Is it ED or something worse?

[Michael224]

OK, so I am a healthy 20 year old and for the past year and a half or almost 2 years i have not been able to get a full erection without the help of some type of over the counter pill (viagra cialis livetra) now almost 2 years ago, i had full erections all the time. Morning afternoon and night. In the middle of class, in church. all the time. I masterbate normally i think for a 20 year old. no more than twice a day, and sometimes skipping 3 or 4 days at a time. I had sex with my partner wonderfully, with no problems. Now, I can get an erection with a pill but when i get the condom out it goes down, it seems without constant attention my penis doesnt react even with over the counter help. I cannot even arouse myself anymore. I dont know what to do. I have never heard of a 20 year old with ED problems, and i always thought it occured in older men. sometimes it feels like i should have an erection but its just as normal as it can be and none occurs. so i feel like im still sexually aroused but no erection is present. can that be a vascular problem? with the help of a pill i have an erection but not near the effect i used to have naturally. The penis is not as straight and has more of a bend. Not an upwards bend but downwards, so i feel that it is not Peyronies, I am a very active person, i was a 3 letter athlete in high school, and i continue to work out. I know i am in good shape and this just stumps me. Also i am not under any stress what so ever, and for it to last 2 years just seems like it would be more of a physical problem. I have a risk of heart disease in my family, and have been around smoking all my life. can this be a hardening of the arteries (Atherosclerosis) I know this can occur in the pelvic region. I also have a little burning sensation when i urinate but only after orgasm, it never happens any other time. PLEASE HELP IM REALLY WORRIED ABOUT MY HEALTH!

[Michael224]

Ok thanks! But do you know of the chances of this being a vascular problem, and the problem with the burning urination?

[Stephen Liroff, MD]

It is good that you are seeking help for this problem. Sexual dysfunction can occur at any age and the earlier that you pursue evaluation and treatment the sooner you can return to adequate sexual function. I think that you should get both a physical evaluation from a urologist interested in sexual dysfunction as well as a sex therapist to evaluate you from an emotional standpoint. Probably the sex therapist can refer you to a urologist. Certainly what started out as a physical issue can end up being an emotional one so both specialties need to be consulted.
As regards Peyronie's disease, the direction of angulation has nothing to do with the diagnosis. The finding of scarring that causes penile deviation is the hallmark to look (feel) for. Usually there is a lump (plaque) along the shaft on the side with the acute angulation, but it may only be a subtle thickening. Your urologic evaluation should uncover this if Peyronie's is part of the problem.
Keep an open mind as to the cause.
S.A.Liroff, M.D.

[Michael224]

also i want to add that i dont have any morning erections anymore. None at all. That sign in itself usually persists that something is wrong. Not just emotional but something more serious. the burning sensation after orgasm only last about 2 or 3 seconds while urinating but it is a burning sensation none the less...