Erectile Issues: Causes of Discomfort and Changes in Ejaculation

Q: Erectile Issues: Causes of Discomfort and Changes in Ejaculation

Hello, sir： Thank you for your question. <br>I would like to address your inquiry and provide the following advice： The state of erection can vary from day to day, and erections that occur outside of sexual activity, without visual or auditory sexual stimuli, do not reach the eja

Sexual dysfunction issues

Hello, Doctor:
1.
Why is it that during erections, sometimes it feels very engorged and uncomfortable, almost like I'm about to ejaculate, while at other times, the erection is just a normal one without that feeling of fullness or the urge to ejaculate?
2.
Previously, if I didn't ejaculate for about 3 days to a week, I would experience nocturnal emissions, but now I don't have any nocturnal emissions at all.
What could be the reason for this? Thank you.

Jie Sen, 20~29 year old female. Ask Date: 2011/12/07

Dr. Lin Hexing reply Urology

Hello, sir: Thank you for your question.
I would like to address your inquiry and provide the following advice: The state of erection can vary from day to day, and erections that occur outside of sexual activity, without visual or auditory sexual stimuli, do not reach the ejaculation stage.
Since you are still young, sperm production is robust.
If there is a prolonged period without ejaculation, the seminal vesicles may become filled with sperm, leading to potential issues such as nocturnal emissions.
Lastly, I wish you peace and happiness.

Reply Date: 2011/12/07

More Info

Erectile issues and changes in ejaculation can be complex and multifaceted, often influenced by a combination of physical, psychological, and hormonal factors. Let's break down your concerns regarding discomfort during erections and changes in ejaculation, including the absence of nocturnal emissions (commonly referred to as "wet dreams").

1. Discomfort During Erections
The sensation of discomfort during an erection can be attributed to several factors:
- Vascular Changes: Erection is primarily a vascular event, where blood flow increases to the penis. If there is an increase in blood flow that exceeds the normal capacity of the penile tissues to accommodate it, it can lead to a feeling of fullness or discomfort. This is often described as a "hard" erection, which can sometimes be uncomfortable.

- Psychological Factors: Anxiety, stress, or arousal levels can affect how you perceive sensations during an erection. If you are feeling particularly anxious or excited, it may heighten the sensations associated with an erection, leading to discomfort.

- Hormonal Influences: Testosterone levels play a significant role in sexual function. Fluctuations in hormone levels can affect the quality of erections and the sensations experienced during them.

- Physical Health: Conditions such as Peyronie's disease, which involves the development of fibrous scar tissue inside the penis, can lead to painful erections. Other underlying health issues, such as diabetes or cardiovascular problems, can also affect erectile function and sensation.

2. Changes in Ejaculation and Absence of Nocturnal Emissions
The changes you've noticed regarding ejaculation and the absence of nocturnal emissions can also be influenced by various factors:
- Frequency of Sexual Activity: If you are engaging in sexual activity less frequently, your body may adjust by reducing the occurrence of nocturnal emissions. The body often regulates sperm production and ejaculation based on sexual activity levels.

- Age and Hormonal Changes: As men age, testosterone levels naturally decline, which can affect libido, erectile function, and ejaculation. This hormonal shift can lead to changes in the frequency and intensity of nocturnal emissions.

- Psychological Factors: Stress, anxiety, or changes in mental health can impact sexual function and desire. If you are experiencing increased stress or anxiety, it may affect your sexual health, including the occurrence of nocturnal emissions.

- Medical Conditions: Certain medical conditions, such as diabetes or neurological disorders, can affect nerve function and blood flow, leading to changes in sexual function and ejaculation patterns.

Recommendations
1. Consult a Healthcare Provider: It is essential to discuss these symptoms with a healthcare provider, preferably a urologist or a specialist in sexual health. They can conduct a thorough evaluation, including a physical examination and possibly blood tests to check hormone levels.

2. Lifestyle Modifications: Consider lifestyle changes that promote overall health, such as regular exercise, a balanced diet, and stress management techniques. These can improve blood flow and hormonal balance, potentially alleviating some of your symptoms.

3. Mental Health Support: If psychological factors are contributing to your symptoms, speaking with a mental health professional can be beneficial. Therapy can help address anxiety or stress that may be impacting your sexual health.

4. Open Communication: If you are in a relationship, maintaining open communication with your partner about your experiences and feelings can help alleviate anxiety and improve intimacy.

In summary, discomfort during erections and changes in ejaculation can arise from a variety of factors, including physiological, psychological, and hormonal influences. A comprehensive evaluation by a healthcare professional is crucial for understanding the underlying causes and determining the best course of action.

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