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Urology (Expert Forum)
ED since early age
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.
ED since early age
by bct4058, Nov 24, 2006 12:00AM
I am a 25 year old male with ED and PE ever since I have been sexually active.
I have considered three possible physical sources. First, I am slight and have abnormally small amounts of hair on my chest, arms, and face (but quite a bit in the pubic area), and am concerned about my hormonal levels. I got some basic tests – Prolactin at 13.6 (2.2-18.5 ng/mL) and Testosterone at 571 (200-1200 ng/DL). The blood was taken at mid-morning.
Second, when I began masturbating at 12 I experienced a extremely severe dull pain in my groin and lower penis after ejaculation, particularly the first time ejaculating. The pain diminished as I masturbated with more frequency but still occurred after orgasm for several years, but I no longer experience this and never discovered the source.
Finally, I received some testicular trauma at the age of thirteen – my scrotum was punctured by the small end of a chicken wire fence. The doctors said there was no internal damage (there was hardly any bleeding) but no follow up tests were ever performed. I received two stitches.
My specific symptoms are as follows. When with a sexual partner I have considerable difficulty getting, but more specifically maintaining an erection. Sometimes I get erect very quickly during foreplay (more when I was younger) but I lose erections extremely quickly without constant, focused physical stimulation. As far as I can recall this has always been the case, but I did not really realize that something was wrong until I tried to have intercourse late in college.
I have never been able to successfully perform intercourse medication. Usually to get erect I need intense oral or manual (with lubrication – I do not precum) stimulation, and often I am not able to sustain a full erection. When I reach the point of sufficient hardness for penetration I am too close to orgasm, and *** when I enter my partner, often on the first thrust. Frequently this occurs when I am not even fully erect and penetration is difficult.
For the last year I have been using Viagra, which has helped but I have to take *a lot*. With 50 mg things are a little better and it is somewhat easier to get erections, but intercourse usually doesn’t last more than a few minutes and sometimes much less. With 100mg the difference is dramatic and intercourse is sustained and intense.
I have discussed the problem with doctors and therapists in the past, and most assume that the source is mental and caused by anxiety. This seems to me increasingly unlikely since I am currently with a supportive partner and the problems are severe and do not seem to be improving. Moreover I believe the symptoms, while less noticeable in the past, have existed at least since I was 16 and first became sexually active.
The problem is deeply affecting my self esteem and my ability to pursue and sustain healthy relationships, and I don’t know what medical course to pursue. I really need help. Thanks.
I have considered three possible physical sources. First, I am slight and have abnormally small amounts of hair on my chest, arms, and face (but quite a bit in the pubic area), and am concerned about my hormonal levels. I got some basic tests – Prolactin at 13.6 (2.2-18.5 ng/mL) and Testosterone at 571 (200-1200 ng/DL). The blood was taken at mid-morning.
Second, when I began masturbating at 12 I experienced a extremely severe dull pain in my groin and lower penis after ejaculation, particularly the first time ejaculating. The pain diminished as I masturbated with more frequency but still occurred after orgasm for several years, but I no longer experience this and never discovered the source.
Finally, I received some testicular trauma at the age of thirteen – my scrotum was punctured by the small end of a chicken wire fence. The doctors said there was no internal damage (there was hardly any bleeding) but no follow up tests were ever performed. I received two stitches.
My specific symptoms are as follows. When with a sexual partner I have considerable difficulty getting, but more specifically maintaining an erection. Sometimes I get erect very quickly during foreplay (more when I was younger) but I lose erections extremely quickly without constant, focused physical stimulation. As far as I can recall this has always been the case, but I did not really realize that something was wrong until I tried to have intercourse late in college.
I have never been able to successfully perform intercourse medication. Usually to get erect I need intense oral or manual (with lubrication – I do not precum) stimulation, and often I am not able to sustain a full erection. When I reach the point of sufficient hardness for penetration I am too close to orgasm, and *** when I enter my partner, often on the first thrust. Frequently this occurs when I am not even fully erect and penetration is difficult.
For the last year I have been using Viagra, which has helped but I have to take *a lot*. With 50 mg things are a little better and it is somewhat easier to get erections, but intercourse usually doesn’t last more than a few minutes and sometimes much less. With 100mg the difference is dramatic and intercourse is sustained and intense.
I have discussed the problem with doctors and therapists in the past, and most assume that the source is mental and caused by anxiety. This seems to me increasingly unlikely since I am currently with a supportive partner and the problems are severe and do not seem to be improving. Moreover I believe the symptoms, while less noticeable in the past, have existed at least since I was 16 and first became sexually active.
The problem is deeply affecting my self esteem and my ability to pursue and sustain healthy relationships, and I don’t know what medical course to pursue. I really need help. Thanks.
Doctor's Answer
by Kevin Pho, MD, Nov 25, 2006 12:00AM
, Nov 25, 2006 12:00AM
It is difficult to say without evaluation.
Low testosterone would be an unlikely cause given the normal levels.
You can consider anatomical or vascular causes - and this can be imaged with an ultrasound or MRI of the penis.
If the tests continue to be negative - psychogenic causes indeed comprise a large proportion of ED cases.
Blood tests checking for diabetes or thyroid dysfunction should also be considered.
These options can be discussed with your personal physician, or in conjunction with a urologist.
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.
Kevin, M.D.
kevinmd_
Low testosterone would be an unlikely cause given the normal levels.
You can consider anatomical or vascular causes - and this can be imaged with an ultrasound or MRI of the penis.
If the tests continue to be negative - psychogenic causes indeed comprise a large proportion of ED cases.
Blood tests checking for diabetes or thyroid dysfunction should also be considered.
These options can be discussed with your personal physician, or in conjunction with a urologist.
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.
Kevin, M.D.
kevinmd_
Member Comments
by gqxtk3333, Nov 26, 2006 12:00AM
To: Sexual Dysfunction
0