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1560233 tn?1294821797

Any Hope?

I'm 58yrs. I once weighted 300 lbs (01/2010) and had very high b/p (2XX/18X) but starting in 04/2010 & ended in 07/2010, I now weight 200 lbs. I wake up with an erection but it's not not often. Once while walking a mile, I had an erection lasting for 20 mins. I have a finacee & while at work, I think of her & have an erection. Sometimes after I wake up, I get an erection thinking of her. So once while necking, oral sex on her, she wanted intercourse but I was unable to. I scheduled an appt with my urologist to have a penile doppler ultrasound. My question is do I have bloackage/damage to my penile blood vessels & if so, can they be repaired. A lot is riding on this.
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523042 tn?1212181495
Hi Teddy.

First, congratulations on taking responsibility for improving your health by losing weight and exercising.

Since you have erections upon awakening, it's doubtful that there's any physiological issue affecting erections. However, it will probably set your mind at ease to have a thorough urological exam. I cannot answer any questions about blockage--your urologist will be able to do that.

What I CAN tell you is that it sounds as though your penis is healthy--it's your brain that's getting in the way. Here are some possibilities:

Welcome to your 50’s! When you're younger and just beginning to be sexual with others, erections pop up everywhere--including when you don't want them! Post-pubescent men are highly excitable. As you age, you’ll find that you need more direct touch and stimulation. This is just part of life and doesn’t indicate any underlying condition to worry about.

Also as part of the aging process, you'll find that erections sometimes take longer, and even come and go. Again, this is not an indication if ill health, but just part of life. Sexual interest ebbs and flows as well, depending on other circumstances in your life.  Also realize the more stress you’re under, the less energy your body has to respond sexually, so stop worrying!

It sounds as though something about being sexual with a partner is problematic for you. I bet if you think for awhile, you might be able to identify just what that is. Here are some possibilities: Much of your problem may be due to your attitude. Once your penis didn't act as you expected, you probably started feeling anxious and judging yourself, which can be a vicious circle. The more you worry about erections, the more your penis won’t cooperate. In fact, it can be downright rebellious!  Many men feel that if their erection goes down even a tiny bit, there’s something wrong with them. Where does this come from?

Men receive so many messages that sex is about “performance” and pleasing a partner, rather than just enjoying the pleasure of it. Everything is goal-oriented—like a football game. By being so goal-oriented, some men never get to feel the simple pleasures of touch, of kissing, of soft skin on skin. And, of course, if you can allow yourself to let go of goals and just enjoy, guess what? That erection will come right back. So don’t focus so much on penis-vagina (p-v) sex as the “end-all, be-all” of sex, but rather just let yourself relax and enjoy whatever occurs. And don’t have p-v sex until you’re ready.

The other message that many men receive is that sex is somehow dirty and wrong, unless you’re doing it for reproductive purposes. Sometimes this can creep into our unconscious thoughts and sabotage any pleasure. Ask yourself whether you have any conflicts about being sexual—any old messages that might be lurking in your subconscious.

There are many other reasons why you may be inhibited with your partner. This could be due to anxiety—either about sex in general, or about some aspect of your relationship. It’s possible that you were anxious with your fiancée because of “first-time jitters.” Or perhaps the intimacy of sex is making you uncomfortable? Why would that be? What does it represent to you—and to your partner? These are questions to ask yourself. Or it might just be that some aspect of partner sex creates anxiety. Or perhaps you weren’t yet turned on enough.  

To sum up: Worrying about erections is a dead-end street. All it will do is make you anxious, which will make your penis very uncooperative. And remember you don't need an erection to be sexual, have fun, experience pleasure, etc. Relax, enjoy your own unique sexuality and stop judging yourself. And find partners who aren’t hung up on outdated macho ideas of what constitutes “good” sex. Many people are more interested in a caring, sensitive partner than one with a “porn star” penis. For more information about this and other men’s issues, I recommend the book, “The New Male Sexuality,” by Bernie Zilbergeld, Ph.D., widely available both used and in paperback. The information in this book has helped millions of men overcome discomfort and anxiety about sex. Good luck to you. Dr. J

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