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Urology  (Expert Forum)
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Erectile Dysfunction, possible cause...
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

Erectile Dysfunction, possible cause...

by alothmank, Dec 18, 2003 12:00AM
Hello,



I am 26 years old and I’ve been experiencing erectile dysfunction for well over a year.  Before the onset of my problem, I used to get strong erections, pleasurably masturbate, and achieve orgasms without effort since I was 13, almost daily, until about one year ago.  I started experiencing soft erections, delayed orgasm, and noticeably weak ejaculation.  The problem occurred suddenly as far as I consciously noticed it.  The first cause I think could be alcohol.  Although not an alcoholic, in the past two or three years, I’ve been occasionally drinking a lot in weekends.  I cannot asses how much of alcohol consumption can cause ED, but I must admit that sometimes when I drink I do it quite extremely; such as drinking a bottle of whisky in one day.  Now that may seem like a high alcohol tolerance, but, honestly, I used to do it in my time off only and mostly I would go for a couple of weeks without drinking a drop.  That used to be ok and before the onset of my ED problem; there was even a long period of abstinence from alcohol that lasted almost half a year.  However just before the onset, there was a vacation of two weeks in which I drank quite a lot and extremely without drinking enough water, and I think I had hangovers several days in a row.  Unfortunately I took it too far with the alcohol and I remember having testicular pain that lasted about two days.  This is the key point.  It was like a stabbing pain deep inside my testicles.  Days after my vacation, I attempted to get into my usual activity of masturbation but I could not get an adequate erection at all.  Since then, it requires me to do a lot of hand work just to get an erection which fades away as soon as I leave off my hand.  It requires me to do rough hand motion to achieve orgasm for at least as long as 30 minutes to one hour.  My question is does this pain symptom and weakness sound like penis nerve damage due to alcoholism?  I also never obtain any spontaneous erection now, even while watching pornographic material, which used to occur seamlessly before the onset of my ED problem.  Sexual libido hasn’t gone low though.  Before, a girl merely touching my groin area would used to get me an erection.  Now, I can’t get an erection if a girl massages my penis until I do it myself with a firm grip.  To add to my personal background, I’ve had only few short term sexual partners in my life, in the past 2 years.   Another cause maybe desensitization of my penis due to over masturbation (there was a day when I masturbated 7 times in which little bleeding occurred in the skin).  Do you think that over masturbation can be the cause of my ED?  I do get sexually aroused; it’s just the area under the belt that is not cooperating.  I think if it is anxiety, it would not last a whole year and it would not cause all of the different complaints of weak erections, and delayed orgasm, and weak ejaculation.  My morning erections are also quite rare and not as rigid as they used to be.

by Kevin Pho, MD, Dec 20, 2003 12:00AM
I am not aware of exuberent masturbation as being a cause of ED.  If the libido isn't low, then it isn't likely a hormonal problem (i.e. low testosterone).  You may want to obtain these levels just to check.  



Extensive alcohol use can cause neuropathy in some cases.  Electrodiagnostic testing by a neurologist may be considered if this is suspected by your personal physician.  



I would also do a vascular check (i.e. checking groin pulses, ultrasound of the penis to evaluate any vasculature problem).  If you are experiencing stabbing pain in the testicles, you may want to obtain a scrotal ultrasound as well to evaluate any acute scrotal conditions.



One of the more comprehensive tests is nocturnal penile tumescence testing, which can quantify whether erectile dysfunction is impaired or not.  This can be discussed with your personal physician.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.

Member Comments

by aladdin, Jan 22, 2004 12:00AM
To: Sexual Dysfunction
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