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Erectile difficulties - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Erectile Dysfunction
Answered by

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
User :   Hello. I'm 24 years old and I'm having erectile difficulties. The first time I tried to have sex was at the age of 18 under the influence of marijuana in my girlfriends driveway in my car. The anxiety of being high and in her driveway made an erection impossible. Since then I've had several sexual partners but I've failed to have erections at certain times with a lot of them without manual sustained stimulation. I'm not sure if it's a medical problem or not but it's been following me around for years and that makes me think it could be psychological. My masturbation techniques are probably not the best as well, as I tend to engage in manual stimulation before I'm fully hard and I'm worried that I've trained myself to only respond to sexual stimulation in that way. Because of this I tend to keep my PC muscle clenched well before full erection and sometimes I can only remain hard by teetering on the edge of orgasm. At other times, however, I can slowly continue stimulation while relaxing and keeping my PC muscle unclenched while maintaining erection, but this seems to be the exception. I feel like if I was to try to engage in sex that I would need a lot of stimulation and I would feel hurried to get my penis inside of her before I lose the erection. The last two times I've tried to have sex this happened, and it was with two amazing women that I had had my eye on for a long time. I know this is lengthy but I hope it's been appropriately detailed. Thanks.
Doctor :   Hi
Doctor :   Dr .... here
User :   hello
Doctor :   Let me read what you have typed.
User :   sure
Doctor :   Do you have any symptoms other than this?
Doctor :   Are you on any medications?
User :   not really, no. I take claritin regularly but that's it
User :   as far as other symptoms, i suppose not...
Doctor :   Are you taking Claritine regularly? Has it been prescribed by your doc?
User :   no just the over the counter allergy medicine claritin for pollen, etc.
Doctor :   Do you take it daily as it can cause erectile dysfunction if taken before intercourse.
User :   i take it in the morning usually so most of the time it's pretty distanced from when i'd be sexually active. erectile dysfunction though? I've never read or heard that before
Doctor :   There are various causes of erectile dysfunction as stress, performance anxiety, drug intake etc.
Doctor :   1)Never go to bed stressed for the performance.
User :   i could have performance anxiety for sure considering that it's happened and i always worry about it
Doctor :   2)Avoid smoke and alcohol intake before having intercourse.
User :   sometimes i have difficulty staying full mast when i masturbate though, this is mostly when i stop stimulation
Doctor :   3)Do some form of yoga or meditation regularly.
User :   thats what sortof concerns me. and then i worry about that. it could be all mental. it's just confusing
User :   i feel like i have to really focus on the aspect of friction in my mind to stay aroused sometimes instead of simply being aroused. it's rather bothersome and annoying
Doctor :   4)Practice Start and Stop technique ( Start the intercourse and then stop in between for few seconds again start the process, it will help in increasing the time of erection)
Doctor :   5)Reduce frequency of masturbation if it is too much as it will decrease the erection time.
User :   am i doing a disservice to myself by beginning stimulation before fully erect?
User :   ah, ok. interesting.
Doctor :   6)Apply Prilox gel one hour before intercourse on your penis and leave it. Then before going to bed just wash it off.
Doctor :   6)Increase your foreplay time as it definitely helps in sustained erection.
User :   im afraid if i numb it i just wont get hard period. i need that physical stimulation to get an erection most of the time
Doctor :   8_Avoid any kind of drug, alcohol, stimulants, marijuana etc as they effect your sexual performance
Doctor :   Ask your partner to give stimulation. In fact both of you can stimulate each other.
User :   stimulants meaning caffeine? what about sleep btw
User :   i rarely get enough
Doctor :   Yes
User :   does my problem seem at all like a medical issue?
User :   and what about exercise
Doctor :   No its not to be bothered about as performance anxiety is very much common .
Doctor :   Exercise keeps you healthy and also increases the hormone level
User :   i read something recently that suggested that perspective has 180'd to believe that 90% of ED is due to physical problems. is this false information?
User :   Also...I was thinking about visiting a urologist or a psychologist. any recommendations of these ideas or if either would be a better option than the other?
Doctor :   No about 80% is due to stress, depression, anxiety etc and only 20 % is due to ant physical causes as old age, disease like diabetes
User :   Ok. well i'm pretty sure i'm not diabetic. I'm not very old of course either.
