Erectile Dysfunction in Teenagers: Causes and Solutions

Experiencing difficulty achieving an erection during masturbation while watching adult content?

Hello Doctor, I am currently a senior in high school.
I started watching adult films in the third grade of elementary school and began masturbating in the fifth grade.
After entering high school, the frequency increased to at least once a day, and sometimes 3 to 4 times on weekends.
About six months ago (April of this year), I noticed a decline in the hardness of my erections and the sensitivity of my penis when watching adult films and masturbating.
During the period of school closures due to the pandemic and summer vacation (May to August), my masturbation frequency became even more frequent.
Even though the hardness was not as good as before, I maintained a high frequency of masturbation, sometimes even ejaculating while in a semi-erect state.
Recently (from late August to November), I found that I could not achieve an erection at all without manual stimulation while watching adult films (showing a completely flaccid state).
Even with manual stimulation, it was difficult to achieve an erection (about 40% hardness), and I would lose my erection immediately if I got distracted.
I suspect that the long-term exposure to extreme and highly stimulating adult films, along with frequent masturbation, may have caused sensory and nerve desensitization.
Therefore, I tried abstaining for a few days before attempting to masturbate again, managing to abstain for up to 8 days (I have a high sex drive, making it difficult to maintain abstinence).
After resuming masturbation, I noticed a recovery to about 80% hardness, but when I tried again the next day, it returned to a flaccid state.
I also attempted to watch various types of adult films or revisit some of my favorites, but it remained difficult to achieve an erection.
However, during the abstinence period, I occasionally experienced unintentional erections, not due to sexual stimulation, but for example, during class, I would have an erection for no apparent reason, with a hardness of about 80%.
Regarding morning erections, I have not experienced them for about two years, and there were none during the abstinence period.
Is this normal for someone my age? I currently have a girlfriend, and while we have not engaged in sexual intercourse, we have been intimate.
Previously, when we met, I would easily become aroused from holding hands, hugging, or smelling her hair.
Recently, during several meetings, I found that I did not achieve an erection during these actions and needed to engage in stimulating behaviors, such as rubbing her chest or using my penis against her buttocks, to become erect.
The hardness is also not what it used to be; previously, I would achieve a full erection that was hard to subside, but now it is about 70-80% hardness and subsides more quickly.
I remember during elementary and middle school, I could achieve an erection immediately through fantasy or by viewing erotic images and videos, and I experienced morning erections daily.
Now, at the age of high school, my hardness is noticeably less, and I find it almost impossible to feel the "rock-hard" sensation I had in middle school, and I have completely lost morning erections for over two years.
Now, I am facing the issue of not being able to achieve an erection while watching adult films and masturbating, which has persisted for about six months.
Should I see a urologist? I feel that at my age, I should not be experiencing these issues, but the symptoms have lasted for quite a while and seem to be worsening, which has troubled me for a long time.
I am currently preparing for college entrance exams and have less time to seek medical attention, but I am afraid that delaying it will cause me to miss the optimal treatment window and make the problem more complicated.
I am very afraid that in the near future, when I try to engage in sexual activity with my girlfriend, I will not be able to maintain an erection.
I love my girlfriend very much, and I do not want to disappoint or hurt her or risk breaking up with her.
Doctor, should I seek medical attention as soon as possible? Or can I wait until after the exams (in about 80 days) to see a doctor? Or is it unnecessary to seek medical attention? Should I try to abstain for more days (for example, one month)? I am 18 years old, a senior in high school, 173 cm tall, weighing 63 kg.
Due to academic commitments, I often stay up late, usually going to bed around 2 AM.
I do not smoke or drink, but I have become less active since entering high school.
Although I am a college entrance exam candidate, I believe I can rule out excessive academic pressure as an issue; I feel no academic pressure at all, as I study for myself and enjoy it.
Thank you for your response, and I apologize for the lengthy message.
I appreciate your help.

Niming, 10~19 year old female. Ask Date: 2021/11/08

Dr. Xu Wencang reply Urology

Further observation is possible, and there should be no issues with the organs.
It is advisable to participate in more outdoor activities.

Reply Date: 2021/11/08

More Info

Erectile dysfunction (ED) in teenagers is a complex issue that can stem from various physical, psychological, and lifestyle factors. Your situation, as described, reflects a concerning trend that many young men may experience, particularly in the context of frequent pornography consumption and masturbation.
Firstly, it’s important to understand that erectile dysfunction is not solely a condition of older adults; it can affect younger individuals as well. In your case, the decline in erectile function could be attributed to several factors:
1. Psychological Factors: Anxiety, stress, and performance pressure can significantly impact sexual function. Even if you feel you have no academic pressure, the anticipation of sexual encounters and the fear of not performing can create anxiety that affects your ability to achieve or maintain an erection.

2. Physical Factors: Hormonal changes during adolescence can also play a role. The absence of morning erections (morning wood) may indicate hormonal imbalances or other physiological issues. However, it’s not uncommon for young men to experience fluctuations in their sexual health as they grow.

3. Impact of Pornography: Regular consumption of pornography, especially if it involves extreme or unrealistic scenarios, can desensitize the brain's reward system. This desensitization may lead to difficulties in achieving arousal in real-life situations, as the brain becomes conditioned to respond only to the high levels of stimulation found in pornography.

4. Lifestyle Choices: Factors such as lack of physical activity, poor sleep patterns, and unhealthy habits can also contribute to erectile dysfunction. You mentioned that you often stay up late and do not exercise regularly, which can affect your overall health and sexual function.

Given your concerns, it is advisable to seek medical advice. Consulting a urologist or a healthcare provider specializing in sexual health can provide you with a comprehensive evaluation. They can help rule out any underlying medical conditions and offer tailored advice or treatment options.
In the meantime, here are some steps you can consider:
- Limit Pornography Consumption: Reducing or eliminating pornography from your routine may help reset your sexual response. This can allow you to regain sensitivity and improve your ability to respond to real-life sexual stimuli.

- Practice Healthy Habits: Incorporate regular physical activity into your routine, maintain a balanced diet, and ensure you get adequate sleep. These changes can improve your overall health and potentially enhance your sexual function.

- Mindfulness and Relaxation Techniques: Engaging in mindfulness practices, such as meditation or deep-breathing exercises, can help reduce anxiety and improve your mental state regarding sexual performance.

- Open Communication: If you feel comfortable, discuss your concerns with your girlfriend. Open communication can alleviate some pressure and help both of you navigate your intimate relationship more comfortably.

While it may be tempting to wait until after your exams to seek help, it is crucial to address these issues sooner rather than later. Delaying treatment could exacerbate the problem and lead to further anxiety or distress. Remember, seeking help is a sign of strength, and addressing these concerns now can lead to better outcomes in the future.

In summary, your situation is not uncommon, and there are various factors at play. Seeking professional help is a wise decision, and taking proactive steps to improve your lifestyle and mental health can significantly benefit your sexual health.

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