29-Year-Old Male Seeking Guidance on Absence of Morning Erections and Nightfall
Hello, I'm a 29-year-old male, standing at 5'8" and weighing 70 kg. For quite a while, I've been experiencing a lack of both morning erections and night emissions. Five years ago, I ceased masturbating, during which period I did experience nocturnal emissions. However, I have occasionally noticed semen while straining during bowel movements. Currently, my masturbation frequency is about once a month, and I only observe semen then. There have been no morning erections or night emissions at all. Additionally, I am not on any regular medications. What potential causes could be behind this? Which diagnostic tests would you recommend? Should I be concerned about this situation? Thank you for your help.
Answers (1)
9/9/2025, 4:40:38 PM
OpenHealth AI
It's understandable to feel concerned about changes in your sexual health, particularly regarding the absence of morning erections and nocturnal emissions. These changes can be influenced by a variety of factors, and while they may not always indicate a serious issue, it's important to explore them further.
Possible Causes:
- Hormonal Factors: Low testosterone levels can affect both morning erections and overall sexual health.
- Psychological Factors: Stress, anxiety, or changes in mood can impact sexual function and libido.
- Physical Health: Conditions such as obesity, diabetes, or cardiovascular issues can play a role.
- Infrequent Masturbation: As you've noted that your frequency is quite low, this may affect your body's natural functions related to ejaculation and erections.
Next Steps:
- Keep a Log: Track any changes in your erections, sexual desire, and overall mood. This will help you see patterns over time.
- Lifestyle Adjustments: Ensure you're maintaining a healthy diet, regular exercise, and good sleep quality, as these can positively impact hormone levels and overall health.
- Self-Check for Stressors: Reflect on any psychological stressors in your life and consider stress-reducing activities like mindfulness or exercise.
- Consider Testing: While I won’t recommend specific tests, think about discussing with a healthcare provider screening for testosterone levels, thyroid function, and possibly other hormone levels. This can give valuable insight into your symptoms.
Being proactive in understanding your body and its functions is commendable. If you notice any additional concerning symptoms or if things do not improve over time, seeking medical advice would be a good step forward.
Related Questions
Concerns Over High ALT Levels
Last Thursday, I (28-year-old female) visited my primary care physician for some routine blood tests. While most of my results were within normal ranges, I was alarmed to find that my ALT was significantly elevated—about eight times higher than the upper limit of normal (based on information I found, this could equate to around 440 U/L in my country, Sweden, which uses different measurement units). Interestingly, I haven't experienced any obvious symptoms linked to liver issues, aside from some fatigue, nausea, and a decreased appetite. I initially attributed these symptoms to my use of Wegovy over the past 12 weeks for weight loss, combined with my strict low-calorie diet, which has led to roughly a 30-pound weight loss over the last two and a half months. Both my physician and I were taken aback by this development, especially since my ALT levels were perfectly normal just a few months ago in May. Consequently, my doctor requested follow-up blood tests this past Monday, and to our relief, my ALT had dropped to approximately 6.6 times the expected maximum over the weekend. All other liver markers—including ALP, bilirubin, GGT, albumin, lactate dehydrogenase, and PT/INR—came back normal. Despite the reassuring results of my liver panel, I still find myself anxious that my elevated ALT might indicate a serious condition such as autoimmune hepatitis or another liver-related issue. I rarely consume alcohol, I have never overdosed on medication, and I don't engage in intense exercise or have other known health disorders. Furthermore, I have not used drugs or traveled recently. While I do face obesity, which can lead to non-alcoholic fatty liver disease, this concern has never surfaced in the past. My physician suspects that the elevation could be related to my Wegovy treatment or possibly the low-dose quetiapine (50 mg) I take for anxiety and insomnia, along with pantoprazole (20 mg) for acid reflux. Daily, I also use escitalopram (20 mg), Yaz birth control, and supplements such as omega-3, iron, and multivitamins. The only significant change in my medications since May has been the introduction of Wegovy, and I have been taking ibuprofen occasionally for headaches, while adhering to the recommended limits of 400 mg. I'm left wondering whether such a high ALT level could arise without pointing to serious liver damage or disease. If it’s not indicative of significant liver issues, what could lead to this situation? Additionally, is it feasible to have something like autoimmune hepatitis if only the ALT is raised while other liver tests remain within normal limits? At present, the plan from my physician involves another round of blood tests in two weeks to further investigate these findings.
