Urological Issues: Ejaculation Problems and Treatment Options

Q: Urological Issues: Ejaculation Problems and Treatment Options

Hello： Please note that this response is for reference only and cannot replace a doctor's consultation.<br>1. <br>The doctor hasn't clearly explained my condition, and my symptoms persist. <br>Could I have chronic prostatitis or other issues? -- It's hard to say. <br>If there has

I'm not sure what the problem is?

Hello doctor, I encountered a problem after masturbation last month.
During that session, I tried to suppress my urges by tensing my abdomen, but it seemed like I still reached orgasm.
However, while my mind felt like it had climaxed, no semen was ejaculated, and afterward, my penis became flaccid.
It seemed like only a small amount of semen was released.
The next day, I started experiencing difficulties with erections, discomfort in the perineum during masturbation, and tightness that made ejaculation difficult.
I visited two doctors; one said it was an infection and prescribed antibiotics for a week, but since I didn't feel much discomfort, I didn't need a follow-up.
The other doctor suggested it was a psychological issue and prescribed two medications: Circulatory Sensitivity and Sucralose.

I have a couple of questions:
1.
The doctors didn't explain clearly what is wrong with me, and my symptoms persist.
Am I suffering from chronic prostatitis or possibly other issues?
2.
I am currently taking the two medications mentioned, but do I really need them? I'm confused about whether my problem is psychological or physiological.
Could you please evaluate my situation? I would greatly appreciate it.

Wu zhu, 30~39 year old female. Ask Date: 2021/07/30

Dr. Du Shixi reply Urology

Hello: Please note that this response is for reference only and cannot replace a doctor's consultation.
1.
The doctor hasn't clearly explained my condition, and my symptoms persist.
Could I have chronic prostatitis or other issues? -- It's hard to say.
If there has been no unsafe sexual behavior, it may be necessary to focus on lifestyle factors such as exercise, sleep, and hydration.
2.
I have been taking the two medications mentioned, but do I still need to continue? -- If you have been taking them for more than a week without any improvement, the effectiveness may be insufficient, and you should seek further medical attention.
I am confused about whether my issues are psychological or physiological.
Could you please evaluate my situation? -- It is likely that both factors are involved.
The physiological issues may have reached a certain level, leading to psychological effects.
Therefore, it is important to relax, pay attention to your lifestyle habits, and avoid unsafe sexual behavior.
Wishing you good health.

Reply Date: 2021/07/30

More Info

Understanding ejaculation problems can be complex, as they often involve both physiological and psychological factors. Based on your description, it seems you are experiencing a combination of symptoms that could indicate a few potential issues, including possible prostatitis, psychological factors, or other urological conditions.

1. Understanding Your Symptoms: The symptoms you describe—difficulty achieving an erection, discomfort in the perineal area, and issues with ejaculation—can indeed be associated with chronic prostatitis or pelvic pain syndrome. Chronic prostatitis is characterized by pelvic pain and urinary symptoms, and it can sometimes lead to sexual dysfunction. The fact that you experienced a significant change in your sexual function after a specific event (the episode of intense sexual arousal followed by a lack of ejaculation) suggests that there may be a connection between that event and your current symptoms.

2. Medical Evaluation: It is essential to have a thorough evaluation by a urologist who can assess your symptoms in detail. This may include a physical examination, a review of your medical history, and possibly some diagnostic tests such as urine analysis, prostate-specific antigen (PSA) testing, or imaging studies. Given that one doctor suggested an infection and prescribed antibiotics, it would be prudent to ensure that any potential infection is adequately addressed. If symptoms persist after completing the antibiotic course, further investigation is warranted.

3. Psychological Factors: The second physician's suggestion that your symptoms may be psychological is also valid. Sexual function can be significantly impacted by stress, anxiety, and psychological factors. If you are experiencing anxiety about your sexual performance or are preoccupied with your symptoms, this could contribute to the difficulties you are facing. It may be beneficial to speak with a mental health professional who specializes in sexual health to explore these aspects further.

4. Medication Considerations: Regarding the medications prescribed (Ciruclo and Shukol), these are often used to help with blood flow and may assist in addressing erectile dysfunction. However, their effectiveness can vary based on the underlying cause of your symptoms. If your issues are primarily psychological, these medications may not be as effective. It is essential to discuss with your prescribing physician whether these medications are appropriate for your specific situation and whether they should be continued.

5. Lifestyle and Management: In addition to medical treatment, consider lifestyle factors that can impact sexual health. Regular exercise, a balanced diet, adequate hydration, and stress management techniques (such as mindfulness or relaxation exercises) can all contribute positively to sexual function. Avoiding excessive alcohol and recreational drugs is also advisable, as these can exacerbate erectile dysfunction.

6. Follow-Up: If your symptoms do not improve or worsen, it is crucial to follow up with your healthcare provider. A urologist can provide specialized care and may recommend additional treatments, such as pelvic floor physical therapy, if appropriate.

In summary, your symptoms warrant a comprehensive evaluation to determine the underlying cause. Both physiological and psychological factors may be at play, and addressing both aspects is essential for effective treatment. Don't hesitate to seek a second opinion or further evaluation if you feel your concerns are not being adequately addressed. Your sexual health is an important aspect of your overall well-being, and you deserve to have clarity and effective management of your symptoms.

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