Erectile Dysfunction: Causes and Solutions for Young Men

Q: Erectile Dysfunction: Causes and Solutions for Young Men

Concerned Individual： Hello, I don't know if you've noticed, but every time you have an erection, the hardness and size of the penis can vary? Many people believe that the penis should be the same size when erect, but that's not the case. <br>The size of an erection can differ du

Help!

Hello doctor, I have some questions to ask you.
During my high school years, I was quite satisfied with the size, thickness, and hardness of my penis when erect.
However, after entering college, everything seemed normal in my freshman year, but by my sophomore year, I started experiencing issues.
It felt like the size and thickness of my penis decreased when erect, and it wasn't as hard as before.
For a long period, especially in the mornings, I noticed that I wasn't having any erections upon waking up—this lasted almost an entire semester.
During winter break, I visited a urologist due to this problem.
The doctor told me that I had an excess of female hormones and prescribed medication, which improved my condition.
My hardness returned, and I began to have morning erections again, but I still feel that the size and thickness of my penis are different from my high school days.
Additionally, when erect, if I am not stimulated, it quickly decreases in size and droops.
The angle of my erection used to be quite good, but now it barely exceeds 90 degrees and sometimes even falls below that.
Is this a sign of sexual dysfunction? What should I do?
Moreover, the most important point is that I have noticed that I no longer feel excited when watching adult films or when my girlfriend performs oral sex on me.
In simple terms, I feel like I have lost my sex drive.
I'm only 21 years old; how could I have no sex drive? Engaging in sexual activities or watching adult films feels like a routine task.
Is this due to hormonal issues, or could it be an injury to my penis? If it is an injury, what should I do? (I previously asked a doctor about my penis, as there is a dent in the area when erect, and the doctor said it was a normal phenomenon.)

Fanrao de ren, 20~29 year old female. Ask Date: 2007/07/04

Dr. Xu Weikai reply Urology

Concerned Individual: Hello, I don't know if you've noticed, but every time you have an erection, the hardness and size of the penis can vary? Many people believe that the penis should be the same size when erect, but that's not the case.
The size of an erection can differ due to factors such as the level of arousal, degree of engorgement, and overall health.
In your situation, aside from ruling out endocrine (hormonal) factors, you should consider whether you have become accustomed to the current stimuli.
In other words, if you are no longer responding significantly to the current stimuli, this could lead to insufficient neural excitation, resulting in poorer engorgement during erections.
If it is due to female hormone factors, treatment may be necessary.
Generally, after a period of treatment, improvements can be seen quickly.
However, if female hormone levels remain elevated long-term, other issues, such as a brain tumor, must be considered.
Injuries to the penis can lead to noticeable changes in appearance, such as bruising, but minor injuries typically do not affect sexual function.
Additionally, for younger individuals, many issues stem from psychological factors.
It is important to relax and not focus too much on this, as increased attention can lead to greater psychogenic interference with erections.
Response from Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2007/07/04

More Info

Erectile dysfunction (ED) in young men is a multifaceted issue that can stem from various causes, including psychological, physiological, and lifestyle factors. As a 21-year-old experiencing changes in erectile function, it’s important to understand the potential reasons behind these changes and the available solutions.

Causes of Erectile Dysfunction in Young Men
1. Psychological Factors: Anxiety, stress, and depression are significant contributors to ED, especially in younger men. The pressure to perform sexually, particularly in new relationships or during high-stress periods like exams, can lead to performance anxiety, which may inhibit the ability to achieve or maintain an erection.
2. Hormonal Imbalances: Hormonal issues, particularly low testosterone levels or an imbalance between testosterone and estrogen, can affect libido and erectile function. Your previous experience with hormonal treatment suggests that this could be a relevant factor in your case.

3. Lifestyle Choices: Poor diet, lack of exercise, smoking, and excessive alcohol consumption can negatively impact erectile function. A sedentary lifestyle and unhealthy eating habits can lead to weight gain and cardiovascular issues, which are known risk factors for ED.

4. Physical Health: Conditions such as diabetes, hypertension, and vascular diseases can affect blood flow to the penis, leading to difficulties in achieving an erection. Additionally, any history of trauma or injury to the genital area can also contribute to erectile issues.

5. Neurological Factors: Nerve damage from conditions like multiple sclerosis or even from injuries can affect the signals necessary for an erection.

Symptoms and Signs
You mentioned experiencing a decrease in the hardness and size of your erections, as well as a lack of sexual desire. These symptoms can indicate underlying issues that may require medical attention. The fact that you previously had a good response to hormonal treatment suggests that hormonal factors might still be at play.

Solutions and Treatment Options
1. Consult a Healthcare Professional: It’s crucial to have a thorough evaluation by a healthcare provider, preferably a urologist or an endocrinologist, to assess your hormonal levels and overall health. Blood tests can help determine if there are any hormonal imbalances that need addressing.

2. Psychological Counseling: If psychological factors are contributing to your ED, speaking with a therapist or counselor can be beneficial. Cognitive-behavioral therapy (CBT) is particularly effective for performance anxiety and other psychological issues related to sexual function.

3. Lifestyle Modifications: Improving your lifestyle can have a significant impact on erectile function. Regular exercise, a balanced diet rich in fruits, vegetables, whole grains, and lean proteins, and maintaining a healthy weight can improve blood flow and overall health. Reducing stress through mindfulness, yoga, or other relaxation techniques can also help.

4. Medication: If hormonal imbalances are confirmed, your doctor may recommend hormone replacement therapy. Additionally, medications like phosphodiesterase type 5 inhibitors (e.g., Viagra, Cialis) can be prescribed to help achieve and maintain erections.

5. Education and Communication: Understanding your body and communicating openly with your partner about your experiences and feelings can alleviate some of the pressure you may feel during sexual encounters.

Conclusion
At 21, experiencing erectile dysfunction can be concerning, but it’s important to remember that many young men face similar challenges. The key is to address the underlying causes, whether they are psychological, hormonal, or lifestyle-related. Seeking professional help and making positive changes in your life can lead to significant improvements in your sexual health and overall well-being. Remember, you are not alone in this, and there are effective treatments available.

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