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Suffering From Erectile Dysfunction. What Treatment Should Be Done?

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Posted on Tue, 27 Nov 2012
Question: Hello Sir,
I am 29 year old male.Sir , I am involved in masterbation since I was 16 and into sexual activities since 24.I have certain doubts about my sex life.Hence I am dictating it whole here:
1.When I engaged in foreplay for the very first time , I did not have the mind setup to penetrate the female.I did not try to penetrate, neither she wanted.I could maintain the erection for around an hour without any issue and had a pleasant experience.
2.Now next time when I tried to penetrate her , I suddenly found my erection down as i put on condom ..was very emberrasing.
3.Same happened for one more time.
4.Finally , a day after I was successful in insertion and had a good time as I got my confidence back.
5.Since then , I did not face any issue in maintaining my erection and had nice sessions of more than 20 sex sessions with her.Whenever down , I discovered my own ways to get back the erection.We had nice back to back sex sessions as well.

6.Now I got a chance to do sex with another lady.I did not like her but the oppurtunity to do sex brought me there.Same happened , I could not maintain the erection when I went for insertion.Whole night went in vain.In the morning , I could get my erection back and had a nice sex session.

7.Another Female : I met her , did like her but found her bulky when she removed her clothes.I could not maintain the erection again and waited.After sometime , I had my erection back and had a nice sex session.After that , we had nice sessions of sex without any issues for 6-7 times.Sometimes , back to back with a gap of an hour or so.

One thing common amongst top girls were that nobody was virgin and had loose vaginas.
8.Now I got married to a virgin girl.In the initial few sessions, I tried to penetrate my wife.Due to v.tight vagina and after making lots of unsuccessful efforts , I always used to lose my erection as I used to lose excitement.After 3-4 weeks of unsuccessful attempts , I got the technique/posture to penetrate her and finally we had a nice session of sex. But since she is still tight , I dont always get the appropriate erection to penetrate.Almost 50% of the times, I get it and then I insert.Another 50% of the times , I manage with fingering.

In summary , I was able to penetrate other girls easily because those were not virgin but with wife , faced some emberrassment coz she was virgin.

I am little confused here .My wife is away for some time.So , I thought of writing this to you and see if everythng is normal with me ? After first ejaculation , it takes me not less than an hour to get back to normal erection.Is that normal ?
Now , I am afraid that if I get a chance of sex with a new lady , I am no sure how my penis would respond after above experiences

doctor
Answered by Dr. Jonas Sundarakumar (6 hours later)
Hello and welcome to Healthcare Magic. Thanks for your query.

Your sexual problem, erectile dysfunction is, in fact, the most common sexual problem in men. Now, in your case, you have mentioned clearly that your erection problem is there only during certain situations (i.e. when you are not getting turned on adequately) and that you have been able to have good erections and perform well otherwise. Such a situational problem is most likely to be due to psychological causes and not any medical problems and the fact is that in more than 80% of cases of sexual problems, psychological factors play a major role in causing or aggravating the problem.

Now, regarding the specific sexual problem that you are facing with your wife, I would like to give you the following suggestions.
Firstly, remember, that the vagina is a very elastic structure and with proper sexual arousal, it can expand adequately. Secondly, lubrication is also essential for comfortable sexual intercourse, and adequate lubrication will be present only if the woman is sexually aroused adequately. When the vagina doesn't open up or get lubricated adequately, sexual intercourse becomes uncomfortable, and this discomfort itself will cause the male partner to loose his erection. Moreover, repeated attempts to penetrate and not able to do so properly will soon turn off your mood and also cause you to lose the erection. This is what seems to be happening in your case.

So, one simple and effective way to handle this would be to enhance your foreplay. This will ensure that the vagina expands and becomes lubricated adequately before penetration. Moreover, with a good foreplay, you will also be sufficiently aroused and hence be able to sustain the erection longer. Remember, more arousal means, more blood supply to the penis, which in turn means better and longer-lasting erections.

The second aspect is the subconscious "performance anxiety", which may also be contributing to your sexual problem. After a few negative experiences, you may subconsciously become doubtful and anxious whether you will be able to perfrom well this time or not. This subconscious fear or doubt itself will lead on to poor erections and poor performance. This soon becomes a "viscious cycle" - that is, anxiety leads to poor performance and poor performance then leads to further anxiety and this keeps on worsening.

So, I would advise you to try the following suggestions.

