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Forum Name: Male Sexual Disorders

Question: 22 year old: ED/unable to perform sexually


 levir - Tue Feb 14, 2006 5:34 am

Sorry for the long post...but I wanted to be very detailed. I really appreciate everyone that takes the time to read through this. I am a very frustrated individual.

Background: I am a successful, attractive, physically-fit 22-year-old male. I am 6'1 185 pounds and I work out regularly. I am not taking any medication and to my knowledge have no family history of this type of problem. I have never had surgery for any reason...nor have I ever had any major injuries--not even a broken bone or a concussion. I drink socially (2-3 drinks) about once/week. I am on a regular sleep schedule 7 days/week. I have never taken any illegal drugs, I don't smoke, and I eat healthy. I have always been a very social person. I played varsity basketball and tennis all through highschool, graduated with a 3.8 GPA, and was voted prom king out of a school of over 2000 students. I graduated from college a semester early with an excellent gradepoint average and have already paid off all of my student loans. I have more good friends than I can count and have virtually never gone without having a girlfriend. All good stuff. Now onto the problem...

I am having a sexual problem that I have found very little information on. I have a decent sex drive...but I have never made it past the heavy kissing/hugging/caressing stage in relations with women. I have been having this problem since my first relationship with a girl several years ago...and as a result have never actually had sexual intercourse. It just never makes it to that point...

My penis "leaks" a very large amount of pre-ejaculate and I have a very difficult time maintaining (or often times even getting) an erection. This is obviously quite embarrassing--especially when there is such a large amount of pre-ejaculate that it soaks through my pants. Other than my sex life (or lack thereof) my life is great. I have a great job where I've been working my way up the corporate ladder, I will be receiving my masters degree in the spring, I have a supportive family, I have a great girlfriend that I love and dozens of close friends. I don't feel depression/nerves/etc are playing a major role in this issue. Obviously at this point I do become nervous when I'm with my girlfriend and she's obviously very interested in intercourse...because I know I cannot perform. But that was not initially the issue. This is something I notice even when alone!

This is a problem that has ruined relationships and really taken a toll on my overall lifestyle over the last several years. I've had relationships with over a dozen women that I was very sexually attracted to and the same thing happens everytime...ultimately ending the relationships. Even when the idea of intercourse isn't on my mind I still run into the "leaking" issue during kissing, caressing, or even holding hands with a woman! I've been with my current girlfriend for nearly 3 months and I would really hate to lose her over this. I discussed my problem with her openly. She was very understanding...and we've been working on it...but the problem is still there. She's a 20-year-old girl who was sexually active prior to our relationship...and at this point I'm considering breaking up with her because I know she wants what I can't give her. It's terrible...but I've dealt with this same situation many times before. It's virtually impossible for me to have a fulfilling relationship with a woman because of this problem. It is extremely frustrating and is something that I don't feel I will ever learn to accept.

I masturbate 3-4 times/week. During masturbation sessions my erection is usually semi-soft...and while I still leak a large quantity of pre-ejaculate...I do usually reach orgasm if I rush to that point. I have also noticed the length of my erect penis (even when firm) appears to be decreasing over time. I'm 100% sure that this is a physical problem...but obviously some psychological issues are involved as well. As soon as I begin to feel arrousal it is as-if the floodgates simply open up and the pre-ejaculate pours out until (sexually) I'm exhausted.

I have tried taking Viagra...and it seems to help to some degree...but doesn't eliminate the problem. I also don't like the idea of taking prescription medication for ED at the age of 22! If that is ultimately the only solution I will learn to live with that (taking one of the 'once-a-day' Viagra alternatives, perhaps) but I'm hoping there is another answer. Some herbs? Exercises? Diet? Changing my masturbation habits? Is there surgery for this type of problem? Have you heard of other people with this problem? I have no idea--that's where I'm hoping you come in.

Thank you for your time.
 DoctorJohn - Tue Feb 14, 2006 6:10 am

Dear Levir,

I sounds to me that you have a very high level of performance anxiety. I think you need to refer to some of the relaxation techniques described by Masters and Johnson.

I am unaware of any physical illness that could cause your penis to shrink in the manner you describe and suspect that this is also secondary to your high anxiety levels.

Best wishes

DJ
 levir - Tue Feb 14, 2006 6:51 am

DJ:

I really appreciate your response. My question to you: is it normal for a person suffering from performance anxiety to have the same problems even when alone--attempting masturbation? Why is it that there is such a large quantity of pre-ejaculate even when simply cuddling with my girlfriend? Is massive quantities of pre-ejaculate a common symptom of erectile dysfunction? Is it a common symptom of performance anxiety? During any arousal whatsoever pre-ejaculate begins flowing constantly--even when an erection is not present. I can be in a public place holding hands with my girlfriend and spots on the front of my pants become literally saturated with pre-ejaculate.

I have attempted many (if not all) of the techniques for overcoming performance anxiety...but the situation seems completely involuntary. I reach sexual exhaustion before any attempt at intercourse can even be made.

Thank you again for your response. Anymore information you can add would be greatly appreciated.
 DoctorJohn - Tue Feb 14, 2006 8:47 am

Dear Levir,

Are you absolutely certain that the fluid you secrete is actually pre-ejaculatory fluid rather than semen? The former is clear in colour while the latter is milky. It strikes me that you may be having a prolonged subliminal ejaculation (or climax).

And, yes, high levels of performance anxiety could certainly impair the quality of your erection even during masturbation. Have you ever tried masturbating after two or three shots of liquor? I'm not suggesting that you resort to alcohol to resolve the problem, but a small amount of alcohol taken quickly does have a marked anxiolytic effect and I think this might be a useful diagnostic test to show that the source of your problem is psychological rather than physical.

Best wishes,

DJ
 levir - Tue Feb 14, 2006 5:32 pm

If I am, in fact, suffering from severe performance anxiety...I'm afraid I will have to live with this problem for the rest of my life. I can be completely relaxed...just hanging out watching a movie and cuddling with my girlfriend...and it happens involuntarily. I don't even feel aroused during these times...just content. Many times I don't even realize it has happened until I stand up and/or shift around. The first doctor I went to recommended psychiatric therapy...and a dozen one-hour sessions and thousands of dollars later it did not appear to help even the slightest bit. There is no type of counseling that can solve this type of problem. The only time I feel any form of anxiety is when a woman is clearly wanting to have intercourse with me and I know I can't...because the problem has already happened. It happens involuntarily before I even think about getting involved sexually with a woman.

I was hoping there was some type of drug...or even surgery that could solve the problem. If this is performance anxiety it is far more severe than any case I have ever heard about...and I will apparently have to learn to live without relationships for the rest of my life.

Thank you for your time.
 DoctorJohn - Wed Feb 15, 2006 6:50 am

Dear Levir,

It was certainly not my intention to make you feel and sound so dspondent. All I'm saying is that I don't think there's an underlying physical cause for your sexual dysfuntion.

Another question I should have asked you is do you still have normal morning erections or erections if you awaken from a deep sleep? Because the existence of such erections very much rules against a physical cause.

With regard to medication, there are a group of drugs called anticholinergic drugs a small dose of which might very well dramatically reduce the severe problem you appear to be having with pre-ejaculation

Best wishes,

DJ

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