Erectile Dysfunction: Causes, Concerns, and Solutions

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I would like to ask the doctor~~ I used to have normal morning erections~~ I would quickly achieve an erection during sexual fantasies~~ Sometimes I would engage in DIY, but only about twice a month~ However, the hardness of my erections is not sufficient~ After getting a girlfriend, during our first time, after foreplay, I entered and within less than a minute I ejaculated~~ What is this problem? Is it premature ejaculation?~~ Now, when I engage in sexual activity, it is still the same~~ Is this a psychological factor or a physiological one?~~ Would taking Viagra or Cialis effectively improve the situation?~ Does watching a lot of adult content lead to difficulties in achieving normal erections?~ I have been unable to achieve a normal erection these past few days~ Even if I do get an erection, it is not firm and quickly subsides~~ Is there a problem with this?~~ Does this count as erectile dysfunction?~~~ Would taking Viagra cause erectile issues in a normal person?~~ Should I see a doctor?~~ How can I reduce sensitivity in the glans and prolong ejaculation time?~~

Shan Zhu, 20~29 year old female. Ask Date: 2005/03/21

Dr. Xu Weikai reply Urology

Hello, generally speaking, most sexual issues in young people are quite sensitive, which can lead to premature ejaculation.
As for erectile firmness, as long as one can penetrate the vagina normally, it should be sufficient.
Premature ejaculation is quite common in your age group and is usually due to a lack of experience (referring to both partners) and increased nervousness.
With some time for exploration and learning, it typically improves gradually.
There are many ways to reduce sensitivity, and the simplest method is to use a condom, which generally decreases the sensitivity of the glans and helps delay ejaculation.
Medications like Viagra, when taken properly, do not cause erectile dysfunction, but they also do not provide much help.
Frequently viewing adult content may lead some individuals to become accustomed to that type of stimulation, resulting in the need for stronger sexual stimuli to achieve an erection.
Urology Department Chief, Dr.
Hsu Wei-Kai, responding on behalf of the Taitung Hospital of the Department of Health, Executive Yuan, cares about you.

Reply Date: 2005/03/21

More Info

Erectile dysfunction (ED) and premature ejaculation (PE) are common concerns that can significantly affect a man's quality of life and intimate relationships. Understanding the underlying causes, potential solutions, and when to seek medical advice is crucial for managing these conditions effectively.

Causes of Erectile Dysfunction
ED can arise from a variety of factors, which can be broadly categorized into psychological and physiological causes:
1. Psychological Factors: Stress, anxiety, depression, and relationship issues can all contribute to ED. Performance anxiety, particularly in new relationships, can lead to a cycle of anxiety that exacerbates the problem. It’s not uncommon for men to experience temporary ED when they are nervous or under pressure.

2. Physiological Factors: Conditions such as diabetes, hypertension, cardiovascular disease, and hormonal imbalances can lead to ED. Additionally, lifestyle factors like smoking, excessive alcohol consumption, and obesity can also play a role.
3. Neurological Factors: Nerve damage from conditions like multiple sclerosis or spinal cord injuries can affect the ability to achieve an erection.

4. Medication Side Effects: Certain medications, including those for high blood pressure and depression, can contribute to ED.

Concerns Regarding Premature Ejaculation
Premature ejaculation is characterized by ejaculation that occurs with minimal sexual stimulation, often within one minute of penetration. This can be distressing and may lead to feelings of inadequacy or anxiety. Like ED, PE can have both psychological and physiological causes:
- Psychological Factors: Anxiety about sexual performance or past experiences can lead to PE.

- Physiological Factors: Hormonal issues, inflammation of the prostate or urethra, and certain neurological conditions can contribute.

Solutions and Treatment Options
1. Lifestyle Changes: Improving overall health through regular exercise, a balanced diet, and reducing alcohol and tobacco use can enhance sexual function.

2. Psychological Counseling: Therapy can help address anxiety, depression, or relationship issues that may be contributing to ED or PE.

3. Medications:
- Phosphodiesterase type 5 inhibitors (PDE5i) such as Viagra (sildenafil) or Cialis (tadalafil) can be effective for ED. These medications work by increasing blood flow to the penis, helping to achieve and maintain an erection.

- Delay Sprays or Creams: These can help reduce sensitivity and prolong the time to ejaculation.

- Selective Serotonin Reuptake Inhibitors (SSRIs): Some SSRIs are used off-label to treat PE due to their side effect of delayed ejaculation.

4. Behavioral Techniques: Techniques such as the "stop-start" method or the "squeeze" technique can help manage PE.

5. Medical Consultation: If you are experiencing persistent ED or PE, it is advisable to consult a healthcare provider. They can conduct a thorough evaluation to determine the underlying causes and recommend appropriate treatments.

Concerns About Pornography and Sexual Function
Excessive consumption of pornography can lead to unrealistic expectations about sex and may contribute to ED in some individuals. It can desensitize the brain's reward system, making it harder to achieve arousal in real-life situations. If you find that your use of pornography is affecting your sexual function, it may be beneficial to reduce consumption and seek professional guidance.

Conclusion
In summary, your experiences with erectile dysfunction and premature ejaculation could stem from a combination of psychological and physiological factors. It is essential to approach this issue holistically, considering both mental and physical health. Consulting with a healthcare professional can provide clarity and help you explore effective treatment options tailored to your specific situation. Remember, these conditions are common, and seeking help is a positive step towards improving your sexual health and overall well-being.

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