Morning Erections: Causes and Solutions for Erectile Issues

In the morning, there is no morning erection, and the firmness is lacking?

I have been doing DIY almost every day since I was 12 years old.
Previously, even after DIY, I would still wake up with an erection, typically at an angle around 11 o'clock.
When I needed to urinate, I had to push down to avoid splashing on the toilet seat or making a mess.
However, for the past 1-2 years, I have not experienced that level of firmness in the morning, and I have even stopped having morning erections.
I thought this might be due to my frequent DIY sessions, so I didn't think much of it.
A couple of years ago, I had a significant incident where I contracted gonorrhea.
I went to a general urology clinic, received an injection, and took medication.
After the medication, my urine was brown.
The doctor said I was fine after the injection and completing the medication, so I didn't pay much attention afterward.
I have been smoking for about 16 years.
Recently, due to work stress, I have been staying up late and smoking more, which has affected my sleep.
Sometimes I would drink a little to help me sleep, but after the alcohol wore off, I found it even harder to sleep.
Currently, I am single and have not had sexual intercourse for about six months.
Recently, I decided to indulge a bit.
During foreplay before showering, my firmness was relatively normal, although not as firm as before.
However, when I put on a condom to penetrate, I lost my erection.
The lady was stimulating me, but it didn't help.
In the end, I was only semi-erect when she performed oral sex on me.
Afterward, I went to the hospital for blood tests, and my cholesterol and uric acid levels were normal, but my testosterone was low compared to others my age.
Since I have not had children yet, the doctor prescribed ovulation medication for me, half a pill a day, and I am scheduled to have another blood test in a month.
I have just started taking the medication for a week.
I forgot to ask the doctor if I can take maca or zinc supplements during this medication period.
Can I still do DIY during this time? I feel that when I watch videos and DIY, my erection is not very lasting.
After a strong peak, it becomes somewhat soft.
I am unsure if this is due to my perceived erectile issues causing me mental distress or if it has worsened.
I would like to ask the doctor if this is considered erectile dysfunction or infertility? Is it treatable?

Niming, 30~39 year old female. Ask Date: 2022/07/08

Dr. Chen Jiansheng reply Urology

Please seek medical attention.

Reply Date: 2022/07/08

More Info

Understanding morning erections, also known as nocturnal penile tumescence, is essential for grasping male sexual health. Morning erections are a normal physiological response that occurs during the REM (rapid eye movement) phase of sleep. They are a sign of healthy blood flow and nerve function in the penis, and they typically occur several times throughout the night.
In your case, the absence of morning erections and the difficulties you've experienced with achieving and maintaining an erection can be concerning. Various factors can contribute to erectile dysfunction (ED), including psychological issues, hormonal imbalances, lifestyle choices, and underlying medical conditions.

1. Psychological Factors: Stress, anxiety, and depression can significantly impact sexual performance. You mentioned experiencing increased work stress and sleeplessness, which could contribute to your erectile issues. Psychological factors can create a cycle of anxiety that exacerbates the problem.

2. Hormonal Imbalances: Low testosterone levels can lead to reduced libido and erectile dysfunction. You noted that your testosterone levels were lower than average for your age, which could be a significant factor in your situation. The medication prescribed by your doctor may help restore your testosterone levels, potentially improving your erectile function.

3. Lifestyle Choices: Smoking, excessive alcohol consumption, and lack of sleep can negatively affect erectile function. You mentioned a smoking history of 16 years and increased alcohol use due to stress. Both smoking and heavy drinking can impair blood flow and nerve function, leading to difficulties in achieving and maintaining an erection.

4. Physical Health: Conditions such as diabetes, hypertension, and high cholesterol can also contribute to erectile dysfunction. While your recent blood tests showed normal cholesterol and uric acid levels, it's essential to maintain overall physical health to support sexual function.

Regarding your questions about supplements like maca or zinc during your treatment, it's crucial to consult your healthcare provider before adding any supplements to your regimen. Some supplements may interact with medications or have side effects that could complicate your treatment.

As for whether you can continue to engage in self-stimulation (DIY), it is generally safe to do so unless your doctor advises otherwise. However, if you find that self-stimulation is causing frustration or anxiety regarding your erectile function, it may be beneficial to take a break and focus on your treatment and recovery.

In terms of whether this constitutes erectile dysfunction or infertility, it's essential to differentiate between the two. Erectile dysfunction refers to the inability to achieve or maintain an erection sufficient for sexual intercourse, while infertility relates to the inability to conceive a child. Since you mentioned that you have not been sexually active for some time, it may be premature to label your situation as infertility.
The good news is that many cases of erectile dysfunction are treatable. With the right approach, including lifestyle changes, medical treatment, and possibly therapy for any psychological components, you can improve your sexual health. It's essential to maintain open communication with your healthcare provider about your symptoms, treatment progress, and any concerns you may have.

In summary, your situation involves multiple factors, including hormonal imbalances, lifestyle choices, and psychological stress. Addressing these issues holistically can lead to improvement in your erectile function and overall sexual health. Regular follow-ups with your healthcare provider will be crucial in monitoring your progress and adjusting your treatment plan as necessary.

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