Sexual Function Issues: A Young Adult's Concerns

Q: Sexual Function Issues: A Young Adult's Concerns

Hello： The answers provided here are for reference only and cannot replace a physician's examination.<br>1. <br>Does varicocele affect sexual function? --> No.<br>2. <br>Can the duration of masturbation be improved by frequently retracting the foreskin to reduce sensitivity of th

Sexual Dysfunction Related Syndromes

Hello Doctor: I am currently 21 years old and have phimosis and varicocele.
I do not smoke or drink.
During the summer vacation, I masturbate about every two to three days.
I am a senior in college preparing for graduate school entrance exams, and I am experiencing stress related to this, along with a habit of staying up late since college (although I usually exercise, I have temporarily stopped due to the pandemic and exam preparations).
During my college years, I stayed in a dormitory and rarely went home, so I generally did not engage in masturbation while at the dorm.
I started masturbating in the sixth grade and developed this habit.
Due to a lack of knowledge about sexuality, I thought that finishing quickly during masturbation was normal until the second year of junior high school.
Additionally, because my parents did not provide me with any privacy, I could only hide in the bathroom to masturbate while showering or using the toilet.
My average masturbation duration was under five minutes, and I often faced situations where I was urged to leave the bathroom because I took too long.
After junior high, I tried to extend my masturbation duration to avoid finishing too quickly, but I still felt that the time from arousal to ejaculation was very short, and I often accidentally ejaculated without control.
Until college, aside from the duration issue, I did not have many other problems.
In my freshman year, I had my first girlfriend, and I would get an erection just from holding hands or hugging.
However, I experienced testicular pain, so I went to a urologist and was diagnosed with varicocele.
Around the age of 19, I also began to have issues with poor erection quality during masturbation and often experienced premature ejaculation.
I had intimate experiences with my girlfriend, such as touching her breasts, about three times, but we never had sexual intercourse.
She performed oral sex on me twice, and both times I ejaculated after just a few thrusts.
To this day, I still sometimes experience poor erection quality or finish quickly during masturbation (currently, I feel the urge to ejaculate after about a minute of masturbation) and often become flaccid shortly after ejaculation.
I have not yet had sexual intercourse, and since I just started dating my current girlfriend, I am very worried about having a negative experience if we become intimate.
Therefore, I would like to ask the doctor the following questions:
1.
Does varicocele affect sexual function?
2.
Can the duration of masturbation be improved by frequently retracting the foreskin to reduce sensitivity of the glans?
3.
I have read articles and watched videos that define premature ejaculation as "inability to control ejaculation." I would like to know if my situation, where I can ejaculate when I want but sometimes experience a small amount of leakage (pre-ejaculation), falls within the definition of premature ejaculation.
4.
I have a habit of watching adult content in college (averaging once or twice a day), but I only browse briefly without engaging in masturbation.
Would reducing this habit help improve my erection quality and duration of masturbation?
5.
Is my issue with erection quality during masturbation considered a psychological erectile dysfunction, or could it be related to other physiological issues?
6.
Do the above issues potentially affect my future sexual life? I am very anxious due to my experiences of finishing quickly and having poor erection quality, which is why I am seeking your consultation.
I look forward to your response.
Thank you for your help.

Nimingzhe123, 20~29 year old female. Ask Date: 2021/08/09

Dr. Du Shixi reply Urology

Hello: The answers provided here are for reference only and cannot replace a physician's examination.
1.
Does varicocele affect sexual function? --> No.
2.
Can the duration of masturbation be improved by frequently retracting the foreskin to reduce sensitivity of the glans? --> Yes, but the effect may vary.
3.
I have read articles and watched videos that describe premature ejaculation as "the inability to control ejaculation." I usually can ejaculate when I want to, but sometimes I experience a little leakage.
Does this fall under the definition of premature ejaculation? --> There are multiple definitions of premature ejaculation; you can refer to http://www.tand.org.tw/publications/into.asp?/55.html for detailed explanations.
4.
I have a habit of watching adult content frequently (averaging once or twice a day), but I only browse briefly without engaging in masturbation.
If I reduce this habit, will it improve my erection and masturbation duration issues? --> The effect is likely minimal.
5.
Is my issue with erection hardness considered a psychogenic erectile problem, or could it be related to other physiological issues? --> A physician's evaluation is necessary; most physiological issues are not significant.
6.
Will the above issues potentially affect my future sexual life? --> There is no definitive answer; just be sure to pay attention to your health.
Wishing you good health.

Reply Date: 2021/08/09

More Info

It's understandable to have concerns about sexual function, especially at the age of 21 when many young adults are navigating relationships and their own sexual health. Let's address your questions one by one, while also providing some context and advice based on medical knowledge.

1. Does varicocele affect sexual function?
Varicocele, which is an enlargement of the veins within the scrotum, can potentially impact sexual function. It is often associated with reduced testosterone levels and can affect sperm production, which may lead to fertility issues. However, its direct impact on sexual desire or erectile function can vary from person to person. Some studies suggest that treating varicocele may improve testosterone levels and sexual function, but this is not universally experienced. Consulting with a urologist can provide more personalized insights.

2. Can pushing back the foreskin during masturbation help reduce sensitivity?
Yes, some individuals find that exposing the glans (the head of the penis) by retracting the foreskin can help decrease sensitivity over time. This may lead to longer-lasting sexual experiences. However, it's important to approach this gradually and ensure that it is comfortable, as excessive friction or discomfort can lead to other issues.

3. Is the occasional leakage of semen during masturbation considered premature ejaculation?
Premature ejaculation (PE) is generally defined as ejaculation that occurs with minimal sexual stimulation before, during, or shortly after penetration, leading to distress. If you find that you are leaking semen without intending to, it may indicate a lack of control, which could be classified as a form of PE. However, it’s essential to differentiate between occasional leakage and consistent premature ejaculation. If this is a recurring issue that causes distress, it may be worth discussing with a healthcare professional.

4. Can reducing adult content consumption improve erection and masturbation duration?
There is some evidence suggesting that excessive consumption of pornography can lead to unrealistic expectations about sex and may contribute to issues like erectile dysfunction or premature ejaculation. Reducing exposure to adult content may help recalibrate your sexual responses and improve your overall sexual health. It’s beneficial to focus on real-life interactions and experiences rather than relying on pornography.

5. Is the issue with erection hardness psychological or physiological?
Erection hardness can be influenced by both psychological and physiological factors. Anxiety, stress, and performance pressure can lead to difficulties in achieving or maintaining an erection, which is often termed psychological erectile dysfunction. However, underlying physical issues, such as varicocele or hormonal imbalances, can also play a role. A thorough evaluation by a healthcare provider can help determine the root cause.

6. Will these issues affect future sexual experiences?
While it’s natural to be concerned about how current issues may impact future sexual experiences, many sexual function problems can be addressed with appropriate interventions. Open communication with partners, seeking professional advice, and possibly engaging in therapy or counseling can help alleviate anxiety and improve sexual experiences.
In conclusion, it’s crucial to approach these concerns holistically. Consider consulting a urologist or a sexual health specialist who can provide tailored advice and treatment options. Additionally, addressing any underlying anxiety or stress through counseling or therapy can be beneficial. Remember, sexual health is a common concern, and seeking help is a proactive step towards improving your overall well-being.

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