Erectile Issues: Causes and Solutions for Young Men

Q: Erectile Issues: Causes and Solutions for Young Men

Chris： Hello, at 18 years old, I think psychological factors are likely more significant. <br>Typically, individuals who have engaged in long-term masturbation may experience decreased sensitivity, meaning that a greater level of stimulation is required to achieve an erection. <b

Penile erection

Hello Doctor,
Since middle school, I have had a habit of masturbation, about once every 1 to 2 days.
Last year, when I was about to have intercourse with my girlfriend, I encountered some issues.
Firstly, my girlfriend's lubrication was insufficient, making penetration difficult, possibly due to inadequate foreplay.
However, after trying several times, I discovered a more serious problem: whenever I put on a condom, I could only maintain an erection for a short time before it would go soft.
No matter how much manual stimulation I received, it still felt flaccid, and I had to stop.
As a result, it has been almost six months, and we are still both virgins.
Despite this, I still achieve a firm erection when I masturbate, so I am not overly anxious.
Additionally, since I am currently preparing for university entrance exams, I believe this is not an urgent issue.
I have researched a lot and think it is likely psychological erectile dysfunction.
However, due to the repeated failures to have intercourse with my girlfriend, I have reduced the frequency of masturbation over the past six months.

About two weeks ago, I noticed that the sensitivity of my penis has decreased significantly.
Firstly, I cannot achieve an erection through sexual fantasies; I must use manual stimulation.
When watching adult films, I might be able to get an erection, but it often goes soft within seconds.
Therefore, I still need manual stimulation to ejaculate, but it happens very quickly—within just a few strokes.
When I ejaculate, it feels like the hardness I had when I first got an erection is no longer there, which is quite distressing.
I looked up some information online and saw that some people say morning erections are a good indicator of erectile health.
So, I have been paying special attention to my penis's changes in the morning.
However, the worst part is that when I wake up, I feel the urge to urinate but do not have an erection.
In simple terms, it feels like I just have a normal urge to urinate without any erection.
I am unsure how long this has been happening, but it has been like this for the past few days.
I believe I am still relatively young, so why am I experiencing these symptoms? I have been under more stress lately due to preparing for the university entrance exams, and my physical activity has been low, but I did not have these issues two weeks ago.
What could be the problem? Should I seek medical attention?
Thank you, Doctor, for patiently reading this!

Chris, 10~19 year old female. Ask Date: 2005/02/27

Dr. Xu Weikai reply Urology

Chris: Hello, at 18 years old, I think psychological factors are likely more significant.
Typically, individuals who have engaged in long-term masturbation may experience decreased sensitivity, meaning that a greater level of stimulation is required to achieve an erection.
I believe your situation is similar.
Firstly, due to prolonged masturbation, you may have experienced reduced sensitivity.
When you are with your girlfriend, both of you may lack experience and feel nervous, leading to insufficient lubrication, which makes it difficult to achieve intercourse (since both are inexperienced and unsure of which positions or methods are easier to perform).
Secondly, you are using a condom during sexual activity.
What, is there a problem with using a condom? Yes, because condoms provide a protective barrier for the glans, making it harder for direct stimulation to reach the glans, which complicates achieving an erection.
(Sometimes, I suggest to friends with premature ejaculation to use double-layered condoms to reduce stimulation to the glans.) Additionally, using a condom can further decrease lubrication, as the natural lubrication from the penis is trapped inside the condom, making it less effective.
In inexperienced females, the natural lubrication may already be insufficient, leading to increased dryness.
My recommendations are as follows: go to a pharmacy and purchase some lubricant (if you're embarrassed, you can say it's for medical use with a nasogastric tube), there are small packages available, about 3-5cc each.
Avoid buying lubricants with anesthetic properties, as this could lead to worse outcomes (as it would numb the glans and vagina, making them very insensitive, which would make it even harder to achieve an erection, and secretion may also decrease).
Note: An erection in the morning due to bladder fullness indicates that your nerve pathways are intact and functioning properly.
The absence of an erection does not necessarily indicate a problem.
I think you can relax a bit; with the help of lubricant, you should have good news.
Sincerely, Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2005/02/27

More Info

Erectile issues, particularly in young men, can be a source of significant concern and anxiety. Based on your description, it appears that you are experiencing a combination of psychological and possibly physiological factors that may be contributing to your difficulties with maintaining an erection during sexual activity, especially with your girlfriend.
Firstly, it’s important to understand that erectile dysfunction (ED) can occur in young men and is often linked to psychological factors such as anxiety, stress, and performance pressure. Given that you mentioned preparing for university entrance exams, it’s plausible that the stress associated with this situation is impacting your sexual performance. Performance anxiety can create a cycle where the fear of not being able to perform leads to further difficulties, which in turn increases anxiety.

You also noted that you have no issues achieving an erection during masturbation, which suggests that your erectile function is intact when you are in a familiar and less pressured environment. This is a common scenario where the psychological context of the situation plays a significant role. The fact that you are able to achieve an erection while watching pornography or through manual stimulation indicates that your body is capable of responding sexually, but the added pressure of a partner may be causing your body to react differently.

The issue of reduced sensitivity and difficulty achieving an erection in the morning could also be indicative of psychological stress rather than a physical problem. Morning erections are typically a sign of healthy erectile function, and their absence can sometimes be a signal of underlying issues. However, in your case, the stress and anxiety you are experiencing may be overshadowing your body's natural responses.

Here are some suggestions to help you navigate this situation:
1. Communication with Your Partner: Openly discussing your concerns with your girlfriend can alleviate some of the pressure you feel. Understanding that both of you are in this together can help reduce anxiety.

2. Focus on Foreplay: Since you mentioned that your girlfriend's lubrication was an issue, focusing on extended foreplay can help both of you feel more comfortable and may enhance arousal, making penetration easier.

3. Reduce Stress: Engage in stress-reducing activities such as exercise, meditation, or hobbies that you enjoy. Regular physical activity can improve mood and reduce anxiety, which may help with sexual performance.

4. Limit Pornography: While it can be tempting to rely on pornography for arousal, it can sometimes create unrealistic expectations and desensitize you to real-life sexual experiences. Consider reducing your consumption to see if it helps with sensitivity and arousal.

5. Seek Professional Help: If these issues persist, it may be beneficial to consult a healthcare professional or a therapist who specializes in sexual health. They can provide tailored advice and support, and if necessary, evaluate for any underlying medical conditions.

6. Consider Lifestyle Changes: Ensure you are maintaining a healthy lifestyle, including a balanced diet, regular exercise, and adequate sleep. These factors can significantly impact overall health and sexual function.

In conclusion, while it’s understandable to feel concerned about these changes in your sexual health, many young men experience similar issues, often related to psychological factors. By addressing stress, improving communication, and possibly seeking professional guidance, you can work towards resolving these challenges. Remember, you are not alone in this, and there are effective strategies and resources available to help you.

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