Doctor :   First you can try the suggestions which i have explained and then if you do not found any change you can visit any urologist
User :   So no caffeine at all? :/
Doctor :   Also you do not have any other symptoms so i am suggesting you some things which would help you
Doctor :   Caffeine you can take but not before going to bed.
User :   sounds like a stupid question but what other symptoms what i be looking for other than having trouble getting/maintaining erections that are related? in this case
User :   going to bed as in having sex? or actually sleeping
Doctor :   Like pain, burning in penis, urine problem, etc
User :   and also from what you're saying, a urologist would be more apt to assess a medical condition, is this correct?
User :   ok, i see. yes i am symptomless in that case.
Doctor :   Is there anything else you would like to know?
User :   would seeing a psychologist be beneficial in issues of performance anxiety?
Doctor :   Not really required right now
User :   i was just wondering if talking about it out loud may lessen my fears
User :   i dont wanna disappoint myself again. which i know is half of what performance anxiety is. but either way.
Doctor :   If you want you can then see if it helps
User :   so are there correlations between marijuana usage and anxiety?
Doctor :   Definitely marijuana does cause anxiety.
Doctor :   Thats why i recommend you to avoid marijuana.
User :   i always felt a little self conscious in high school. i started using marijuana heavily from 18-22/23. only in the last year have i really cut WAY back. I only smoke every month or so now. Are there any long lasting effects of marijuana in this way or by refraining from use should i return to normal?
Doctor :   Since last year have you not used marijuana at all?
User :   better out of high school boosted my confidence/self esteem a lot but i got lost in weed and didnt realize my true potential in that way. don't get me wrong, my grades at school here are very high
User :   i still smoked some over the course of last spring
User :   a little this summer
User :   i finally realized when i bought it i would smoke it until it was gone, at least when i was home after classes/work.
User :   classic substance abuse signs that i dont need. im much happier without it, but i wonder about the anxiety. can it cause depression as well?
Doctor :   It appreciable that now you have left it and please do not start it again As it has been months you left it no need to worry now
User :   and sorry, i wanted to reiterate my question about quitting and relieving myself of anxiety symptoms. to some extent my brother is the same way and he doesn't smoke often at all and never has much
Doctor :   Yes after quitting there are symptoms as depression for some time
User :   not serious anxiety. i'll put it this way; im fairly charming around the ladies when i've had a couple of beers, but sometimes i'm more nervous in my normal state. i figure this is normal but i wish i could capitalize on that confidence more.
Doctor :   You need to be more confident about yourself
User :   not cocky charming. im still altruistic in the way i carry myself. im a mindful person, and im not just trying to get in everybody's pants or anything. but i want to ooze that confidence more often
Doctor :   That confidence you can build by yourself
User :   im working on that. i wish i had more time for exercise but im so busy with school and work now. im also vice pres. of an honor society here on campus, but that also takes away time (yet does produce higher levels of confidence)
User :   any suggestions in confidence building techniques?
User :   ?
Doctor :   1)Talk to your friends about your apprehensions.
User :   oh i do this. its helped. im actually very open for a guy. it's difficult because i only have a handful of great guy friends that can actually talk about deeper issues. most guys stay pretty surface level
User :   but nonetheless i will continue to do so.
Doctor :   2)Identify the blocks
Doctor :   3)maintain a diary which situations make you lose confidence
Doctor :   4)Try to overcome these situations
User :   most often when i feel like ive acted out of line or been brash about something. more often than not i realize that im judging myself too harshly compared to those around me. almost a little too self-aware i suppose.
User :   not to jump back too much, but
User :   is any alcohol too much alcohol when it comes to sexual activity?
Doctor :   Any alcohol taken before sexual activity affects performance as it depresses the mind.
User :   i dont understand. a friend of mine will get blackout drunk sometimes and has no problems in the bedroom. im not saying that's my goal but it still confuses me.
Doctor :   Though occasional one drink can be taken
Doctor :   It depends on person to person and varies according to the alcohol affect on the body of person.
User :   what's your take on psychadelic mushrooms?
User :   random i know.
Doctor :   I do not recommend it though i have heard of it as there is no proof of their efficacy
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