Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

It is very distressing to have poor erection in young age. Masturbation is considered as a part of normal human sexual behaviour and is is very common among young males. It is practiced by >80% male. It does not have any bad effects on health and does not lead to any medical problems.

Some people have many wrong ideas about masturbation - that it causes ill effects on health like nervous weakness, reduced energy, etc or sexual problems like erectile dysfunction. All this is not true and these are just myths and misconceptions. But If you have guilt related to masturbation, it can cause stress/anxiety/depression, which can affect erection. So do not feel guilt whenever you masturbate.

Erection do not get affected by masturbation in long term. If you have normal erection during masturbation and poor erection during sex it indicate conditioning of body for masturbation, which will solve after few days of stoppage of masturbation.

Erectile dysfunction can be a result of a psychological or physical problem.
Psychological causes: Most common cause in young patients. These include performance anxiety, emotional weakness, inferiority complex, stress, marital or relationship problems, low mood, feelings of guilt, and the effects of a past sexual and emotional trauma. Men with psychological problem usually have normal nocturnal erections and erections upon awakening, whereas men with physical problem often do not.

Physical causes: Include neurological disorders, alcoholism, drug abuse, hormonal imbalances, diabetes, hypertension, blood vessel disease and chronic diseases.

What I can understand from your query is that you are not able to have hard erection which is required for intercourse. You are 26 years of age and at this age, any difficulty in getting or maintain an erection is due to psychological reasons in most of the cases. I hope you are not taking any alcohol or smoking as sometimes these can also cause erectile dysfunction.

I will describe some simple measures which you can incorporate and these should help you:
-First of all, quit smoking and alcohol (if you are taking any)
-Stop worrying excessively regarding masturbation.
-Eat a healthy diet: fruits, milk and eggs
-Have faith in yourself and do not take any stress. You can talk to your partner openly and indulge in plenty of foreplay before sex. As you will worry, your problem will increase further. You can also plan to some short vacation for honeymoon, which will relieve your stress.
-Exercise, particularly aerobic exercise (like: Jogging, skipping and cycling) daily. It will increase blood flow all over body and will reduce stress.
-The commonly prescribed drug by the doctors is sildenafil (Viagra) or Tadalafil (Megalis), which causes erections to be stronger and long lasting, but should be taken after prescription. It is important to rule out medical conditions specially related to cardiovascular system before starting such treatment. Both of these medicines have excellent result in physical causes of erectile dysfunction.

There is also need to rule out certain medical conditions which can affect erection. These include diabetes, high blood pressure, heart or thyroid conditions, poor circulation, penile venous incompetency and neurological causes. For that comprehensive evaluation and tests, help of other specialist may also needed.

Apart from that in person evaluation and examination by psychiatrist may be necessary in your case to identify and treat psychological cause of ED, specially sexual anxiety.

You can first follow steps mentioned by me for 1 month, if there is no change, it is better to get evaluated and investigated by physician and psychiatrist to rule out above conditions mentioned by me.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,

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Hello again,
Thanks for follow up.

You have only 3 times sexual experience in last 3 years. Many time at initiation of sexual activities persons may have difficulty in sustaining erection due to performance anxiety due to lack of experience. So, do not worry much about past failure and follow above mentioned steps in future.

Excessive thinking which is difficult to control and leading to personal distress can be due to ocd) in your case, which need evaluation to confirm diagnosis. It may be related to your erection problem (psychological reason for ED). For evaluation, you can visit nearby psychiatrist.

In drug treatment of ocd most commonly SSRI (selective serotonin reuptake inhibitors) are used. SSRI takes around 3-4 weeks to show its effect. Non drug treatment like cognitive behavior therapy (form of psychotherapy) is helpful, which also takes weeks to show its effect.


Wish you good health.
Regards.

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