Erectile Issues and Pain During Intercourse: A Urology Perspective

Hardness issues?

Hello, Dr.
Hsu: I have two questions to ask.

1.
When I try to insert during intercourse with my girlfriend, I find that my erection is not firm enough.
It is normal, but I can't achieve a very hard erection.
If I can't insert after a while, I tend to lose my erection easily.
Neither of us is a first-timer, but we have both been away from our previous partners for some time and are still adjusting to each other (such as the angle of entry, etc.).
Generally, I am quite responsive, but if I do lose my erection, I can regain it after some stimulation, although it doesn't last long.
2.
After several attempts, I was able to penetrate, but my girlfriend keeps saying it hurts, and there has been some bleeding.
This has happened two or three times, but the amount of bleeding has decreased each time.
She suspects that her hymen hasn't completely ruptured, but after each bleeding episode, we stop and when we try again, I encounter the first issue (difficulty maintaining an erection).

I would like to ask you, regarding the first situation, can medications like Viagra or other methods help improve it? As for the second situation, I would like to confirm if my girlfriend's suspicion is correct.
Thank you!

flyport, 30~39 year old female. Ask Date: 2013/10/08

Dr. Xu Weikai reply Urology

Hello, 1.
It is likely that insufficient experience is causing the sexual dysfunction.
2.
You can stimulate the female partner more to ensure that the vaginal secretions are adequately lubricated before penetration, which should make the process smoother.
As for whether the hymen is causing the obstruction, it is necessary to consult a gynecologist.
If there are any unclear points, feel free to ask again for further discussion and research.
Answers from the internet should only be used as a reference; if necessary, it is important to seek medical attention at a healthcare facility.
This response is from Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2013/10/08

More Info

Erectile dysfunction (ED) and pain during intercourse can be distressing issues for many individuals and couples. Your concerns touch on both physiological and psychological aspects of sexual health, which are important to address comprehensively.

1. Understanding Erectile Dysfunction:
The situation you described, where you find it difficult to maintain an erection during intercourse, is not uncommon, especially in the context of new relationships or after a period of sexual inactivity. Factors such as anxiety, stress, and performance pressure can significantly impact erectile function. It’s important to note that occasional difficulties with maintaining an erection are normal, but if this becomes a frequent issue, it may be classified as erectile dysfunction.

Medications like Viagra (sildenafil) can be effective for many men experiencing ED. These medications work by increasing blood flow to the penis, helping to achieve and maintain an erection. However, it’s crucial to consult with a healthcare provider before starting any medication to ensure it’s appropriate for your specific situation and to discuss any potential side effects or interactions with other medications you may be taking.

In addition to medication, there are other strategies you might consider:
- Communication: Openly discussing your concerns with your partner can alleviate some of the performance anxiety.

- Relaxation Techniques: Engaging in relaxation exercises or mindfulness can help reduce anxiety and improve sexual performance.

- Counseling: If anxiety or psychological factors are contributing to your ED, speaking with a therapist who specializes in sexual health may be beneficial.

2. Pain and Bleeding During Intercourse:
The pain and bleeding your girlfriend experiences during intercourse are concerning and should be addressed promptly. While it’s possible that the bleeding could be related to the hymen, especially if she is inexperienced with penetrative sex, there are other potential causes that need to be considered. Pain during intercourse, known as dyspareunia, can result from various factors, including:
- Insufficient Lubrication: If there isn’t enough natural lubrication, it can cause friction and pain. Using a water-based lubricant can help alleviate this issue.

- Vaginismus: This is a condition where involuntary muscle contractions make penetration painful or impossible.

- Infections or Medical Conditions: Conditions such as vulvodynia, pelvic inflammatory disease, or other gynecological issues can also cause pain during intercourse.

It’s essential for your girlfriend to consult with a healthcare provider to determine the underlying cause of her pain and bleeding. A thorough examination can help identify any medical issues that may need treatment.

In summary, both erectile dysfunction and pain during intercourse can have multiple contributing factors, including physical, psychological, and relational dynamics. It’s advisable to seek professional medical advice to explore treatment options for ED and to address any concerns regarding pain and bleeding during intercourse. Open communication with your partner and a willingness to seek help can significantly improve your sexual health and relationship satisfaction.

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