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What could cause low erection angles in 18-year-olds?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I am 18 years old and my penis does not achieve an erection at a 90-degree angle; it only reaches about 20 to 30 degrees. Additionally, I have noticed that when I masturbate, no sperm or only a small, watery amount is ejaculated. I do not experience any pain. Also, sometimes a watery substance similar to sperm is released involuntarily when I use the toilet. I am a virgin, have a healthy weight, and regularly go to the gym. Could you provide some advice or insight into what might be causing these issues?

Kindly help.

Thank you.

Answered by Dr. Madhav Tiwari

Hello,

Welcome to icliniq.com.

I understand your concern.

It is quite unusual for someone as young as you to experience erectile dysfunction (inability to achieve or maintain an erection sufficient for sexual intercourse). This issue could potentially be linked to anxiety, self-confidence, or a previous negative experience.

To better understand and address your concerns, could you please provide more information on the following:

  1. Do you have diabetes or hypertension?

  2. Have you undergone any surgeries in the past?

  3. Are there any thyroid issues you are aware of?

  4. Do you smoke, consume alcohol, or use any recreational drugs?

  5. How often do you masturbate each week?

  6. Do you experience any pain during an erection or after ejaculation?

  7. Have you attempted intercourse before without success?

Thank you.

Patient's Query

Hello doctor,

Thank you for your reply.

I am not sure if I have diabetes or hypertension. What are the typical symptoms of these conditions? I have not undergone any surgeries in the past, and I am not aware of any thyroid issues. I have never smoked or used drugs, and I only tried a sip of alcohol about three to four years ago.

To be honest, I have never masturbated in the traditional sense because it does not elicit any feelings for me. However, I have a habit of rubbing my penis against the bed (lying face down). I do this almost daily and have become somewhat dependent on this method for arousal. Initially, when I started, semen was ejaculated, but over time, this has ceased. I experience no pain during erections. I have never had any physical relationships; I am still a virgin. I will send photos for assessment when I have an erection.

Kindly help.

Thank you.

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

So what you were practicing is called prone masturbation. Unfortunately, it has a lot of bad effects on the penile sensations, especially if you do it aggressively. Because it gives the man enhanced pleasure, when men revert to normal masturbation they never really feel it is enough and do not get a proper orgasm. Additionally, it can damage nerve endings in certain cases. I would recommend you stop practicing prone masturbation. Please revert with the image of the erection and we will decide how to proceed further.

Please do not hesitate to reach out if you need further assistance.

Thank you.

Patient's Query

Hello doctor,

Thank you for your reply.

I sent the photos. My penis got hard instantly but the problem is no sperms came out. Can it can be cured? I am very upset about it.

Kindly help.

Thank you.

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

The photo that you have shared (the attachment removed to protect the patient's identity) is this the maximum erection you get?

Thank you.

Patient's Query

Hello doctor,

Thank you for the reply.

Yes, doctor. Can this be cured?

Please help.

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

You will first need to undergo some evaluation. In my opinion, the image does not show a full erection. To assess this further, please have the following test done: a penile Doppler ultrasound. Just to clarify, does your penis not become more erect than what is shown in the picture?

Regards.

Patient's Query

Hello doctor,

Thank you for the reply.

Yes, sir, that is the maximum. When I try to move my penis, it rises slightly, but I am unable to maintain the position. In those photos, my penis is not completely pointing downward toward the floor, it is angled slightly higher.

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

I understand. Please get the scan done as I mentioned above.

Regards.

Patient's Query

Hello doctor,

Thank you for the reply.

Is there an alternative name for the test?

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

No, it is called a penile Doppler. It is a type of ultrasound.

Regards.

Patient's Query

Hello doctor,

Thank you for the reply.

I will get the tests done.

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

Please get back to me with the results.

Regards.

Patient's Query

Hello doctor,

Thank you for the reply.

Could you provide me with a prescription or something similar?

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

I have attached the same.

Patient's Query

Hello doctor,

Thank you for the reply.

