Patient: I am 22 and have problems maintaining an erection during sex. I have absolutely no problems during masturbation, but as soon as I have a girl in bed I struggle. This has been a problem for around four years and is worst when I’m sober. I have a happy life apart from this! Is there anything at all I can try to help?
Doctor: Erection problems may cause significant emotional disturbance. Erection is a complex combination of psychologic, neurolo gic, hemodynamic, mechanical and hormonal components. Psychologic erectile dysfunction may start suddenly, varies with partner and circumstance, more common in younger men and may have presence of morning erection. Depression and anxiety problems may also manifest as erectile problems. Neurologic (brain and spinal cord) causes may also manifest with erectile problems but usually occurs together with problems in urination and defecation. Conditions that clog the blood vessels (diabetes) may result to this problem as well. An example of a mechanical cause would be Peyronie’s disease. In this disease, there is a tissue thickening inside the penile shaft and erection problems may follow. Hormonal problems (thyroid hormones and low testosterone) may result to low libido (sexual desire) and erection problems. Various blood test, procedures and mere physical exam by a doctor will help establish the cause of your distressing problem. I would advise for you to see a doctor so you can be completely evaluated and the root cause will be addressed to accordingly. However, there are also natural ways you may try to improve the erection problems. Try exercising regularly and eat foods that can boost your nitric oxide levels (beans, nuts, seafoods, among others). Erection starts w/ mental conditioning and this will in turn produce nitric oxide in the brain. Nitric oxide acts as a potent vasodilator (opens up blood vessels) and as you know, influx of blood to the penile blood vessels coupled with other factors is responsible for erection. Enhancing your body’s nitric oxide levels might help with your problem. There are also several erectile dysfunction drugs but it is better for you to see a doctor because there are a few conditions wherein these drugs should not be given. I do hope this helps and I wish you all the best.