Erectile Dysfunction: Causes, Symptoms, and Solutions

Erectile dysfunction

I have not had any sexual desire for the past two months, not even feeling anything when watching adult films, and I don't feel the urge to masturbate.
Even when I do watch, I have no sexual arousal.
My penis only becomes erect when I manually stimulate it, but the base remains soft and does not achieve full rigidity.
The glans does not have the upward firmness when pressed down.
Even if I manage to get an erection, it becomes soft within a few seconds without stimulation.
When I touch my penis, I feel little sensation at the urethral frenulum, and the sensitivity at the base has diminished.
Additionally, I have a mild herniated disc and have been experiencing lower back pain for over six months.
About a month ago, after vigorous stimulation, I felt the urge to ejaculate, but pain started at the junction of my lower back and buttocks, and although I felt the sensation of ejaculation, no semen was expelled.
What could be the issue? Should I get my prostate checked for inflammation? Would abstaining for a month help improve the situation?

A-Ri, 30~39 year old female. Ask Date: 2022/10/21

Dr. Chen Jiansheng reply Urology

Please seek medical attention.

Reply Date: 2022/10/21

More Info

Erectile dysfunction (ED) is a complex condition that can stem from various physical and psychological factors. Your recent experiences, including a lack of sexual desire, difficulty achieving and maintaining an erection, and changes in sensation, suggest that you may be dealing with a multifaceted issue that warrants further investigation.

Causes of Erectile Dysfunction
1. Physical Factors:
- Vascular Issues: Conditions that affect blood flow, such as atherosclerosis or hypertension, can impede the ability to achieve an erection.

- Neurological Conditions: Nerve damage from conditions like diabetes or spinal injuries can affect sexual function. Your mention of a herniated disc could potentially contribute to nerve-related issues.

- Hormonal Imbalances: Low testosterone levels can lead to reduced libido and erectile difficulties.

- Prostate Health: Inflammation or infection of the prostate (prostatitis) can also lead to sexual dysfunction.

2. Psychological Factors:
- Stress and Anxiety: Mental health plays a significant role in sexual function. Anxiety about performance or stress from other areas of life can diminish sexual desire and arousal.

- Depression: This can significantly impact libido and sexual function.

3. Lifestyle Factors:
- Substance Use: Alcohol and recreational drugs can impair sexual function.

- Sedentary Lifestyle: Lack of physical activity can contribute to ED.

Symptoms of Erectile Dysfunction
The symptoms you describe—such as diminished sexual desire, difficulty achieving an erection, and changes in sensation—are common indicators of ED. The fact that you require manual stimulation to achieve an erection and experience a lack of firmness suggests that there may be both physical and possibly psychological components at play.

Solutions and Recommendations
1. Medical Evaluation:
- It is crucial to consult a healthcare provider for a thorough evaluation. This may include blood tests to check hormone levels, prostate health assessments, and possibly imaging studies to evaluate any nerve or vascular issues related to your back pain.

- A urologist can provide specialized insights into erectile dysfunction and prostate health.

2. Lifestyle Modifications:
- Regular exercise, a balanced diet, and avoiding smoking and excessive alcohol can improve overall health and potentially enhance sexual function.

- Managing stress through relaxation techniques, therapy, or counseling can also be beneficial.

3. Psychological Support:
- If psychological factors are contributing to your symptoms, speaking with a mental health professional can help address anxiety, depression, or relationship issues.

4. Medications:
- There are various medications available that can help improve erectile function. These should be discussed with a healthcare provider to determine the most appropriate option for your situation.

5. Prostate Health:
- Given your concerns about potential prostatitis, it would be wise to discuss this with your doctor. Symptoms of prostate issues can overlap with those of ED, and addressing any underlying inflammation or infection may help alleviate some of your symptoms.

Regarding Abstinence
Abstaining from sexual activity for a month may lead to some improvement in sexual function for some individuals, but it is not a guaranteed solution. The underlying causes of your symptoms need to be addressed for lasting improvement.

Conclusion
Erectile dysfunction can be a distressing condition, but it is important to remember that it is often treatable. Seeking medical advice is the first step toward understanding the underlying causes and finding effective solutions. Your symptoms, particularly in the context of your back pain and potential prostate issues, warrant a comprehensive evaluation to ensure that all contributing factors are addressed.

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