Erectile Dysfunction: Causes, Symptoms, and Solutions

Erectile dysfunction

Hello doctor! I am 31 years old and I haven't had sexual intercourse for three months.
The last time I had an issue was: 1.
I became flaccid after achieving an erection while wearing a condom.
2.
I couldn't penetrate due to insufficient hardness.
However, when I consulted a doctor, he said that at my age, erectile dysfunction is unlikely and it might be a psychological issue.
Now, three months later, I find that I need to stimulate my nipples and genital area to achieve an erection during masturbation; I can no longer achieve an erection just by watching adult films (which I could do before).
Additionally, the hardness of my erections is insufficient, and I have refrained from masturbation for 17 days, but I haven't experienced any morning erections.
Does this indicate that my habitual masturbation has led to a lack of response to other stimuli? Am I experiencing erectile dysfunction? The last time I saw a doctor, he prescribed Tadalafil 20mg for me, but he mentioned that it is only for use before sexual activity and should not be taken at other times.

Axiang, 30~39 year old female. Ask Date: 2020/12/18

Dr. Xu Wencang reply Urology

Cialis is also available in a daily tablet form of 5mg, which is more expensive.
Alternatively, a 20mg dose can be taken as needed before sexual activity.

Reply Date: 2020/12/18

More Info

Erectile dysfunction (ED) is a common condition that can affect men of all ages, including those as young as 31. Understanding the causes, symptoms, and potential solutions is crucial for addressing this issue effectively. Based on your description, it seems you are experiencing difficulties with achieving and maintaining an erection, particularly in the context of sexual activity, which can be distressing.

Causes of Erectile Dysfunction
1. Psychological Factors: Stress, anxiety, and depression can significantly impact sexual performance. In your case, the fact that you have not engaged in sexual activity for three months may have created performance anxiety, leading to a cycle of fear and avoidance that exacerbates the problem. Psychological issues can manifest as a lack of desire or difficulty in achieving an erection.

2. Physical Factors: Although you mentioned that your doctor suggested it might not be a physical issue due to your age, it’s important to consider that physical health can still play a role. Conditions such as diabetes, hypertension, hormonal imbalances, or cardiovascular issues can contribute to ED. Lifestyle factors like smoking, excessive alcohol consumption, and lack of physical activity can also have an impact.

3. Habitual Behaviors: Frequent masturbation or reliance on specific types of stimulation (like pornography) can sometimes lead to difficulties in achieving arousal in other contexts. This is sometimes referred to as "porn-induced erectile dysfunction," where the brain becomes conditioned to respond only to certain stimuli.

Symptoms of Erectile Dysfunction
The symptoms you described—difficulty maintaining an erection, reduced hardness, and the need for additional stimulation to achieve an erection—are indeed indicative of erectile dysfunction. The absence of morning erections can also be a sign that something is amiss, as these are typically a sign of healthy erectile function.

Solutions and Recommendations
1. Consultation with a Specialist: Since you have already seen a doctor, it might be beneficial to consult a urologist or a sexual health specialist who can provide a more in-depth evaluation. They may conduct tests to rule out any underlying medical conditions that could be contributing to your symptoms.

2. Psychological Counseling: If psychological factors are suspected, therapy can be very effective. Cognitive-behavioral therapy (CBT) or sex therapy can help address anxiety, improve self-esteem, and change negative thought patterns related to sexual performance.

3. Medication: Tadalafil (Cialis) is a medication that can help with erectile dysfunction by increasing blood flow to the penis. It is important to follow your doctor’s advice regarding its use. While it can be effective, it is not a cure for ED and should be used in conjunction with other treatments or lifestyle changes.

4. Lifestyle Changes: Consider adopting healthier lifestyle habits. Regular exercise, a balanced diet, quitting smoking, and reducing alcohol intake can improve overall health and potentially enhance erectile function.

5. Limit Stimulation: Reducing reliance on pornography and excessive masturbation may help retrain your sexual response. This can involve taking breaks from these activities to allow your body to reset its arousal mechanisms.

6. Open Communication: If you are in a relationship, discussing your concerns with your partner can alleviate some of the pressure you may be feeling. A supportive partner can help create a more relaxed environment for intimacy.

Conclusion
Erectile dysfunction can be a complex issue with both psychological and physical components. Given your age and the symptoms you are experiencing, it is essential to take a holistic approach to treatment. This includes consulting with healthcare professionals, considering psychological support, making lifestyle changes, and using medications as prescribed. Remember, you are not alone in this, and many men experience similar challenges. Seeking help is a positive step towards regaining confidence and improving your sexual health.

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

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