Hormonal Imbalance and Sexual Dysfunction in Men

Hormonal imbalance

Hello doctor, I would like to ask about a situation where I exerted pressure in my abdomen to alleviate the urge to ejaculate during premature ejaculation.
After repeating this about three times, my penis became flaccid on its own without ejaculation, and then I was unable to achieve an erection.
I'm unsure if I experienced orgasm or not.
What could be the reason for this? Could the actions I took lead to sexual dysfunction or injury to the organs? Is there a possibility of hormonal imbalance or central nervous system disruption due to these actions? Afterward, when I attempted to masturbate the next day, my sexual function was not ideal, and I am uncertain about what is happening.
Additionally, I had my testosterone levels tested at the hospital, which dropped from around 4.0 to 2.7.
Is this rate of decline normal? Could the aforementioned actions have caused hormonal imbalance? Since that incident, I have been in a state of anxiety every day, constantly checking if I can achieve an erection.
I no longer enjoy the pleasure I used to experience during masturbation; my penis feels numb and insensitive.
What is happening to me, and what can I do? I am living in great distress every day; please help me.

Xiao You, 30~39 year old female. Ask Date: 2022/09/27

Dr. Cai Zhuorong reply Urology

If anxiety symptoms persist, it may be advisable to seek assistance from a psychiatrist.

Reply Date: 2022/09/27

More Info

Understanding hormonal imbalance and sexual dysfunction in men is a complex issue that intertwines physiological, psychological, and lifestyle factors. The symptoms you describe, including premature ejaculation, difficulty maintaining an erection, and a significant drop in testosterone levels, can be indicative of several underlying issues.

Firstly, it’s important to recognize that sexual function is influenced by a variety of hormones, primarily testosterone. Testosterone plays a crucial role in libido (sexual desire), erectile function, and overall sexual health. A decrease in testosterone levels, such as the drop you mentioned from approximately 4.0 to 2.7, can lead to diminished sexual desire and erectile dysfunction. This decline can be attributed to various factors, including stress, anxiety, lifestyle choices, and even physical health conditions.

The act of trying to control ejaculation by tensing the abdominal muscles can sometimes lead to a temporary loss of erection. This is because the body may become overly focused on the act of controlling ejaculation rather than allowing the natural physiological process to occur. When you repeatedly engage in this behavior, it can create a cycle of anxiety and performance pressure, which may further exacerbate erectile dysfunction. The psychological aspect of sexual performance is significant; anxiety about sexual performance can lead to a self-fulfilling prophecy where the fear of not being able to perform leads to actual performance issues.

Moreover, the feelings of anxiety and the pressure to perform can lead to a heightened state of stress, which can further disrupt hormonal balance. Chronic stress is known to elevate cortisol levels, which can negatively impact testosterone production. This creates a vicious cycle where anxiety leads to erectile dysfunction, which in turn increases anxiety.

Regarding your concerns about potential injury to the sexual organs or hormonal imbalance due to your behaviors, it is unlikely that the actions you described would cause physical injury to the penis. However, the psychological impact of these experiences can lead to a condition known as performance anxiety, which can affect sexual function. If you are experiencing numbness or a lack of sensation, it may be worth considering whether this is related to anxiety or if there are other underlying issues that need to be addressed.

In terms of managing your situation, it is crucial to approach this holistically. Here are some recommendations:
1. Consult a Healthcare Professional: It’s essential to discuss your symptoms with a healthcare provider, preferably a urologist or an endocrinologist. They can conduct a thorough evaluation, including hormone level testing and possibly psychological assessments.

2. Address Psychological Factors: Consider speaking with a mental health professional who specializes in sexual health. Cognitive-behavioral therapy (CBT) can be particularly effective in addressing performance anxiety and related issues.

3. Lifestyle Modifications: Engage in stress-reducing activities such as exercise, meditation, or yoga. These practices can help lower cortisol levels and improve overall well-being.

4. Healthy Sexual Practices: Focus on enjoying sexual experiences without the pressure of performance. This may involve exploring different forms of intimacy that do not solely focus on penetration or ejaculation.

5. Monitor Hormonal Levels: Regular follow-ups with your healthcare provider to monitor testosterone levels and overall hormonal balance can help you understand your body better and adjust treatment as necessary.

6. Avoid Substance Abuse: Limit alcohol and avoid recreational drugs, as these can further complicate sexual function and hormonal balance.

In conclusion, while the symptoms you are experiencing can be distressing, they are not uncommon and can often be managed effectively with the right support and interventions. It’s important to be patient with yourself as you navigate this process and to seek help from professionals who can guide you toward recovery and improved sexual health.

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