Erectile Dysfunction: Causes, Symptoms, and Solutions

Erectile dysfunction?

Hello Doctor, I started masturbating and watching adult films at the age of 15.
Now at 29, I have had two girlfriends, and I have never had concerns regarding my physiological health.
I have also engaged the services of sex workers in the past.
However, around July of this year, I met a new girl, and during intimacy, I suddenly experienced erectile dysfunction (ED) and was subsequently rejected.
Since then, I have struggled to maintain an erection.
My morning erections have gradually decreased.
After this incident, I decided to test myself again by seeing the same sex worker, but I was completely unable to perform.
Recently, I started dating a new girlfriend, but I feel the same lack of arousal (it's completely different from my previous experiences...
I can't even penetrate).
It feels like a nerve connection to my arousal has been severed.
I have no sexual desire, and because of this situation, I have been experiencing ongoing anxiety for the past six months.
I am currently exercising and trying to improve my health, but it seems ineffective.
I do not smoke or drink.
I am unsure which specialist to consult.
Just thinking about being intimate is terrifying.
My sense of arousal has completely vanished, and I don't know what to do.
I kindly ask for your professional assistance.

E, 20~29 year old female. Ask Date: 2020/12/15

Dr. Fu Shizhang reply Urology

It should be classified as psychogenic erectile dysfunction.

Reply Date: 2020/12/15

More Info

Erectile dysfunction (ED) is a complex condition that can significantly affect a person's quality of life and emotional well-being. Understanding its causes, symptoms, and potential solutions is crucial for anyone experiencing this issue, especially in your case, where the onset appears to be sudden and has led to considerable distress.

Causes of Erectile Dysfunction
ED can stem from a variety of factors, which can be broadly categorized into physical, psychological, and lifestyle-related causes:
1. Physical Causes: These include cardiovascular diseases, diabetes, hormonal imbalances (such as low testosterone), neurological disorders, and certain medications. Given your age and the sudden onset of symptoms, it would be prudent to rule out any underlying medical conditions that could be contributing to your ED.

2. Psychological Causes: Anxiety, depression, and stress can significantly impact sexual performance. The experience of losing an erection during intimacy can lead to performance anxiety, creating a vicious cycle where the fear of failure exacerbates the problem. Your mention of panic and fear surrounding sexual encounters suggests that psychological factors may be playing a significant role in your situation.

3. Lifestyle Factors: While you mentioned that you do not smoke or drink, other lifestyle factors such as lack of exercise, poor diet, and inadequate sleep can also contribute to ED. Regular physical activity and a balanced diet can improve overall health and potentially enhance sexual function.

Symptoms of Erectile Dysfunction
The primary symptom of ED is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Other related symptoms may include:
- Reduced sexual desire or libido
- Difficulty achieving an erection during sexual activity
- Erection that is not firm enough for penetration
- Decreased frequency of morning erections

Solutions and Recommendations
1. Consult a Healthcare Professional: Given the complexity of ED, it is essential to consult a healthcare provider. A urologist or a sexual health specialist would be appropriate for your situation. They can conduct a thorough evaluation, including a physical examination and possibly blood tests, to assess hormonal levels, blood sugar, and cardiovascular health.

2. Psychological Counseling: If psychological factors are contributing to your ED, speaking with a mental health professional can be beneficial. Therapy can help address anxiety, depression, or any underlying emotional issues related to sexual performance.

3. Lifestyle Modifications: Continue with your exercise regimen, as physical activity can improve blood flow and overall health. Additionally, consider adopting a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Reducing stress through mindfulness practices, yoga, or meditation can also be helpful.

4. Medications: There are several medications available that can help treat ED by increasing blood flow to the penis. These include phosphodiesterase type 5 (PDE5) inhibitors such as sildenafil (Viagra), tadalafil (Cialis), and others. However, these should only be taken under the guidance of a healthcare provider.

5. Open Communication with Partners: Discussing your feelings and experiences with your partner can help alleviate some of the pressure you may be feeling. A supportive partner can make a significant difference in managing anxiety related to sexual performance.

6. Avoid Self-Diagnosis and Treatment: While it may be tempting to seek quick fixes or over-the-counter solutions, it is crucial to avoid self-diagnosing or self-treating without professional guidance. This can lead to further complications or exacerbate the issue.

Conclusion
Erectile dysfunction can be a challenging condition, but it is important to remember that it is treatable. By seeking professional help and addressing both the physical and psychological aspects of your situation, you can work towards regaining your sexual health and confidence. Remember, you are not alone in this, and many individuals experience similar challenges. Taking the first step to consult with a healthcare provider is crucial in finding the right path forward.

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

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It is advisable to stop masturbation for a few days and observe the situation. The most common cause of erectile dysfunction in young individuals is psychological. If the condition persists, a visit to a urology clinic for examination is recommended.

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