HomeAnswersInternal Medicineerectile dysfunctionWhy am I not able to get an erection without using my hands?

I am unable to sustain an erection. Do I have ED?


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Medically reviewed by

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Published At July 17, 2017
Reviewed AtNovember 30, 2021

Patient's Query

Hello doctor,

I am a 35 year old male. I think I have ED. I am not able to get erections on thoughts alone. However, I am able to get an erection if I use my hand. Also, I masturbate twice daily in an upside down position. I did not have sex recently but when I had it, I was not able to get an erection unless I use my hands or thrust vigorously in my partner's body. Also, I am not able to maintain an erection in her vagina. I am not sexually experienced. Could it be the reason? I would like to know if I have ED. I do not have diabetes or other complications but, have high triglycerides. Also, though I am not obese, I do have belly fat. I have a BMI of 33.

Answered by Dr. Sadaf Mustafa


Welcome to icliniq.com.

I need a little more history to be of any help.

  1. Do you have morning erections?
  2. Do you ejaculate during urination?
  3. Did you always have this problem or only with a recent partner?

For more information consult an internal medicine physician online --> https://icliniq.com./ask-a-doctor-online/internal-medicine-physician

Patient's Query

Thank you doctor,

I am not sure about morning erection in general. I will check for it. But, today I did not have one. I do not ejaculate during urination. I am not sure whether I had this problem before because I was only masturbating, and cannot be sure.

Answered by Dr. Sadaf Mustafa


Welcome back to icliniq.com.

  • The only way to know if you have erectile dysfunction would be to keep an eye on the morning erection or spontaneous erection. They are the first one to go away in case of an erectile dysfunction.
  • I would like you to understand that you have an addiction to masturbation and unfortunately that can take over your sex life if you start to prefer it. If you lose morning erections when observed over the course of the next three months, not just a day or two, then you would need further testing to look for early morning testosterone levels and thyroid testing.
  • Meanwhile, since you still sustain some erection and have an erection during masturbation, we can always work on your pelvic muscle strength.
  • Your BMI (body mass index) is 33, which is characterized as obese. Lose some weight by restricting your carbohydrates intake to 45 gm per day and doing cardio exercises for 200 minutes a week, increased gradually. If your heart is healthy this will build stamina and result in a prolonged erection. Strength training or weight lifting in moderation will also help you.
  • As of now, I would not say that you have erectile dysfunction. But, if you do not follow the instructions, I am afraid you would develop one.
  • Check for the following:
  1. Three months morning erection.
  2. Serum testosterone.
  3. TSH (thyroid stimulating hormone).

Please let me know if you need further assistance. 

For more information consult an internal medicine physician online --> https://icliniq.com./ask-a-doctor-online/internal-medicine-physician

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sadaf Mustafa
Dr. Sadaf Mustafa

Internal Medicine

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