your sexual health and overall well-being.

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