Decreased Libido and Erectile Issues in Young Men

Sexual desire and erection questions?

Doctor, I noticed a sudden decrease in my libido after masturbating one day last year.
I have no sexual urges, and my erections are slow; sometimes they are firm, but other times they are soft.
I thought that masturbation wouldn't harm my body, but this has persisted until today.
I wake up in the morning without an erection, and after going back to sleep for a bit, I wake up with an erection, but it goes away quickly.
I realized something was wrong and went to see a doctor.
They checked my hormone levels, which were over 600, and both doctors said there was no need for further tests and advised me to relax.
I also took some medication for peripheral blood circulation, but it didn't help.
I read online that prostatitis can lead to sexual dysfunction, and I wonder if I might have an asymptomatic type.
I used to often feel like I couldn't fully empty my bladder and sometimes experienced frequent urination before bed.
I also had blood in my urine in the past, but I didn't seek treatment, and now I have no symptoms related to that.
All of this happened last year, and now I have no sexual desire, slow erections, and a decreased frequency of sexual urges.
I feel like I can't react to stimuli like I used to; I would see something stimulating and immediately want to masturbate, but now I don't feel that way at all.
I also engage in long-distance running for exercise.
Regardless of my sexual urges or erections, I am very worried.
I have tried to relax for a few weeks, but nothing has changed.
When I went to the hospital, the doctor said I am very young and that it's unlikely I have any issues.
They mentioned that if I were 56 years old, then they would consider erectile dysfunction to be worth investigating.
But why have I suddenly changed like this? I hope you can provide me with some answers and direction.

Niming, 20~29 year old female. Ask Date: 2015/06/06

Dr. Fu Shizhang reply Urology

Your condition seems to be more related to psychological factors.
Typically, young men without a history of trauma or diabetes, and who have not smoked or consumed alcohol in the past, are more likely to experience erectile dysfunction due to psychological causes.
If you really want to differentiate, it is advisable to undergo a thorough examination at a major hospital.

Reply Date: 2015/06/06

More Info

Decreased libido and erectile dysfunction in young men can be concerning and may stem from a variety of factors. Your experience of a sudden drop in sexual desire and issues with achieving and maintaining an erection can be distressing, especially at a young age. It’s important to understand that these symptoms can be influenced by both physical and psychological factors.

Firstly, hormonal imbalances can play a significant role in sexual function. You mentioned that your hormone levels were checked and found to be within a normal range. However, it’s worth noting that testosterone levels can fluctuate and may not always be indicative of overall sexual health. In young men, low testosterone can lead to decreased libido and erectile dysfunction. If you continue to experience symptoms, it may be beneficial to have a more comprehensive hormonal evaluation, including free testosterone levels and other related hormones.

Psychological factors are also crucial in understanding sexual health. Stress, anxiety, and depression can significantly impact libido and erectile function. You mentioned feeling worried about your symptoms, which can create a cycle of anxiety that exacerbates the problem. It’s essential to address any underlying psychological issues, as they can manifest physically. Consider speaking with a mental health professional who can help you manage anxiety and stress, which may improve your sexual health.

Lifestyle factors should not be overlooked either. Regular exercise, a balanced diet, and adequate sleep are vital for maintaining overall health, including sexual health. You mentioned that you engage in long-distance running, which is excellent for cardiovascular health. However, overtraining can lead to fatigue and decreased libido. Ensure that you are allowing your body enough time to recover and that you are not pushing yourself too hard.

Prostatitis, or inflammation of the prostate, can indeed lead to sexual dysfunction, but it usually presents with other symptoms such as pain during urination, pelvic pain, or discomfort in the genital area. If you have previously experienced urinary issues, it may be worth discussing this with your healthcare provider. A urologist can perform specific tests to rule out any prostate-related issues, including chronic prostatitis, which can sometimes be asymptomatic.

It’s also important to consider the impact of substances on sexual health. Alcohol, recreational drugs, and even certain medications can affect libido and erectile function. If you are taking any medications, review them with your doctor to ensure they are not contributing to your symptoms.

Lastly, communication with your partner can be beneficial. Open discussions about sexual health can alleviate some of the stress and anxiety surrounding performance issues. It’s essential to remember that many men experience fluctuations in libido and erectile function at various points in their lives, and it does not necessarily indicate a permanent issue.

In summary, while your symptoms are concerning, they can often be addressed through a combination of lifestyle changes, psychological support, and medical evaluation. If your symptoms persist, consider seeking a second opinion from a urologist or an endocrinologist who specializes in sexual health. They can provide a more in-depth assessment and tailored treatment options. Remember, you are not alone in this, and many young men face similar challenges. Taking proactive steps can lead to improvement and a better understanding of your sexual health.

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Take a break.