Erectile Issues: Hormones, Angles, and Concerns - Urology

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Erectile issues can be a source of significant concern and anxiety for many men, and it’s important to approach these issues with a clear understanding of the underlying factors that may be contributing to them. Based on your description, it seems you have already taken a proactive step by consulting a urologist and getting your hormone levels checked. The finding of elevated female hormones in your blood can indeed play a role in erectile function, as hormonal balance is crucial for sexual health.

1. Erection Angle and Hormonal Influence: The observation that your erection angle decreases when not continuously stimulated could be related to several factors, including hormonal levels, psychological factors, and possibly vascular issues. Elevated estrogen levels can lead to changes in erectile function, including reduced rigidity and possibly affecting the angle of erection. However, it’s also important to consider that the angle of an erection can be influenced by the level of arousal and stimulation. If you are not continuously stimulated, it is natural for the erection to soften, which can lead to a decrease in angle.
Regarding the concern about venous leakage, this condition occurs when the veins in the penis do not constrict properly during an erection, leading to a loss of rigidity. This can manifest as difficulty maintaining an erection or a decrease in angle. If you suspect this might be an issue, it would be wise to discuss it further with your urologist, who may recommend additional tests such as a Doppler ultrasound to assess blood flow and venous function.

2. Physical Changes and Concerns: The description of a "dividing line" or indentation on the shaft of your penis after an erection is concerning, especially if it is a new development. While it is possible that this could be a result of trauma or injury, such as a penile fracture, the absence of pain during erection is a good sign that a serious injury may not have occurred. However, it’s crucial to have any new or unusual physical changes evaluated by a healthcare professional.
The penis can have natural variations in appearance, and what you are observing may simply be a normal anatomical feature. However, if you are experiencing anxiety about this or if it changes further, it would be best to have a thorough examination by a urologist. They can provide reassurance and determine if any treatment is necessary.

3. Psychological Factors: It’s also worth noting that psychological factors can significantly impact erectile function. Anxiety, stress, and self-consciousness about sexual performance can create a cycle of dysfunction. If you find that your concerns about your erectile function are causing you distress, 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 improving sexual confidence.

4. Lifestyle Factors: In addition to hormonal and psychological factors, lifestyle choices can also affect erectile function. Regular exercise, a balanced diet, and avoiding smoking and excessive alcohol consumption can improve overall health and sexual function.
In summary, while hormonal imbalances can certainly contribute to erectile issues, it’s essential to consider a holistic approach that includes physical, psychological, and lifestyle factors. Continue to work closely with your healthcare providers to address your concerns, and don’t hesitate to seek further evaluations or treatments as needed. Remember, you are not alone in this, and many men experience similar challenges. Open communication with your healthcare team is key to finding effective solutions.