Lack of strong erections


Q: Dear doctor,
I am 28yrs old male.I am married recently. I have been masturbating from my teenage and usually watches porn films. But for masturbating i never used porn as an aid. now let me come to the point, recently i have noticed that i dont strong erections and most of the days i miss morning erections. during sex with my partner i have good erections but cannot maintain for long. but iam able to have successful intercourse. Please could you tell me whether not having morning erections and not maintaining long hard erections is a sign of ED. if so can u suggest me a remedy for it.


Symptoms:  Lack of morning erection(some days i have some days i dont)
difficulty in sustaining hard erection for longer period

A:   Thank you for asking this question on ATD.

A man is said to have erectile dysfunction when his penis regularly fails to give an erection that has been good enough to achieve or maintain sexual penetration. Communication difficulties between partners and relationship stresses can lead to problems initiating or maintaining an erection. Most men have occasionally experienced some difficulty with their penis becoming hard or staying firm, but this is not erectile dysfunction, which is a concern only if satisfactory sexual performance has been impossible on a persistent number of occasions for some time.

Broadly, two forms of erectile dysfunctions exist - the main cause is either medical or psychosocial. Here, psychosocial means psychological effects - including the effects of social relationships - on sexual performance. Of course, medical conditions can also affect psychological well-being, and while the main cause of sexual impotence will be medical or psychological, there can be overlap between the two.

Erectile dysfunction was previously known more widely as 'impotence' before the causes became better understood and successful treatments were formulated. However, Impotence is a term that is still in use. The key questions with regard to erectile dysfunction (ED) include duration of ED, degree of ED, erectile spontaneity, capability to sustain erection, early morning/nocturnal erectile function, timing of last sexual intercourse, and whether the erectile dysfunction is situational or not. According to the experts the definition of erectile dysfunction is “the consistent inability to obtain and/or maintain an erection sufficient for satisfactory sexual performance,” therefore, consistency of ED is important. While the definition of consistency is somewhat debatable most authorities believe that a man with the three-month history of ED warrants treatment.

One of the great myths in sexual medicine is that the presence of a rigid early morning erection indicates psychogenic ED. This has been disproved by researchers. The presence of good early morning erections is suggestive only of adequate veno occlusive function (The veins hold the blood for erection). To understand the causes of erectile dysfunction, it helps to understand how an erection happens physically.
Relaxation of muscle (in parts of the penis and the walls of the arteries supplying it) allows blood to rush into the cylinder-shaped spongy tissue of the so-called erectile chambers, and valves prevent the venous loss of this pressure. The resulting hardness persists until after stimulation has stopped or an ejaculation has happened. This blood flow process is led by nervous and hormonal triggers activated when the brain is stimulated by touch or other stimuli, and these brain signals can be suppressed by anxiety.

Thus, it is the consistent inability of maintaining erection that matters and not the timing in regard to day or night, morning or evening. If you have difficulty getting an erection, please seek medical help. Don't hide the problem and suffer in silence, as so many men do! Your first move should be to consult your GP. Please do not go for magic pills or potions as advertised on the internet. Doctors have treatment for ED and you may benefit from the modern treatment. Please have this examined by a doctor and seek remedy. If you go to a doctor, he should take a full history of your problem and then examine you to see if there are any physical causes for your ED. Therapists or counsellors (for instance at Relate) will probably be very useful, but they aren't able to do physical examinations, nor can they prescribe drugs. A doctor would do a test for diabetes and possibly other lab tests as well. The doctor should also do a test for diabetes and possibly other lab tests as well. After that, he may well be able to give you some indication of the likely cause of your ED. If he can't, then ask if can refer you to someone who can give you further help. Once the cause(s) of your erectile dysfunction has been identified, you can get treatment.

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