Dr. Yousef Abbas
Andrology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
Have a good day.
I am a 22-year-old male, and my height is 5'7 inches, and my weight is 76 kg. I had this frustrating experience because my girlfriend and I decided to have sex. We have been doing well enough to make ourselves aroused. I will do the work first for her, and after I make her cum, she will do her work for me by giving me a blowjob.
So after that, it went really well. I did not cum fast, but when I came, my erection suddenly went down. Since it was my first time, I felt disappointed in myself and my partner's feelings. We tried to make it hard again. It went hard for a while, but when she tried to put my penis inside of her, at first it went in and well, but after 35-40 seconds, I felt that my penis erection was going down again.
In the past months (or years), I admit that I do not have a consistent routine for my health and physical body. I can say that I am healthy and do workouts sometimes, but I am so frustrated with my performance that I think I have erectile dysfunction.
But before I forget to say, I took cannabis edibles (indica) (1/4 amount of cookies) (twice or thrice a week). I took 1/4 of the cookies 45 minutes before we did it. I do not know if it is the cause, but I think it affects me to have an ED (erectile dysfunction).
I just want to say that I have asthma too, but I do not think it is the reason for my ED.
I admit that I used to watch porn like there is a time that I watch porn every day. I do not know why, because when I am watching porn, I can ejaculate like twice or thrice just in one night. Is that the cause of my ED?
Please help me. I really love my partner, we know that sex is just a part of it, but I want her to feel my passion when it comes to sex. I am doing my best in performance, but my erection makes me so frustrated.
Would you please give me advice on how to treat my situation? I do not know if it is ED or anything, but I am sure that it is not normal. I am hoping that you will respond. Thank you so much.
Hi,
Welcome back to icliniq.com.
I feel with you, but what you describe is not real erectile dysfunction. Of course, porn and masturbation can cause a gradual ED, but, normally, a man cannot have sex two times after another without a break. This pause is flexible in time, sometimes 15 minutes to 2 hours on other occasions. The reasons are complex. Please trust me that it is normal.
Problematic is the performance pressure that leads to an adrenaline release. And nothing kills an erection better than adrenaline.
So, stop watching porn, do not masturbate, accept that men need a break after real sex, and delete the idea from your mind that it could be a real erectile dysfunction.
If you have difficulties stopping masturbation, contact me again, and I will prescribe you medications that will make you never do it again. But at the moment, I see no reason to be so hard on that issue. You will manage it. If not, come back, and you will get the medications. However, during that therapy, your interest in sex would also decrease. Therefore, let us try it with discipline first.
Do not worry, and you will be fine.
The Probable causes
Investigations to be done
Probable diagnosis
Treatment plan
Regarding follow up
Patient's Query
Hi doctor,
Thank you so much for your response.
It is a great relief for me. I think I expected too much since it was my first time. May I ask again? Recently I had a long fever, and I do not know if it is a COVID-19 infection. I also lost weight. After that time, when I got sick, I had not been so active in exercising, and I ate unhealthy foods. Lastly, I also could not get enough sleep, like my sleep is just not normal. Do you think it is the reason why it is so long for me to get hard again?
And may I ask if it is normal that when I cum, my penis erection goes down so fast? Thanks again, doctor.
I have attached my laboratory results tested by my girlfriend two days ago.
Hi,
Welcome back to icliniq.com.
Just a fever is not a typical symptom of COVID-19. The coronavirus typically causes other symptoms.
As mentioned before, I am sure that everything is fine with your penis. I would be worried if it would not become flaccid after sex. That is the way men function.
Your girlfriend must understand that you have a biological penis and not an on/off dildo (sex toy). Your body needs its time.
But since this seems to cause a lot of pressure and masturbation is also a problem. I will prescribe you anti-compulsion medication, which will make it easy for you to stop masturbation.
Treatment plan
Regarding follow up
Patient's Query
Thank you, doctor,
It is not a problem at all for her doctor. I am just frustrated with my first experience, and it made me think if I should go for a specimen analysis or a Testosterone test to be relieved.
Hello,
Welcome back to icliniq.com.
I understand that it appears logical that testosterone and “performance” are directly or even closely related. However, they are not. That is why Viagra (Sildenafil) had to be invented (originally as a heart medication) because testosterone boosters only help in men above 55 years of age with an age-related low level of free testosterone and a malfunction of SHBG (Sex hormone-binding globulin).
So the tests you are thinking about would be a big waste of money.
However, I can prescribe you a medication that (among many other things) corrects the signaling between the brain and the genitals leading to a much longer time until ejaculation in most men.
Do you want to try that?
Let me know.
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