This patient support community is for discussions relating to urology issues, benign prostate disease, penis curvature, cystisis, pediatric urology, prostate, sexual dysfunction and urological cancers.
Inability to maintain hard erection - performance anxiety
I'm a very fit athletic 39 year old male, but I have a problem maintaining erections hard enough for penetration. Unlike many of the posts on here this is not a new problem for me I've always been this way. During sexual intercourse with any partner over the years, my sexual excitement has generally lead to a semi hard penis which only became fully hard at the last moments prior to ejaculation after lots of stimulation and usually after stuffing the penis into my partners vagina. I also take a long time to ejaculate and often have had sexual partners where I might be hard for a long while but not actually come. Of note on average once a week I wake up with a penetration strength hard on, but it tends not to last even when thinking about sexual fantasies .... the problem isn't the erections themselves but maintaining them at penetration strength ... the erection at penetration strength is a relatively momentary thing for me. I've tried the penile excercises [Kegal] and certainly they help with the hardness but not the maintaing of the hard erections.
I live with a woman and I've fathered 3 children and to be honest always thought this was the way sex was supposed to be and have never seemed to get the same pleasure out of sex as some of my male colleagues. Sex has never been a big part of my relationships as I've always tended to avoid it to be honest, just too much effort ! I've had some exciting sexual encounters over the last few year and have only been able to maintain even acceptable erections by using Viagra or Cialis and usually I have not come in these encounters.
I've spoken to my Doctor who has prescribed Viagra/Cialis which has helped to some extent but not resolved the problem.
It has got to a stage now that I'm losing faith in the viagra/cialis approach and have had on occasion lost any erection during a sexual encounter even with these. The problem is that in my head I want sex all the time, but when it comes to the act, I have no faith in the ability to maintain my erection hard enough for penetration. I'm in the performance anxiety cycle I believe.
I'm desperate, I want sex all the time and feel I am missing out on a vital part of life, but every time I am in a sexual situation I worry that I won't be able to perform !
I wonder if there is something physically wrong with me, as I know that most men seem to be able to get an erection strong enough for penetration at the start of a sexual encounter and are able to maintain that for the duration of the encounter without even thinking about it, it is just there for them ! My penetration strength erection is generally momentary and most of the time I am in semi erect mode.
As you can tell Doctor this is a source of much anxiety for me and I've tried most things and I just want to solve this and move on with my life. All advice and guidance would be gratefully received ...
im 21 i have the same issues...when you are alone...you only have one goal when masterbating (masturbating)...to please yourself..i know its not hard to maintain a hard on when you aare masterbating (masturbating)..when you are with someone that goal remaines..BUT theres another goal..pleasing your partner... and any doubt's nervousness can bring difficulties in maintaining an erection...the love juice is gone from your penis...you need it back...id sujest a second honeymoon might save you..remember the good ol days..bring back the good romantic loving memories...
I am 32 and I suffer from sexual performance anxiety too. I am always able to attain a strong erection but just before penetration I sometimes get too anxious and lose it. ED drugs were helpful in my case: Cialis, Vigamed (not available in the US, but you can order it on the Internet) and yohimbe.
Dr Epp focused on the issue as being mainly psychological and at the time that made some sense, however my issues with maintaining penetration strength erections as opposed to getting an erection (or semi-erection) had always been there. This was not something new to me, all my sexual life it had been the same. In truth, I did not actually realise until much later on in life that this was not the norm.
Since posting the above, I've done the doctors visits, viagra/levitra/cialis therapies (which all helped to some degree but did not solve the problem) culminating in a visit about 6 months ago to a Urologist who confirmed the cause was PHYSICAL and not psychological. I've was diagnosed with a Venous Leak.
Venous Leak Definition - "An erection is produced when blood to the penis compress the veins in the corpora cavernosa so the blood cannot leave. Venous leakage is a result of these veins not closing well enough to retain the blood, and the erection is lost." - Wikipedia
My Venous leak is a naturally occurring physical condition affecting somewhere between 5 and 10% of men according to my urologist. There are various degrees of Venous Leaks Mild, Medium, Severe. Mine is mild/medium and the urologist advised that there is no cure. Previously surgery was advised but the surgical interventions in the past have proved ineffective and so this course is no longer advised in terms of curing the condition. Essentially the urologist advised that the condition cannot be cured, but using viagra/cialise/levitra and appropriate penis rings (**** rings) around the base and shaft can provide extended durations and stronger erection. But again it is not a cure, merely something that improves things. In Severe cases penile implants are considered an option, but fortunately my case is Mild/Medium in that I can get erections to some degree.
Though there is no easy cure for my condition, I must say I felt quite relieved in many ways. My condition is not my fault, it is not in my head, there is nothing psychologically wrong with me. Yes it is a physical condition but I feel very fortunate in many ways I have three beautiful children, a lovely wife and though my sex life is probably under par there are so many worse conditions in life that people have to contend with. Believe it or not, knowing that your condition isn't your fault, that it is nothing you've done or not done, that you are normal psychologically, is a huge relief ! I'm going to work hard on my Kegel exercises, experiment with different rings, and use Viagra/Levitra/Cialis until I find the best combination for me.
To you guys suffering out there, and I know personally that the mental anguish of this is enormous, I would earnestly encourage you to search for and find an understanding Doctor to whom you can really talk and if his advice doesn't work, get to a good Urologist and keep banging on doors until to you get the answers that help you ! Above all remember, it's not your fault ... it's nothing you did or didn't do ... it's very very common to have such problems, just go get help and don't stop banging on doors until you get the answers that help you !
i am a 41 year female, and my husband is 56 years of age we have only been married for 3 months now, and we have been having these same problems, he's excited to have me but then its hard for him to maintain an erection, its hard for me and even more harder for him, as i have to watch him cry in disappointment as not being able to satisfied his young beautiful wife, does cialis really work. we are desperate.
I am 73 and have serious heart issues but have been very active sexually through 53 years of marriage. Have slowly gotten the leaky vein problem to the point it's a major problem. The urologist has recommend Edex shots. Rings work but are constricting. Go to have the initial training shot tomorrow.
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