Erectile Dysfunction: A 24-Year-Old's Journey to Recovery

Erectile dysfunction?

Hello Doctor, I have had a habit of masturbation since elementary school.
I am now 24 years old, maintain a regular daily routine, exercise regularly, and have no psychological stress.
I enjoy reading, but in November of last year, I suddenly encountered issues with erections.
During sexual intercourse, if there is no stimulation, I lose my erection.
Although I can penetrate, the rigidity is very poor.
Since that incident, I have noticed that during masturbation, I also lack firmness, and watching adult videos does not elicit a response unless I manually stimulate myself, but it still remains quite soft.
Morning erections have also disappeared for over a year.
I have consulted a urologist, had blood tests and urinalysis, and everything came back normal.
The doctor mentioned that at my age, it is unlikely that I have a hormone deficiency.
I was prescribed 5 mg of Cialis, which significantly improved my condition, and I started experiencing morning erections again.
I even tried hiring an escort once, and there were no issues; I was able to achieve an erection without any physical contact.
However, I noticed that once I stopped taking the medication, my condition began to decline again.
Today, during masturbation, I found that no matter how I stimulated myself, I could not achieve an erection at all, which left me very confused.
I understand that the doctor might suggest it is a psychological factor, but I live my life with minimal stress and have no underlying issues.
I am at a loss as to what to do next.

Xiao Cai, 20~29 year old female. Ask Date: 2021/04/16

Dr. Chen Jiansheng reply Urology

Please return for a follow-up appointment and inform the physician, then request an adjustment to the treatment plan.

Reply Date: 2021/04/16

More Info

Erectile dysfunction (ED) can be a challenging and distressing condition, especially for someone as young as 24. Your experience highlights a complex interplay of physical and psychological factors that can contribute to ED. Let's break down your situation and explore potential avenues for recovery.

Firstly, it's important to understand that erectile dysfunction is not solely a physical issue. While you have undergone tests that returned normal results, indicating no hormonal deficiencies or other medical conditions, psychological factors can still play a significant role. Stress, anxiety, and even performance pressure can lead to difficulties in achieving or maintaining an erection. Even if you feel you are not under stress, the subconscious mind can sometimes harbor anxieties that affect sexual performance.

The fact that you experienced improvement with the medication (Sildenafil, commonly known as Viagra) suggests that there may be a physiological component to your ED. This medication works by increasing blood flow to the penis, which can help achieve an erection when there is sexual stimulation. However, the return of symptoms after stopping the medication indicates that the underlying issue may not have been fully addressed.

Here are some steps you can consider to further understand and potentially resolve your erectile dysfunction:
1. Continued Medical Evaluation: Since you have already seen a urologist, it may be beneficial to seek a second opinion or consult a specialist in sexual medicine. They can provide a more comprehensive evaluation, including tests for blood flow, nerve function, and other potential causes of ED.

2. Psychological Counseling: Even if you feel you are not under stress, speaking with a therapist who specializes in sexual health can be beneficial. They can help you explore any subconscious anxieties or fears related to sexual performance. Cognitive-behavioral therapy (CBT) has been shown to be effective for many individuals dealing with ED.

3. Lifestyle Modifications: Maintaining a healthy lifestyle is crucial. Regular exercise, a balanced diet, and adequate sleep can improve overall health and potentially enhance sexual function. Avoiding excessive alcohol and quitting smoking can also have a positive impact.

4. Pelvic Floor Exercises: Strengthening the pelvic floor muscles can improve erectile function. Kegel exercises, which involve contracting and relaxing the muscles that control urination, can be particularly helpful.

5. Gradual Desensitization: If you find that you are relying on manual stimulation to achieve an erection, consider practicing gradual desensitization. This involves slowly reintroducing sexual activity without the pressure of performance, allowing your body to respond naturally.

6. Medication Management: If you find that the medication helps, discuss with your doctor the possibility of a more long-term management plan. There are various medications available, and your doctor can help determine the best approach for you.

7. Open Communication: If you are in a relationship, open communication with your partner about your experiences and feelings can alleviate some of the pressure you may be feeling. A supportive partner can make a significant difference in your recovery journey.

In conclusion, while your situation is understandably frustrating, it is important to remember that erectile dysfunction is a common issue and can often be treated effectively. By exploring both the physical and psychological aspects of your condition, you can work towards regaining confidence and improving your sexual health. Don't hesitate to reach out for professional help, as a tailored approach can lead to better outcomes.

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