I am sorry. I did not understand.

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

I have attached the prescription for you.

Regards.

Patient's Query

Hello doctor,

Thank you for the reply.

I got it, doctor.

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

Please get it done and share the results with me.

Regards.

Patient's Query

Hello doctor,

Thank you for the reply.

Doctor, when will the prescription be approved?

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

They will get it done soon. If there is an issue, I will send another prescription.

Kind regards.

Patient's Query

Hello doctor,

Thank you for the reply.

Okay, doctor, no problem. I received the report.

Initially, the doctor administered an injection in my penis on both the right and left sides. Is this a normal procedure? Now, I have a red circle on my penis, which I think is blood. It also hurts a bit sometimes. Additionally, I noticed a hump on my penis and am feeling a little pain in that area.

What is it?

Please suggest.

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

Your report is normal, which means there is no physical problem. The reason for poor erections is often anxiety, along with dependence on prone masturbation (lying on your stomach). Here is my advice for you:

  1. Stop practicing prone masturbation.
  2. Instead, you can masturbate normally, two to three times a week.
  3. Drink at least 0.79 gallons of water per day.
  4. Avoid sitting for long periods without taking a break. Stand up or move every one to one and a half hours.
  5. Avoid sitting on hard surfaces.

Please take the following medications for one month and then get back to me with the results:

  1. Tablet Tazzle (Tadalafil) 5 mg: Once, in the night before food.
  2. Tablet Cranpac D (Cranberry and D-Mannose): Once in the morning.
  3. Tablet Econorm (Saccharomyces boulardii) 250 mg: Once in the morning.
  4. Tablet Chymoral forte (Trypsin Chymotrypsin): Thrice daily.

Consult your specialist doctor, discuss with him or her, and take the medicines with their consent. After one month, please get back to me, and we will decide whether to continue or stop the medications.

Kind regards.

Patient's Query

Hello doctor,

Thank you for the reply.

Just to clarify, should the last three medications be taken after food, or can they be taken at any time? Lastly, I take creatine for the gym. Should I stop it, or is it okay to continue?

Please help.

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

The last three medications can be taken as you wish, but taking them after meals would be better. I recommend avoiding creatine.

Kind regards.

Patient's Query

Hello doctor,

Thank you for the reply.

One more question, what about the hump on my penis? I noticed it after the test.

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

It is probably not due to the injection. It should settle down in a couple of days.

Kind regards.

Patient's Query

Hello doctor,

Thank you for the reply.

Sorry for bothering you.

Why am I not gaining weight even though I am eating a lot?

Also, could you please send me the prescription with the medications? Without the prescription, they are refusing to give me the medicines.

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

I will send you the prescription.

Follow up if you have any doubt.

Regards.

Patient's Query

Hello doctor,

Thank you for the reply.

I have been taking those tablets for a week, but I am experiencing issues like stomach pain (mostly on the right side), gas, bloating, lack of appetite, frequent stools, and weakness. Sometimes, I have to go to the toilet three to four times, but usually two times. The stool color is also yellow or reddish.

Please help.

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

You can stop tablet Cranpac D and see if that helps. Some people may experience gastritis as a side effect. The other medications should not cause these symptoms.

Kind regards.

Patient's Query

Hello doctor,

Thank you for the reply.

I have completed the course of medications. I felt a little better at first, but now it has returned to how it was before, and I am still unable to stop prone masturbation.

Please help.

Answered by Dr. Madhav Tiwari

Hello,

Welcome back to icliniq.com.

Please continue the medication for another six months. Regarding prone masturbation, I strongly advise against it. It can have really detrimental consequences in the long term. With some determination, I am confident you will be able to resist the urge for prone masturbate and find that conventional methods can be just as satisfying for men.

Kind regards.
Medically reviewed byiCliniq medical review team
Published At September 26, 2024
Reviewed AtJuly 3, 2026

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

Dr. Madhav Tiwari
Dr. Madhav Tiwari

General Surgery
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