Erectile Issues at 23: Causes and Solutions

What should I do?

Doctor, I am 23 years old and can achieve normal erections and ejaculation, but I often experience insufficient hardness and it softens quickly, making it difficult to penetrate during intercourse.
Could this be due to a lack of exercise, excessive indulgence in the past, or possibly benign prostatic hyperplasia or stones? Is it possible to have benign prostatic hyperplasia at such a young age? I also seem to have issues with poor blood circulation, as my legs sometimes feel numb.
What should I do about this?

A Dong, 20~29 year old female. Ask Date: 2003/09/20

Dr. Xu Weikai reply Urology

In the past few days, I have been busy and did not check my email, so my response is delayed.
To further clarify based on your description, I would like to ask you a few questions: 1.
If there is no sexual intercourse and no ejaculation, how long can an erection be maintained with continuous stimulation? 2.
When you say "the hardness is often insufficient," do you mean that the hardness is inadequate when you want to engage in intercourse, or is it that the hardness is poor even during regular erections? 3.
May I ask how much you weigh at the age of 23? Would that be considered overweight?
When discussing erectile dysfunction, it can generally be categorized into vascular factors, neurological factors, and psychological factors.
Young individuals often experience issues due to lack of experience or anxiety affecting performance, meaning that most cases are psychologically induced.
However, if your regular erection hardness is poor, it could indicate a venous issue, most likely due to venous insufficiency.
Additionally, if you are somewhat overweight and lack exercise, it could be due to elevated blood lipids causing inadequate arterial perfusion.

Of course, at the age of 23, psychological factors are the most common cause, so try not to be too anxious.
From a Western medical perspective, excessive sexual activity typically does not cause erectile dysfunction.
As for the benign prostatic hyperplasia (BPH) and stones you mentioned, they generally do not affect sexual function.
The prostate usually begins to develop slowly around age 35, with symptoms appearing around 55 to 60, at which point evaluation or further treatment may be necessary.
It is unlikely for a 23-year-old to have issues in this regard.

Frequent leg numbness may indicate symptoms of nerve compression, possibly due to skeletal issues or poor posture.
I recommend that you get up and move around frequently, avoid sitting for too long, or consider purchasing a better chair, which should help improve the situation.
This issue requires further evaluation, and you can consult a urologist, neurologist, or orthopedic physician nearby.

Such problems can vary in severity; for example, poor posture or prolonged cycling can often lead to numbness in the buttocks, which may result in nerve injury and subsequently lead to erectile dysfunction.
Generally, most instances of numbness (for example, resting your arms on a table and causing them to go numb) have a low chance of causing neuropathy, but if numbness occurs frequently, it is advisable to pay attention to it.

Reply Date: 2003/09/20

More Info

Erectile dysfunction (ED) at a young age, such as 23, can be concerning and may stem from various causes. It's important to understand that while ED is often associated with older individuals, younger men can also experience it due to a range of physical, psychological, and lifestyle factors.
Firstly, let's address the physical aspects. You mentioned concerns about blood circulation, which can indeed affect erectile function. The penis requires adequate blood flow to achieve and maintain an erection. If you're experiencing symptoms like leg numbness, it could indicate underlying circulatory issues. Conditions such as peripheral artery disease (PAD) can lead to reduced blood flow, not just to the legs but also to the pelvic area, potentially contributing to erectile difficulties.

Regarding your question about prostate enlargement (benign prostatic hyperplasia, BPH) at a young age, it is relatively uncommon but not impossible. BPH typically occurs in older men, but younger men can experience prostate issues due to other factors, including hormonal imbalances or inflammation. However, it is more likely that your symptoms are related to other causes rather than BPH at your age.

Psychological factors can also play a significant role in ED. Stress, anxiety, and depression can all impact sexual performance. If you have a history of excessive sexual activity or have experienced anxiety related to sexual performance, these could contribute to your current issues. It’s essential to consider whether there are any psychological barriers or stressors in your life that might be affecting your sexual health.

Lifestyle factors, such as lack of exercise, can also contribute to erectile issues. Regular physical activity improves cardiovascular health, enhances blood flow, and can help alleviate stress and anxiety. If you are not exercising regularly, incorporating physical activity into your routine could be beneficial not only for your erectile function but also for your overall health.

In terms of solutions, here are some steps you can take:
1. Consult a Healthcare Professional: It’s crucial to speak with a healthcare provider about your symptoms. They can conduct a thorough evaluation, including a physical examination and possibly blood tests, to rule out any underlying medical conditions.

2. Lifestyle Changes: Incorporate regular exercise into your routine. Aim for at least 150 minutes of moderate aerobic activity each week, along with strength training exercises. This can improve blood circulation and overall health.

3. Healthy Diet: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support cardiovascular health. Foods that are good for circulation, such as those high in omega-3 fatty acids (like fish) and antioxidants, may also be beneficial.

4. Manage Stress: Consider techniques such as mindfulness, meditation, or yoga to help manage stress and anxiety. If psychological factors are a concern, speaking with a therapist or counselor may be helpful.

5. Avoid Substance Abuse: Limit alcohol consumption and avoid recreational drugs, as these can negatively impact erectile function.

6. Regular Check-ups: Keep up with regular health check-ups to monitor your overall health and address any emerging issues early.

In conclusion, while experiencing erectile issues at 23 can be distressing, it is essential to approach the situation holistically. By addressing potential physical, psychological, and lifestyle factors, you can work towards improving your erectile function and overall well-being. Don't hesitate to seek professional help, as they can provide tailored advice and treatment options based on your specific situation.

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