Dr. Ramchandra Lamba
Psychiatry
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Patient's Query
Hello doctor,
I am 30 years old. I am a healthy individual with no signs of BP or heart issues. I have done a healthy heart screening where they checked heart plus blood flow in legs, lipid profile, liver function test, vitamin D and everything is normal. My morning erections frequency is fine, (not every morning I get it) sometimes during afternoon sleep. I have a phimosis issue. Recently last three attempts I had an issue with erections and unable to maintain it. I am worried and piling up stress.
Another issue is ejaculation. I feel I have delayed ejaculation as I am not able to ejaculate. When I masturbate I can ejaculate in the normal interval, I am not able to understand if phimosis causing delayed ejaculation and ED issue? Apart from the last three instances, I had this issue for a few months and then it resolved, I got erections for the next 10-12 sexual instances.
In addition, I do not have diabetes, I used to masturbate a lot by watching porn (kind of addicted) a few years ago then the frequency reduced as I became more mature. I am worried if this is the reason for ED? When I start sex all my attention goes to whether I am getting erections or not. I eat a healthy diet and do cardio three times a week. Please guide.
Hi,
Welcome to icliniq.com.
I have gone through your query and find that you are physically active and healthy. You have phimosis but that is not causing you much problem.
For the last few occasions you have erection problems and delayed ejaculation, it can occur because of many issues including the stress or performance or time hurry. Once you had one episode of ED (erectile dysfunction) or delayed ejaculation it can cause you anxiety and that can lead to ED for the next sexual activity.
If the issue is not affecting you regularly or at least 50 percent of your sexual activity then it is not required any medical treatment. Just continue your cardio workout and take healthy food and take adequate sleep.
Patient's Query
Thank you doctor,
It is not yet 50% but I would say 25% of time for ED and for delayed ejaculation its about 50%. I can say as it is maybe because of phimosis. I am not able to get that sensation. But when I masturbate always I ejaculate. Last few episodes of soft erections I had a few months ago too. Do you think it is something wrong about nerves or is that venous leak issue? Can ED medication help me to gain that confidence?
Hi,
Welcome back to icliniq.com.
It is unlikely that ED or delayed ejaculation is caused by phimosis. If your phimosis is causing you problems then it can be corrected by surgery. It is unlikely a case of venous leak or nerve damage because it is not regular and in your age the most common cause is stress or anxiety or psychological in nature.
ED medicine such as Sildenafil or Tadalafil can help you to manage your ED and that can boost your confidence. You can give a trial of Sildenafil 50 mg and see the response.
Patient's Query
Thank you doctor,
Does this medicine make me dependent on that? Why I am not getting morning erections every day? Do you think I have any other physical issues that can happen due to excessive masturbation? In addition, when I did other tests my blood circulation in legs were normal so what is causing less blood flow to the penis that affecting erection? I am trying to find out if anything wrong with my system? Delayed ejaculation also caused by stress or ED?
Hi,
Welcome back to icliniq.com.
No these medicines do not make you dependent. Morning erection does not occur daily in all men. It may occur daily in few men while it may occur once in a week in few men, so it is a normal variation. Masturbation per se does not cause any problem.
Normal blood flow to legs indicates that you have normal flow in your artery and vein. It may indicate that your penis artery and vein are normal probably. It does not indicate any problems. So just relax.
So it is unlikely that you have a physical cause of your problem, it is most likely psychological in nature. So just do regular exercise and take a healthy diet and avoid alcohol or tobacco products.
Delay ejaculation can be caused by stress and by some drugs like anti-hypertensive drugs or antidepressant drugs.
Just relax and give sufficient time. Do regular exercise. Take a healthy diet. Manage your stress effectively. Spend enough time in foreplay.
I hope this helps.
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