Erectile Issues: Seeking Help for Sexual Performance

Please help me, doctor?

Doctor, I would like to ask you a question.
When I first start to engage in sexual activity, I get an erection, but when it's time to penetrate, I become soft.
Does this mean I have erectile dysfunction? Also, when I am soft, I still experience ejaculation.
Please help me resolve this issue.
Additionally, I tend to feel anxious during sex without realizing it.
Can you help me with this problem as well? Thank you.

Xiao Dong, 20~29 year old female. Ask Date: 2004/08/09

Dr. Xu Weikai reply Urology

Hello.
To ask in more detail, how long after penetration did it become flaccid? Or did it become flaccid before penetration? The situation you described could potentially be caused by venous insufficiency, which requires special examinations for diagnosis.
Generally, erectile dysfunction in young individuals is often due to psychological factors such as lack of experience or anxiety, rather than issues with organ function.
As both partners gain experience, these problems tend to improve over time.
Of course, I always emphasize that sexual activity is a mutual endeavor; both partners must cooperate to achieve a more fulfilling experience, rather than feeling obligated.

Director of Urology, Taitung Hospital, Department of Health, Executive Yuan, Hsu Wei-Kai.

Reply Date: 2004/08/09

More Info

Erectile dysfunction (ED) is a common issue that many men face at some point in their lives. It can be particularly distressing when it interferes with sexual performance and intimacy. Based on your description, it seems that you are experiencing difficulties maintaining an erection during sexual activity, which can lead to feelings of anxiety and frustration. Let's explore some potential causes and solutions for your situation.

Firstly, it's important to understand that erectile dysfunction can be influenced by a variety of factors, including psychological, physiological, and relational aspects. Anxiety, stress, and performance pressure can significantly impact your ability to maintain an erection. It’s not uncommon for men to experience a cycle of anxiety where the fear of not being able to perform leads to further difficulties in achieving or maintaining an erection. This is often referred to as performance anxiety.

From a physiological standpoint, several factors can contribute to erectile dysfunction. These include hormonal imbalances, blood flow issues, nerve damage, and certain medical conditions such as diabetes, hypertension, or heart disease. Lifestyle factors such as smoking, excessive alcohol consumption, and lack of physical activity can also play a role. It’s essential to consider these aspects and consult with a healthcare professional for a thorough evaluation.

In your case, it seems that the anxiety surrounding sexual performance is a significant factor. Here are some strategies that may help you address this issue:
1. Open Communication: Discuss your feelings and concerns with your partner. Open communication can help alleviate some of the pressure you may be feeling and foster a supportive environment.

2. Relaxation Techniques: Practice relaxation techniques such as deep breathing, meditation, or yoga. These can help reduce anxiety and improve your overall mental well-being.

3. Gradual Exposure: Instead of focusing solely on penetrative sex, consider exploring other forms of intimacy with your partner. This can help reduce performance pressure and allow you to enjoy the experience without the stress of achieving an erection.

4. Counseling or Therapy: If anxiety is a significant factor, consider seeking help from a therapist or counselor who specializes in sexual health. Cognitive-behavioral therapy (CBT) can be particularly effective in addressing performance anxiety.

5. Medical Consultation: Since you mentioned that you sometimes experience ejaculation even when your erection is not firm, it may be beneficial to consult a urologist or a sexual health specialist. They can assess your situation and determine if there are any underlying medical issues that need to be addressed. They may also discuss treatment options, which could include medications like phosphodiesterase type 5 inhibitors (e.g., Viagra, Cialis) that can help improve erectile function.

6. Lifestyle Changes: Adopting a healthier lifestyle can have a positive impact on your sexual health. Regular exercise, a balanced diet, and avoiding smoking and excessive alcohol can improve blood flow and overall health.

7. Education: Educate yourself about sexual health and function. Understanding that many men experience similar issues can help normalize your experience and reduce feelings of isolation or shame.

In conclusion, erectile dysfunction is a multifaceted issue that can often be addressed through a combination of communication, relaxation techniques, professional help, and lifestyle changes. It’s essential to approach this issue with patience and understanding, both for yourself and your partner. Seeking help from a healthcare professional can provide you with tailored advice and treatment options that suit your specific needs. Remember, you are not alone in this, and there are effective ways to improve your sexual health and performance.

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