Struggling with Impotence: Seeking Guidance After Years of Treatment
I am a 24-year-old male, standing at 181 cm and weighing 75 kg, identifying as Caucasian. My issues date back approximately eight years, originating in Eastern Europe. Despite my physical health, I have never smoked. The onset of my impotence can be traced back to my mid-teens, around the ages of 16 or 17, and became particularly apparent when I entered into a relationship. Although I was still able to engage in sexual intercourse, the experience was far from satisfying for either partner, as I could only sustain an erection for mere seconds. Additionally, I have not experienced any morning erections and have found it challenging to achieve arousal during masturbation. In an effort to address this, I avoided pornography for several months, but that yielded no improvement. I maintain a fairly active lifestyle, which adds to my frustration. Over the years, I have consulted with three different urologists, but none have provided useful solutions. Initially, I tried tadalafil at a lower dosage of 5 mg, which did not seem effective. A subsequent urologist prescribed me Spedra (200 mg); however, that proved even less effective. I then returned to tadalafil, opting for a higher dose of 20 mg, which was initially beneficial, but I have since reduced it back to 5 mg. Furthermore, I consulted an endocrinologist, and all tests came back normal, including my testosterone levels. At this point, I feel somewhat despondent and am reaching out in hopes that someone might have guidance or suggestions for the next steps to take in addressing this ongoing condition.
Answers (1)
4/4/2025, 8:20:40 AM
OpenHealth AI
I'm sorry to hear about the struggles you've been facing with impotence. It’s understandable to feel frustrated, especially considering the duration and persistence of the issue despite efforts to find a solution. Your situation calls for a thoughtful approach to explore potential underlying factors and new strategies to improve your sexual health.
Main Points
- Impotence can stem from various physical, psychological, or relational factors.
- You've already taken significant steps in consulting specialists and trying medications.
- It might be time to explore new avenues such as therapy or other treatment methods.
Explanation
Erectile dysfunction (ED) at your age can often involve more than just physical health. Despite having normal testosterone levels and not identifying any clear physical issues through your tests, psychological aspects such as anxiety, stress, or past experiences can play a crucial role. Furthermore, the duration of your symptoms suggests that it might be beneficial to reassess both the psychological and physical components of your situation.
Next Steps
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Consider Psychological Support:
- Since there might be psychological factors at play, I recommend seeking support from a mental health professional who specializes in sexual health or relationships. Cognitive Behavioral Therapy (CBT) or sex therapy might be useful in addressing any anxiety or performance issues.
-
Reassess Medication:
- Discuss with your healthcare provider about the possibility of adjusting your current medications or trying alternative treatments. Additional options may include injections or vacuum erection devices, which can improve blood flow and erection quality.
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Lifestyle Review:
- While you maintain an active lifestyle, ensure you have a balanced diet, manage stress effectively, and get adequate sleep. All of these can influence sexual health.
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Connect with a Sexual Health Specialist:
- Since you've consulted urologists and an endocrinologist, consider seeing a sexual health specialist. They can offer a more comprehensive evaluation to identify any underlying issues that may not have been fully explored yet.
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Monitor and Communicate:
- Keep a journal of your symptoms, triggers, and any changes in your situation. This can help you identify patterns and provide valuable information to your healthcare providers.
Addressing impotence can be a process, and it’s important to be patient with yourself while exploring these options. You're not alone in this journey, and with the right approach, improvement is possible. Do let me know if you have further concerns or need more specific help!
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