1) First get rid of thoughts that you may be sexually inadequate or dobts that you may not be able to get an proper erection. Remember that sex is not just a physical act but also a psychological process involving an expression of emotions, intimacy and love. So, just involve yourself in those feelings and stop focussing on your "performance" alone.

2) Improve your communication with your partner - this means both verbal as well as non-verbal communication. Each person has his or her own ways of getting sexually aroused or feeling sexual pleasure. So, this verbal and non-verbal communication will let each of the partners understand what the other finds more enjoyable and arousing.

3) Increase and spice-up your foreplay. Make sure that you initiate penetration only after both of you are fully turned on. This will sove your problem of having difficulty in penetration or losing your erection soon.

4) Distract yourself- try putting on some romantic music or mild lighting and create some romantic environment while having sex.

5) Most importantly, stop "monitoring" your performance. Remember, your partner is not conducting a test and evaluating you. She is also a part of the sexual relationship and wants to make you happy as well. So, there is no need to "prove" anything. If both of you actually get involved intimately and emotionally, then the physical part will automatically happen.

6) Also, avoid alcohol, smoking or any unecessary medication and try to stay stress-free and positive.

Regarding your other question, it is normal to have a gap or a period of latency after ejaculation, before getting an erection again. How quickly you get an erection again will depend on how much you are sexually aroused.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jonas Sundarakumar (1 hour later)
Dear Sir , Thanking you very much for your suggestions.
I generally don't go for the longer foreplay because during foreplay, I think that I will lose my erection if I do a longer foreplay.So , I try to penetrate after a short time. This feeling is generally generally there for the v.first time with a girl.I remember with my ist girl friend , I got rid of this fear after I acheived a comfort zone with her after 2-3 sex sessions and had a pleasant sex experience then for around 6 months.

But how to acheive such comfort zone during very first time with a girl?

Earlier , I adopted a strategy that I will bear in mind during sex session that I will not penetrate , only do foreplay.Only at a later stage if found suitable , I will penetrate.This worked for me with my first Girl friend.
This works only if your partner is very supportive.Sometimes after marriage , you tend to do sex as a duty as well since your partner wants it.In those scenarios , I dont get a good erection.What should I do ?
I enjoy foreplay a lot.But the fear of bad erection devoids me from foreplays.
doctor
Answered by Dr. Jonas Sundarakumar (8 hours later)
Hello again and thanks for writing in.

As you rightly mentioned, being comfortable with your partner and is important for an enjoyable sexual relatonship. Similarly being relaxed, anxiety-free and confident about your yourself is also equally important for a satisfactory sexual performance.

It is not true that foreplay can decrease your erection after some time. A lot of things can be achieved during foreplay. For example, it serves as a means of improving the communication with your partner; it helps both partners relax and get into a comfort zone; it can also help the woman's vagina to get adequately lubricated, expand and facilitate easier penetration.

In situations where you have to have sex as a part of your marital duty, you can still make it enjoyable for yourself. You can spice up your foreplay, try new positions or maybe, each partner can take turns to do things which the other partner likes and thereby, satisfy each other. You can also use this opportunity to use your your imaginations and fantasies, which will also help you get more aroused.

Men often have a misconception that sex within marriage is boring and monotonous. This is mainly because they hesitate to express their sexuality freely and they have to be conservative and traditional. Because of the hesitation on the man's part, the woman also hesitates to exhibit her sexual desires and feelings and ultimately, it becomes a mechanical act for both of you. Sex is not just a duty in marriage, but also something to be enjoyed. So, once you take the initiative and express yourself freely, turn your partner on and make her feel that it's okay to express her sexuality also freely, then sex between husband and wife becomes enjoyable and exciting.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Pychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jonas Sundarakumar (4 hours later)
Sir , thanks for the reply.
Please suggest me a strategy to be anxiety and fear free. Emberrasement before the girl is my big fear.Also , other feeling that too much of foreplay will increase a girl's temptation to be penetrated and in the end if my erection goes down , would not be good for her , ll make her feel bad about me.
After my first experience with my girl friend , I removed this fear and anxiety but erection again went when I went with my second girl friend for the first time as well.

Why does it occur almost always on my first time with a girl ?

Do you think I should go through any type of medical tests for ED ? In RG stone clinics etc.

Do you think I should take any pills on the first time with a girl ?

Regards XXXXXXX
doctor
Answered by Dr. Jonas Sundarakumar (12 hours later)
Hi XXXXXXX

The fact that your problems almost always occur on the first time with a girl clearly indicates that it is predominantly anxiety-related. You seem to be even scared of prolonged foreplay thinking that you will lose your erection and then disappoint your partner. This fear of embarrassment and fear of a erectile dysfunction or poor performance is what I exactly described as "performance anxiety", in your case.

