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38 yr old male long time erectile dysfunction

I could use advice on where to turn for help with my long time ED issues. I'll try to keep it brief and yet detailed:

First had sex when I was 17 with a year long high school girlfriend. Couldn't get an erection hard enough for penetration. I had to manually stimulate myself until hard enough for penetration, but the effort brought me so close to climax that by the time intercourse started it made the time very brief. I dated her for several years after, and rarely had an erection good enough for penetration.

Every women that followed was the same issue, and almost always required heavy foreplay, or manual stimulation before achieving and erection good enough for penetration. This erectile issue was not only with partners, but with myself during masturbation. Usually, my erection would fall flaccid seconds after getting fully hard. I always needed continuous manual stimulation to keep it hard. This, of course, was incredibly frustrating and depressing. I could never keep a woman around very long partly because of my erectile dysfunction.

When I was 25 I finally starting seeing a urologist for help. He dismissed me saying it was psychological and that I was too young for ED. He suggested I see a therapist for sexual help. I tried therapy for awhile, but none of the suggestions helped. I finally convinced the urologist to give me Cialis. Bam! It was a night and day difference. I was finally able to have stronger erections, good enough for penetration, probably 60% of the time. It wasn't perfect, but it was better than nothing.

Now, I'm 38. I still take 5mg Cialis daily. Sometimes I go to masturbate, and my erection is difficult to maintain (while watching porn usually), and then I will realize I forgot to take the medication for a couple days. When I go on a date, I take 10mg just in case. But recently, I met a woman who is wonderful, and I want to make her happy. So I've taken up to 15mg of Cialis sometimes. My erections with her have been decent, but not perfect. We use condoms, which reduces sensitivity, and one time I went flaccid during intercourse. It was incredibly embarassing, and disappointing. I don't think I should continue escalating my Cialis dose. Additionally, I just gave myself vision loss in my right eye from so much Cialis in a short amount of time; a condition they diagnosed as "central serous chorioretinopathy". It might be permanent. I'm very upset about this too.

One morning, I tried having sex with this woman, (having taken 15mg Cialis night before), but I couldn't maintain an erection for penetration. She tried giving me oral sex, and I went flaccid during that too, which has never happened before. I tried manually stimulating myself to orgasm with her help, but I couldn't get hard. It was like my penis was dead. This has never happened before. I blamed my issues that morning on my anxiety about not having much time before I went to work, but I know it's because something is wrong with me; whether it's venous leak, or anxiety, or nerve damage, or whatever.

Since 25 years old, I have tried multiple medications, diet changes, psychotherapy, pelvic floor therapy (they said I have a tight pelvic floor. I now use a device to stretch my internal pelvic floor muscles through my anus weekly). Has anyone ever tried Dynamic Infusion Cavernosometry or Doppler Ultrasound to diagnose venous leak? Do my issues relate to you? Any suggestions would be appreciated. Thank you for reading!
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Avatar universal
I can relate almost 100% to what you explained in your post. I’m 45 and have had severe e.d. Since my first sexual experience at age 17.  I even had the same experience with my doctor in my 20’s as he sent me away telling me I don’t have a problem and I’m too young to have e.d.  Wow was that disappointing and depressing. Then the vicious cycle continued throughout my life. I wasn’t sure if I was depressed because of my condition or if the condition was caused by depression. I had great results with viagra at fairly high doses but the effectiveness of it seemed to wear off over time. Now it’s hit or miss when I take it and often have to combine it with Cialis to make it more effective.  I’ve cycled between wanting to do everything I can to cure myself to just giving up. I believe the root cause for me is psychological however a lifetime of e.d. Seems to have created a self fulfilling prophecy and since neural pathways are physical I’m hoping there’s still hope for reversal. A top urologist at a university hospital was unable to perform an ultrasound as the injection he gave me failed to give me the erection required to do the procedure. I know I can achieve erections though so I believe I’m just severely psychologically traumatized. Situational and social anxiety have also followed me throughout my life. I’m trying an app called mojo to see if it helps me get over this. Beta blockers are on my list to discuss with my doctor as many people take these for performance anxiety issues. I wish both of us luck as I wouldn’t wish erectile dysfunction on my worst enemy.
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20620809 tn?1504362969
Sometimes if we are a heavy masturbater in between sex, the penis becomes desensitized and add on some psychology to it of being nervous or worried and it's rough. I do think that having the ultrasound you want would make sense. Is your doctor willing to do it?
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