and Overcoming Erectile Dysfunction: A Personal Journey

Semi-erect?

Hello Doctor, this month I started noticing that I have difficulty achieving an erection when I engage in sexual activity with my girlfriend.
Even with external stimulation through touching, I can only achieve a partial erection, and it easily becomes flaccid when not stimulated.
Ultimately, I am unable to achieve a full erection for penetration.
This has made me feel quite down.
I visited a urologist, and my testosterone level was 485.
The physical examination showed no abnormalities.
However, the doctor indicated that my condition is psychogenic in nature and recommended that I take an erectile dysfunction medication from Sandoz.
I took half a tablet the first time and a quarter the second time, and I was satisfied with the results both times.
Currently, I am taking the medication about twice a week—once in the evening and once in the morning.
On one occasion when I did not take the medication, I was unable to achieve an erection, and even when I did, it quickly became flaccid, making penetration impossible.
This situation has affected my mood.

I have had a habit of daily masturbation since I was young, except for the year I served in the military, which may have contributed to my current condition.
I have stopped masturbating, but during this month, I have attempted to masturbate two or three times without achieving an erection.
I only experienced some firmness right before ejaculation, but it became flaccid immediately afterward.
My morning erections are still firm, but the day after having sexual intercourse, my morning erection is weak and becomes flaccid with slight touch.
In this state, I have stimulated the base of my penis to achieve an erection again, but it only reaches a partial firmness and is not sufficient for penetration.
After a period without stimulation, it becomes flaccid again.

In the past two weeks, I have also started exercising regularly by running and playing basketball.
I hope to restore my male function soon.
Do I need to schedule another appointment? Please give me some advice.
Thank you very much.

Ray, 30~39 year old female. Ask Date: 2021/02/01

Dr. Xu Wencang reply Urology

Adjust your daily routine again, temporarily use medication to help, and then gradually taper off.

Reply Date: 2021/02/01

More Info

Erectile dysfunction (ED) is a common issue that can affect men of all ages, and it can be caused by a variety of factors, including psychological, physiological, and lifestyle-related issues. Based on your description, it seems that you are experiencing a combination of psychological factors and possibly some physical responses that are contributing to your ED.

Firstly, it’s important to understand that the psychological aspect of ED can be significant. Anxiety, stress, and performance pressure can all contribute to difficulties in achieving or maintaining an erection. Given that you mentioned feeling low and experiencing anxiety about your performance, it is possible that these feelings are exacerbating your condition. The fact that you have had satisfactory results with the medication suggests that there may be a psychological component at play, as the medication can help alleviate some of the physical barriers to achieving an erection.

Your testosterone level of 485 ng/dL is within the normal range, which suggests that hormonal issues are less likely to be the primary cause of your ED. However, it is worth noting that testosterone levels can fluctuate and may not always correlate directly with sexual function. If you continue to have concerns about your testosterone levels, it may be beneficial to discuss this with your healthcare provider.

You mentioned that you have stopped masturbating and have started exercising more frequently. These are positive lifestyle changes that can improve overall health and potentially enhance sexual function. Regular physical activity can improve blood circulation, reduce stress, and boost self-esteem, all of which can contribute to better sexual health. Additionally, maintaining a healthy diet, getting adequate sleep, and managing stress through relaxation techniques or counseling can also be beneficial.

Regarding your use of the medication, it’s important to follow your doctor’s recommendations and not to exceed the prescribed dosage. While it seems to be effective for you, relying solely on medication can sometimes mask underlying issues that need to be addressed. It may be helpful to explore other therapeutic options, such as cognitive-behavioral therapy (CBT), which can help address performance anxiety and any negative thought patterns associated with sexual activity.

As for your question about whether you need to return to the clinic, it may be a good idea to schedule a follow-up appointment, especially if your symptoms persist or worsen. A healthcare professional can provide further evaluation and may suggest additional treatments or therapies that could be beneficial. They can also help you explore any underlying psychological factors that may be contributing to your ED.

In summary, while medication can be an effective short-term solution for ED, addressing the psychological aspects and making lifestyle changes can lead to more sustainable improvements in sexual function. Regular follow-ups with your healthcare provider can ensure that you are on the right track and can help you navigate any ongoing concerns. Remember, you are not alone in this journey, and seeking help is a positive step towards regaining your confidence and sexual health.

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