I'm fairly certain that you don't have any medical problems and hence you don't need any medical tests. You'll only be wasting your money unecessarily. I can assure you that all tests will be negative. Also, if you start taking pills, then you'll soon get used to it and then never be able to overcome this problem without taking medication.

The only way of getting rid of this anxiety is to get rid of your negative thoughts and fears. This will come only by practice and persistent efforts. Stop focussing on your organ or your performance. Remember, sex is something to be enjoyed; it is not a test which you have to pass in front of your partner. So, again, I'm telling you stop worrying about your "performance". Try just getting involved fully, keeping your mind relaxed and not worry about erection or ejaculation - then automatically your functioning will become normal. I can assure you this.

You can also try some relaxation therapies to gain control of your anxiety... like XXXXXXX breathing, yoga, etc. You should also do at least 20 minutes of regular physical exercise everyday and try to eat a healthy balanced diet.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Pychiatrist
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Jonas Sundarakumar

Psychiatrist

Practicing since :2003

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Suffering From Erectile Dysfunction. What Treatment Should Be Done?

Hello and welcome to Healthcare Magic. Thanks for your query.

Your sexual problem, erectile dysfunction is, in fact, the most common sexual problem in men. Now, in your case, you have mentioned clearly that your erection problem is there only during certain situations (i.e. when you are not getting turned on adequately) and that you have been able to have good erections and perform well otherwise. Such a situational problem is most likely to be due to psychological causes and not any medical problems and the fact is that in more than 80% of cases of sexual problems, psychological factors play a major role in causing or aggravating the problem.

Now, regarding the specific sexual problem that you are facing with your wife, I would like to give you the following suggestions.
Firstly, remember, that the vagina is a very elastic structure and with proper sexual arousal, it can expand adequately. Secondly, lubrication is also essential for comfortable sexual intercourse, and adequate lubrication will be present only if the woman is sexually aroused adequately. When the vagina doesn't open up or get lubricated adequately, sexual intercourse becomes uncomfortable, and this discomfort itself will cause the male partner to loose his erection. Moreover, repeated attempts to penetrate and not able to do so properly will soon turn off your mood and also cause you to lose the erection. This is what seems to be happening in your case.

So, one simple and effective way to handle this would be to enhance your foreplay. This will ensure that the vagina expands and becomes lubricated adequately before penetration. Moreover, with a good foreplay, you will also be sufficiently aroused and hence be able to sustain the erection longer. Remember, more arousal means, more blood supply to the penis, which in turn means better and longer-lasting erections.

The second aspect is the subconscious "performance anxiety", which may also be contributing to your sexual problem. After a few negative experiences, you may subconsciously become doubtful and anxious whether you will be able to perfrom well this time or not. This subconscious fear or doubt itself will lead on to poor erections and poor performance. This soon becomes a "viscious cycle" - that is, anxiety leads to poor performance and poor performance then leads to further anxiety and this keeps on worsening.

So, I would advise you to try the following suggestions.

1) First get rid of thoughts that you may be sexually inadequate or dobts that you may not be able to get an proper erection. Remember that sex is not just a physical act but also a psychological process involving an expression of emotions, intimacy and love. So, just involve yourself in those feelings and stop focussing on your "performance" alone.

2) Improve your communication with your partner - this means both verbal as well as non-verbal communication. Each person has his or her own ways of getting sexually aroused or feeling sexual pleasure. So, this verbal and non-verbal communication will let each of the partners understand what the other finds more enjoyable and arousing.

3) Increase and spice-up your foreplay. Make sure that you initiate penetration only after both of you are fully turned on. This will sove your problem of having difficulty in penetration or losing your erection soon.

4) Distract yourself- try putting on some romantic music or mild lighting and create some romantic environment while having sex.

5) Most importantly, stop "monitoring" your performance. Remember, your partner is not conducting a test and evaluating you. She is also a part of the sexual relationship and wants to make you happy as well. So, there is no need to "prove" anything. If both of you actually get involved intimately and emotionally, then the physical part will automatically happen.

6) Also, avoid alcohol, smoking or any unecessary medication and try to stay stress-free and positive.

Regarding your other question, it is normal to have a gap or a period of latency after ejaculation, before getting an erection again. How quickly you get an erection again will depend on how much you are sexually aroused.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist