Erectile Dysfunction: Causes, Symptoms, and Solutions

Erectile dysfunction, male sexual dysfunction?

Hello Dr.
Tsai,
I would like to ask about my current situation.
I have gradually lost my morning erections over the past four years, although I occasionally have had one or two instances of ejaculation with blood.
Since then, I have been able to achieve erections, but they have become increasingly rapid in terms of ejaculation.
Currently, I no longer experience morning erections, and when I want to achieve an erection, it takes a long time.
I have no response when watching adult films, but I can still achieve an erection, albeit slowly and with reduced firmness, which quickly fades away.
It feels like there is no engorgement.
Just a few days ago, I was able to achieve normal erections and had responses while watching adult films, and I also engaged in masturbation.
However, this past week, my situation has changed.
The semen I ejaculate appears slightly yellow.
I do not have any bad habits, but due to work, my exercise has decreased significantly, and my sleep habits have not been sufficient.
However, I am gradually improving my sleep from 4-5 hours to 6-7 hours, although I still do not go to bed early enough.
What tests can I perform on my own to improve my situation? I have not sought medical attention recently, but I am considering it, although the pandemic has made it difficult.

Chen, 20~29 year old female. Ask Date: 2021/06/19

Dr. Cai Zhuorong reply Urology

Your symptoms may warrant a trial of antibiotic treatment, and maintaining a good lifestyle along with moderate exercise can also be beneficial.

Reply Date: 2021/06/19

More Info

Erectile dysfunction (ED) is a common condition that affects many men, and understanding its causes, symptoms, and potential solutions is crucial for effective management. Based on your description, it seems you are experiencing a range of symptoms that could be indicative of ED, including the gradual loss of morning erections, difficulty achieving and maintaining an erection, and changes in ejaculation.

Causes of Erectile Dysfunction
ED can be caused by a variety of factors, which can be broadly categorized into physical, psychological, and lifestyle-related causes:
1. Physical Causes: These include cardiovascular diseases, diabetes, high blood pressure, hormonal imbalances (such as low testosterone), and neurological disorders. Given your mention of changes in ejaculation and the color of your semen, it may be worth investigating any underlying medical conditions that could be contributing to your symptoms.

2. Psychological Causes: Stress, anxiety, depression, and relationship issues can significantly impact sexual performance. The fact that you mentioned a recent change in your ability to respond to sexual stimuli, such as watching pornography, may suggest a psychological component.

3. Lifestyle Factors: Poor sleep, lack of exercise, and unhealthy habits (like smoking or excessive alcohol consumption) can also contribute to ED. You noted that your sleep habits have been improving, which is a positive step, as adequate rest is essential for overall health and sexual function.

Symptoms of Erectile Dysfunction
The symptoms of ED can vary but typically include:
- Difficulty achieving or maintaining an erection
- Reduced sexual desire
- Changes in ejaculation (such as premature ejaculation or changes in the volume or appearance of semen)
- Loss of morning erections
In your case, the absence of morning erections and the difficulty in achieving an erection, along with the changes in semen, are significant indicators that warrant further evaluation.

Solutions and Management
1. Lifestyle Modifications: Improving your sleep hygiene, engaging in regular physical activity, and maintaining a healthy diet can have a positive impact on erectile function. Aim for at least 30 minutes of moderate exercise most days of the week.

2. Stress Management: Consider techniques such as mindfulness, meditation, or counseling to address any psychological factors that may be contributing to your ED.

3. Medical Evaluation: Since you mentioned that you have not sought medical attention yet, it would be advisable to consult a healthcare provider. They can perform a thorough evaluation, which may include blood tests to check hormone levels, blood sugar, and cholesterol levels, as well as a physical examination.

4. Medication: If lifestyle changes and psychological support do not yield improvements, your doctor may discuss the possibility of medications such as phosphodiesterase type 5 inhibitors (e.g., Viagra, Cialis) that can help enhance erectile function.

5. Further Testing: If there are concerns about underlying conditions, additional tests such as a penile Doppler ultrasound or nocturnal penile tumescence testing may be recommended to assess blood flow and erectile function.

Conclusion
Erectile dysfunction can be a complex issue with multiple contributing factors. It is essential to approach this condition holistically, considering both physical and psychological aspects. Given your symptoms and the changes you've experienced, it would be prudent to seek medical advice as soon as possible. A healthcare provider can help you navigate the next steps, provide appropriate testing, and recommend tailored treatment options. Remember, you are not alone in this, and many men experience similar challenges. Taking the first step to seek help is crucial for regaining sexual health and overall well-being.

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

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