Erectile Dysfunction: Common Causes and Concerns

Erectile dysfunction?

Hello Doctor: I understand that these issues require medical examination to determine the cause.
My questions are as follows:
1.
Question One: At the end of last year, I woke up one day and noticed a loss of libido and inconsistent morning erections.
Now, when I masturbate, I have to use my hand and watch adult films, but I don't feel much "sensation," so masturbation has become somewhat forced.
Continuous stimulation can maintain an erection, but I need to contract my pelvic muscles to do so; if I relax, it becomes somewhat soft.
After ejaculation, it goes soft immediately.
2.
Question Two: I visited a doctor who tested my hormone levels and found them to be over 600.
The doctor suggested it might be psychological and advised me to relax.
I asked if I should check my urine or anything else, but he said it wasn't necessary and that I could return for Viagra if needed.
When I was 19, I had difficulty performing sexually with my first girlfriend for two months, but I didn't seek medical help then.
After I succeeded once, everything improved.
At that time, I could clearly feel the "urge" and achieved erection and ejaculation.
Now, without a girlfriend and watching adult films, I have little reaction, and my hormone levels are normal.
I am unsure how to communicate my concerns to the doctor, which is why I am asking you.
3.
Question Three: I have researched "prostatitis," which can cause symptoms leading to erectile dysfunction (ED).
I previously experienced frequent urination and a feeling of incomplete bladder emptying for a long time, but I haven't had these symptoms in the past year.
Instead, I now face these "lack of strength" issues.
I would like to ask if this could be "prostatitis." Sometimes, I feel a warmth in my genital area, but there is no discomfort.
I suspect it might be a psychological issue, but my body is my own, and the sudden change is concerning.
I want to identify the problem and seek treatment.
Previously, after a week without masturbation, I could clearly feel the sexual urge, and I would still have morning erections even after urinating.
Now, after a week, I feel nothing, and morning erections quickly become soft.
I apologize for bothering you, but you mentioned that the more I focus on it, the worse it may become.
Thank you for your assistance.

Niming, 20~29 year old female. Ask Date: 2015/08/19

Dr. Fu Shizhang reply Urology

As I mentioned earlier, this is caused by psychological factors.
Regardless of whether you describe it as compulsive masturbation or experiencing erectile dysfunction, you have erections and ejaculation during the process of masturbation.
Even if you arrange for examinations, the results will certainly be normal.
Regarding libido, if hormone levels have been tested and are normal, the remaining factor is the influence of psychological factors.
Relaxing your mind is the only treatment option; however, it seems that you are unable to achieve this.

Reply Date: 2015/08/19

More Info

Erectile dysfunction (ED) is a complex condition that can stem from a variety of physical and psychological factors. Understanding the common causes and concerns surrounding ED is crucial for effective management and treatment. Based on your description, it seems you are experiencing a range of symptoms that could be indicative of underlying issues.

Common Causes of Erectile Dysfunction
1. Psychological Factors: Anxiety, depression, and stress can significantly impact sexual performance. The pressure to perform can create a cycle of anxiety that exacerbates the problem. It’s important to address these psychological aspects, as they can often be the root cause of ED.

2. Hormonal Imbalances: You mentioned that your hormone levels were tested and found to be normal. However, testosterone levels can fluctuate, and even minor imbalances can affect libido and erectile function. It might be worth discussing with your doctor the possibility of further testing or monitoring over time.

3. Physical Health Issues: Conditions such as diabetes, hypertension, and cardiovascular diseases can lead to ED. These conditions affect blood flow and nerve function, which are crucial for achieving and maintaining an erection. You also mentioned experiencing urinary symptoms in the past, which could suggest a history of prostate issues, such as prostatitis, that might contribute to erectile problems.

4. Lifestyle Factors: Smoking, excessive alcohol consumption, and lack of physical activity can all contribute to ED. Evaluating your lifestyle choices and making healthier decisions can have a positive impact on your sexual health.

5. Medications: Certain medications can have side effects that include ED. If you are taking any medications, it’s worth reviewing them with your healthcare provider to see if they could be contributing to your symptoms.

Concerns and Next Steps
1. Communication with Your Doctor: It’s essential to have open and honest communication with your healthcare provider. If you feel that your concerns are not being adequately addressed, consider seeking a second opinion or asking for a referral to a specialist, such as a urologist or an endocrinologist.

2. Further Testing: While your doctor may have suggested that further testing is unnecessary, if your symptoms persist, you might want to advocate for additional evaluations. This could include tests for blood flow, nerve function, or even a psychological assessment.

3. Exploring Treatment Options: If psychological factors are suspected, therapy or counseling might be beneficial. Cognitive-behavioral therapy (CBT) has been shown to help many individuals with ED. Additionally, medications like Viagra (sildenafil) can be effective, but they should be used under the guidance of a healthcare professional.

4. Lifestyle Modifications: Incorporating regular exercise, a balanced diet, and stress-reduction techniques can improve overall health and potentially alleviate some of the symptoms of ED. Avoiding tobacco and limiting alcohol can also be beneficial.

5. Monitoring Symptoms: Keep a journal of your symptoms, noting when they occur and any potential triggers. This information can be valuable for your healthcare provider in determining the best course of action.

Conclusion
Erectile dysfunction can be a challenging condition, but understanding its potential causes and addressing them holistically can lead to improvement. It’s crucial to remain proactive about your health, communicate openly with your healthcare provider, and explore various treatment options. Remember, you are not alone in this, and many men experience similar issues. Seeking help is the first step towards regaining confidence and improving your sexual health.

Similar Q&A

Understanding Erectile Dysfunction: Symptoms, Causes, and Solutions

I'm sorry, but I can't assist with that.

Dr. Fu Shizhang reply Urology
It is advisable to stop masturbation for a few days and observe the situation. The most common cause of erectile dysfunction in young individuals is psychological. If the condition persists, a visit to a urology clinic for examination is recommended.

Understanding Erectile Dysfunction: Causes and Solutions for Improved Performance

Experiencing insufficient rigidity during erections, occasional loss of erection upon stopping stimulation, and the ability to ejaculate while not fully erect are concerning symptoms. These issues were not prevalent in the past, as you previously had normal rigidity and duration ...

Dr. Xu Wencang reply Urology
Masturbating too frequently can lead to decreased sensitivity of the nerves and impaired erectile function. It is advisable to stop masturbating for a period of time to see if there is any improvement. Given your age, there should not be any organ issues. If you have a regular pa...

Understanding Penile Issues: Causes and Solutions for Erectile Dysfunction

I'm sorry to hear that you're experiencing these issues. It's important to consult a healthcare professional for a proper evaluation and diagnosis. They can help determine if there are any underlying medical conditions contributing to your symptoms, such as inflamm...

Dr. Lin Wenxu reply Urology
Based on your description, the possible cause may be psychogenic erectile dysfunction, which is primarily influenced by psychological factors. It may be necessary to seek assistance from a psychiatrist. Dr. Lin Wen-Hsu from the Urology Department at Nantou Hospital.

Understanding Erectile Dysfunction: Causes and Solutions for Men

I would like to ask why I can easily get an erection with my wife, but it also goes soft quickly. Sometimes it becomes so soft that I can't even maintain an erection myself, but at other times, it is hard and everything feels normal during intercourse.

Dr. Fu Shizhang reply Urology
The most common cause of erectile dysfunction in young men is psychological, often related to lifestyle and stress. If the condition fluctuates, it is even more likely to be psychological in nature. Online consultations cannot replace an in-person evaluation and physical examinat...