Erection Hardness Issues: Causes and Solutions - Urology

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Erectile hardness issues?


Hello, Dr.
Du.
I apologize for disturbing you during your busy schedule.
I have been masturbating since middle school and have developed a liking for watching adult content while doing so.
In the past, I didn't know how to control myself, so I would masturbate every day, sometimes even twice a day.
Although I noticed that my erection wasn't as firm as it was during my high school years, I didn't pay much attention to it.
However, after getting a girlfriend last year, I realized that I couldn't achieve penetration during intercourse, which prompted me to take this issue seriously.

Initially, I visited a urologist who conducted blood tests and a urinalysis, confirming that my testosterone levels were normal.
The doctor suggested that my issues might be related to psychological factors, anxiety, irregular lifestyle, or lack of exercise.
He recommended that I reduce my frequency of watching adult content and masturbating to see if it could help improve the situation.

Since then, I have started exercising regularly, incorporating 30 minutes of high-intensity interval training and weightlifting twice a week.
I also tried to abstain from masturbation for two weeks.
After this period, I found that I could achieve penetration during intercourse, but my erection still wasn't as firm as I would like.
Since my girlfriend and I are in a long-distance relationship, I still primarily rely on masturbation.
I have been maintaining a frequency of 2 to 3 times a week, but I still feel that my erection isn't firm enough, often feeling like I ejaculate before achieving full hardness (about the firmness of a ripe banana).

I couldn't help but research a lot of information and became worried that I might have erectile dysfunction.
I would like to ask you, doctor:
1.
Should I completely abstain from masturbation, or would it be better to try to refrain for a longer period?
2.
I have a longer foreskin, which does not retract completely when I have an erection, but I can easily push it back with my hand.
Could the perception of my erection being softer be due to the thickness of the skin when it is pushed back?
3.
Can a urology clinic test for symptoms of penile blood leakage? When I asked the doctor at the hospital, he said it was unlikely to have blood leakage, but he only performed blood tests and a urinalysis.
Can this determine anything?
4.
My work schedule is irregular, and I usually go to bed around 2 AM and wake up at 10 AM (still getting a full 8 hours of sleep).
Does this have a significant impact on my erections?

Niming, 20~29 year old female. Ask Date: 2021/10/15

Dr. Du Shixi reply Urology


Hello:
1.
Is it better to completely abstain from masturbation or to try to refrain for a longer period? -- No need.
2.
Because my foreskin is longer, it doesn't fully retract when erect, but I can easily push it back with my hand.
Could the softer appearance be an illusion caused by the thicker skin when retracted? -- It shouldn't be.
3.
Can a urologist detect symptoms of penile bleeding? I asked a doctor at the hospital, and he said it's generally unlikely to have bleeding, but he only did a blood test and urinalysis.
Can that determine anything? -- A larger hospital is required, and the examination is invasive.
If the physician determines it's unnecessary, it is unlikely to be performed.
4.
Due to my work schedule, I usually sleep around 2 AM and wake up at 10 AM (still getting a full 8 hours of sleep).
Does this have a significant impact on erections? -- Adequate sleep is important, and diet should not be too greasy.
Wishing you good health.

Reply Date: 2021/10/15

More Info


Understanding erection hardness issues can be complex, as they often involve a combination of physical, psychological, and lifestyle factors. Based on your detailed description, it seems you have already taken some positive steps towards addressing your concerns. Let’s break down your questions and provide some insights.

1. Should you completely abstain from masturbation?
While moderation is key, completely abstaining from masturbation may not be necessary for everyone. It can be beneficial to reduce the frequency, as you have done, to see if this improves your erection quality. The psychological aspect of sexual performance can be significant, and sometimes, the pressure to perform can lead to anxiety, which in turn can affect erection hardness. If you find that reducing the frequency of masturbation helps you feel more confident and improves your performance with your partner, then it may be worth continuing this approach. However, if you feel that abstaining completely is beneficial for your mental state, you might consider trying it for a period.

2. Could your longer foreskin be affecting your erection?
A longer foreskin can sometimes create a sensation that may affect how you perceive your erection. If the foreskin does not retract fully during an erection, it might create a feeling of less rigidity. However, if you can manually retract it without discomfort, it is unlikely to be the sole cause of your concerns. If you suspect that your foreskin is causing issues, it may be worth discussing with a urologist, who can provide guidance on whether any intervention is necessary.

3. Can a urologist detect penile blood flow issues?
Urologists can assess erectile function through various methods, including Doppler ultrasound, which can evaluate blood flow to the penis. While standard blood tests and urinalysis can rule out some systemic issues, they may not directly indicate blood flow problems. If you have concerns about erectile dysfunction related to blood flow, it would be advisable to discuss this specifically with your urologist, who may recommend further testing.

4. Does your sleep schedule affect your erections?
Sleep plays a crucial role in overall health, including sexual health. Irregular sleep patterns can lead to hormonal imbalances and increased stress levels, both of which can negatively impact erectile function. While you are getting a full eight hours of sleep, the timing of your sleep can still affect your circadian rhythms and hormone production. If possible, try to maintain a more regular sleep schedule, as this can help improve your overall well-being and potentially enhance your sexual performance.

In addition to these considerations, it’s important to maintain a healthy lifestyle. Regular exercise, a balanced diet, and managing stress can all contribute positively to sexual health. If you continue to experience concerns about erection hardness, it may be beneficial to seek counseling or therapy, as psychological factors can significantly impact sexual performance.

Lastly, remember that sexual health is a common concern, and many individuals experience fluctuations in their performance. Open communication with your partner about your feelings and experiences can also alleviate some of the pressure you may be feeling. If issues persist, don’t hesitate to seek further medical advice, as there are various treatment options available that can help improve erectile function.

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