Erection Issues: Causes and Treatment Options Explained - Urology

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Erectile dysfunction


During sexual arousal (such as touching a woman's body or watching adult films), if the penis releases a significant amount of clear fluid and then becomes unable to achieve an erection for intercourse, this could be due to several factors, including psychological issues, anxiety, or a temporary physiological response.
It's important to note that the presence of morning erections suggests that there are no underlying organic issues.

As for shockwave therapy, it is typically used for specific erectile dysfunction conditions, and since your doctor has indicated that there are no organic problems, it may not be necessary.
It would be best to discuss your symptoms further with a healthcare professional who specializes in sexual health to determine the most appropriate course of action.

Mr. Huang, 50~59 year old female. Ask Date: 2021/01/13

Dr. Cai Zhuorong reply Urology


The mechanism of shockwave therapy involves increased angiogenesis and hyperemia, with approximately 50% of patients responding well to shockwave treatment.
If you do not have issues with erectile hyperemia, you may consider other treatment options.

Reply Date: 2021/01/13

More Info


Erection issues can be complex and multifactorial, often involving both physical and psychological components. Based on your description, it seems you are experiencing a situation where sexual arousal leads to the secretion of clear fluid from the penis, but you are unable to achieve an erection sufficient for intercourse. This phenomenon can be attributed to several potential causes.

Firstly, the clear fluid you are experiencing is likely pre-ejaculatory fluid, which is produced by the Cowper's glands. This fluid serves to lubricate the urethra and neutralize acidity, but its presence does not necessarily correlate with the ability to achieve or maintain an erection. The fact that you have been evaluated by a doctor and found to have no organic issues, along with the presence of morning erections, suggests that your erectile dysfunction may not be due to a physical problem.

Psychological factors can play a significant role in erectile function. Anxiety, stress, or performance pressure can inhibit the ability to achieve an erection, even in the presence of sexual arousal. This is sometimes referred to as "psychogenic erectile dysfunction." If you find that your inability to maintain an erection occurs primarily in specific situations, such as during sexual activity with a partner or while watching adult content, it may be beneficial to explore these psychological aspects further.

Additionally, lifestyle factors such as fatigue, substance use (including alcohol and recreational drugs), and overall health can impact erectile function. It's important to consider whether any recent changes in your life may be contributing to your current situation.

As for treatment options, there are several avenues you might explore:
1. Counseling or Therapy: If psychological factors are suspected, speaking with a therapist who specializes in sexual health can be beneficial. Cognitive-behavioral therapy (CBT) can help address anxiety and performance issues.

2. Lifestyle Modifications: Improving overall health through regular exercise, a balanced diet, and reducing stress can have a positive impact on erectile function.

3. Medications: If psychological interventions do not yield results, medications such as phosphodiesterase type 5 inhibitors (e.g., Viagra, Cialis) may be prescribed to help achieve and maintain an erection.

4. Shockwave Therapy: This is a newer treatment option that uses acoustic waves to improve blood flow to the penis. While some studies suggest it may be effective for certain types of erectile dysfunction, it is typically more beneficial for those with vascular issues rather than purely psychological causes.

5. Communication with Partner: Open discussions with your partner about your concerns can alleviate some of the pressure you may feel during intimate moments.

In conclusion, while your situation may not warrant shockwave therapy at this stage, it is essential to address both the physical and psychological aspects of erectile dysfunction. Consulting with a healthcare provider who specializes in sexual health can provide you with tailored advice and treatment options based on your specific circumstances. Remember, you are not alone in this, and many men experience similar challenges. Seeking help is a positive step towards finding a solution.

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