Impotence???

I'm 22.  My problem started almost 3 months ago while I was masturbating.  I wasn't doing anything different than normal, just stroking with my hand.  However I had a few beers earlier that night.  Anyways, while I was masturbating I felt a sharp pain or twinge in my lower abdomen below my belly button right about at the waist line.  At that point I stopped stroking and I quickly lost my erection.  Since then I no longer get those erections that just pop up out of nowhere.  Now it seems as though I have to get really worked up to achieve an erection...unless I'm around my girlfriend which I still get easily aroused. Still my erections aren't as strong as before.  Also I've lost some sensitivity and orgasms don't feel as good.  And just last week when I was having sex with my girlfriend I lost my erection...and that's never happened to me before.  However it was our 3rd time having sex that day, but I've never had a problem with that before.

I'm not on any medications, I don't smoke or do any drugs but I occaissionaly drink.  What do you think may be the problem and how could it be corrected?  Thanks.

[Kevin Pho, MD]

Regarding the erections, there are several avenues for evaluation.  The first would be possible endocrine abnormalities - basic studies such as testosterone levels, prolactin level and thyroid tests are basic screens for this.  

Nocturnal penile tumescence testing can also be considered to quantify erectile activity as either normal or impaired.

To test for problems with the blood vessels, ultrasound is employed to determine the patency of the penile deep arteries.

To discuss these tests I would consider being referred to a urologist.  If the examination is not revealing, a referral to a neurologist can also be considered to evaluate for any nerve damage.

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.