Struggling with Erectile Dysfunction: Causes and Solutions

Q: Struggling with Erectile Dysfunction: Causes and Solutions

Hello, there could be several possibilities： 1. <br>Work-related stress may be causing psychological and physiological pressure. <br>2. <br>Additionally, the sexual activity with your wife may have become routine, leading to insufficient stimulation. <br>Changing the way you enga

Experiencing erectile dysfunction during sexual activity?

Hello, Dr.
Hsu.
I can achieve an erection and ejaculate while watching adult films, but over the past year, my sexual performance with my wife has been declining.
Recently, I have been unable to achieve an erection at all, making penetration impossible.
However, I have noticed that I sometimes wake up with an erection in the middle of the night, but I have been experiencing fewer morning erections.
What should I do? I feel very discouraged.
I am 171 cm tall and weigh 85 kg.
I usually go to bed late due to work pressure, which is quite significant.
I have also developed a habit of masturbating daily for the past three years.
Thank you for your response and assistance, doctor.

Xiao Wang, 30~39 year old female. Ask Date: 2010/09/19

Dr. Xu Weikai reply Urology

Hello, there could be several possibilities: 1.
Work-related stress may be causing psychological and physiological pressure.
2.
Additionally, the sexual activity with your wife may have become routine, leading to insufficient stimulation.
Changing the way you engage in sexual activity might help improve the situation.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
This response is from Dr.
Hsu Wei-kai, Director of the Urology Department, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2010/09/19

More Info

Erectile dysfunction (ED) is a common issue that affects many men at various stages of life. Your situation, where you can achieve an erection during sexual stimulation from pornography but struggle with sexual intercourse with your partner, is not uncommon. This phenomenon can be attributed to several factors, including psychological, physiological, and lifestyle-related issues.

Causes of Erectile Dysfunction
1. Psychological Factors: Anxiety, stress, and depression can significantly impact sexual performance. The pressure to perform during intimate moments can lead to performance anxiety, which may inhibit your ability to achieve or maintain an erection. It's essential to address any underlying emotional or psychological issues, as they can create a cycle of anxiety that exacerbates the problem.

2. Physiological Factors: Conditions such as diabetes, hypertension, and cardiovascular diseases can affect blood flow and nerve function, leading to ED. Hormonal imbalances, particularly low testosterone levels, can also contribute to erectile difficulties. Given your age and lifestyle, it might be beneficial to undergo a thorough medical evaluation to rule out any underlying health issues.

3. Lifestyle Factors: Your weight (85 kg at 171 cm suggests a BMI that may categorize you as overweight) and sleep patterns can also play a role in erectile function. Poor sleep quality can lead to fatigue and hormonal imbalances, while excess weight can contribute to cardiovascular issues that affect blood flow. Additionally, daily stress from work can impact your overall well-being and sexual health.

4. Masturbation Habits: Frequent masturbation can sometimes lead to a desensitization effect, where the body becomes accustomed to certain types of stimulation. This can make it more challenging to achieve arousal in different contexts, such as with a partner. However, this is a complex issue and varies from person to person.

Solutions and Recommendations
1. Consult a Healthcare Provider: It's crucial to discuss your symptoms with a healthcare professional. They can conduct a physical examination, review your medical history, and possibly order tests to check for underlying conditions. This step is vital to determine if there are any physiological causes that need to be addressed.

2. Psychological Counseling: If anxiety or stress is a contributing factor, consider speaking with a therapist or counselor. Cognitive-behavioral therapy (CBT) can be particularly effective in addressing performance anxiety and improving sexual confidence.

3. Lifestyle Modifications:
- Weight Management: Aim for a healthier weight through a balanced diet and regular exercise. Losing even a small percentage of body weight can improve erectile function.

- Sleep Hygiene: Prioritize good sleep habits. Aim for 7-9 hours of quality sleep each night to help regulate hormones and reduce stress.

- Stress Management: Engage in stress-reducing activities such as yoga, meditation, or deep-breathing exercises. Finding healthy outlets for stress can improve your overall mental health and sexual function.

4. Limit Pornography Consumption: Reducing the amount of time spent watching pornography may help recalibrate your sexual response and improve your ability to engage with your partner.

5. Medication: If lifestyle changes and counseling do not yield improvements, medications such as phosphodiesterase type 5 inhibitors (e.g., Viagra, Cialis) may be prescribed by your doctor to help achieve and maintain an erection.

6. Open Communication with Your Partner: Discussing your feelings and experiences with your partner can help alleviate some of the pressure you may feel during intimate moments. A supportive partner can make a significant difference in your comfort level.

Follow-Up
It's essential to follow up with your healthcare provider regularly to monitor your progress and make any necessary adjustments to your treatment plan. Erectile dysfunction can often be managed effectively with the right approach, and many men find improvement with a combination of lifestyle changes, therapy, and medical treatment.

In conclusion, while erectile dysfunction can be distressing, understanding the potential causes and exploring various solutions can lead to significant improvements in your sexual health and overall well-being. Don't hesitate to seek help; addressing these issues is a positive step towards regaining confidence and intimacy in your relationship.

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