Concerns About My Toddler's Chin Injury
Approximately a month ago, my granddaughter, who is just two and a half years old, had an unfortunate fall at the playground. We took her to an urgent care facility where the staff thoroughly cleaned the wound and applied steri strips for closure. However, after two weeks, while playing at home, she bumped her chin again, causing the injury to reopen. Upon our visit to the doctor, we learned that stitches should have been used during the initial treatment. They opted for medical adhesive this time and secured it with tape. Now, three weeks later, the chin has been disturbed yet again after another minor bump. What steps should we take from here? Should we consult with a plastic surgeon? We are hopeful that this injury will eventually heal properly, though it seems to be an ongoing issue.
Preparing for a Barium CT Scan for Hernia Evaluation
I am a 42-year-old male, standing 5 feet 11 inches tall and weighing 200 pounds. I have a CT scan scheduled for Friday to assess a potential hernia, as an earlier ultrasound did not reveal anything unusual despite ongoing abdominal discomfort. In the past, at age 28 when I was in better shape, I underwent a barium test that led to severe stool impaction. At that time, I believed I had consumed plenty of water, but it clearly wasn’t sufficient. Now, I am seeking advice on how to avoid a repeat of that unpleasant experience. Is it safe for me to use Restoralax following the CT scan, or are there other measures I can take to mitigate the risk? I’m concerned that relying solely on water and fiber might not be adequate, and I dread having to go through the same ordeal as before.
Elevated Prolactin and DHEA-S - 27 Years Old, 182lbs
After nearly a year of experiencing irregular and absent menstrual cycles, I finally consulted a physician to evaluate my hormonal levels. The tests revealed elevated levels of Prolactin and DHEA-S, while other tests for insulin, cortisol, thyroid hormones, and iron returned normal results. There appears to be no ovarian issues, and I am currently awaiting the interpretation of an MRI scan of my brain, as well as kidney function results. My symptoms have worsened over time. What initially seemed to be mere sadness and depression a few months back has escalated into severe cognitive fog, a struggle to process new information, feelings of detachment, poor time management, impulsive decision-making, pelvic discomfort, frequent calf cramps, insomnia, profound tiredness, hair thinning, and most recently, evening headaches. Over the past seven years, I have faced a series of distressing life events that led me into a very dark period. During this time, I isolated myself from social interactions, engaging only with work, which resulted in a more inactive lifestyle. Could the weight of these experiences have weighed me down so heavily? Additionally, I have been intermittently using Vyvanse for the past three years, having switched to its generic form four months ago. Coincidentally, that period marked a noticeable decline in my overall well-being. I have read that Vyvanse can lower prolactin levels due to its dopamine effects, which makes me curious if anyone else has encountered a similar circumstance. I’d like to know if my experiences resonate with any of you. While I'm waiting for my test results, I am eager to explore possible diets, exercises, books, or any other suggestions that might alleviate my condition. I sincerely value any advice or shared experiences you could offer.
Is There a Connection Between Transverse Myelitis and Vitamin B12 Deficiency? Female, 31
Greetings, I'm reaching out in hopes of gaining some insight. Up until recently, I was in good health, only taking iron supplements in the past and maintaining my vitamin D levels. As a mother to two children, both delivered via c-section within the last three years, I’ve been focused on my family. ### Overview of My Situation - **Before Symptoms Began (November 2024)**: I struggled with continuous fatigue, mental fog, and memory lapses, which I attributed to low ferritin and vitamin D levels, as corroborated by lab tests showing I had deficiencies. At that time, I was about a year postpartum. - **Symptoms Emerged (June 9)**: I awoke to find numbness and tingling sensations extending from my hips down to my feet, roughly 1.5 years after giving birth. - **Initial Diagnosis (June 16)**: At this point, I was diagnosed with a vitamin B12 deficiency, with a serum level of 213 identified. Given my limited meat intake, this diagnosis made sense. - **Commencement of Treatment (Starting June 16)**: I was prescribed B12 injections (cyanocobalamin) three times a week. Initially, I received shots twice weekly, which showed some improvement in my symptoms, although I noted a spread of numbness to my waist during that first week. After 7 weeks of adhering to the B12 regimen: - Tingling and numbness saw enhancement of approximately 70%, primarily localized to my feet by this point. - Both brain fog and fatigue significantly diminished. - **First Emergency Room Visit (June 24)**: I sought emergency care due to an escalation of my symptoms, particularly the spreading numbness. They prescribed a spinal MRI, but it was scheduled for seven weeks later. Throughout this waiting period, I continued the B12 injections, which helped alleviate my symptoms further. - **MRI Results (July 27, available July 30)**: The MRI revealed several T2-weighted hyperintense lesions on the spinal cord from T3 to T8, with specific findings including: - At T3–T4: patchy enhancement in the central area. - At T4–T5: lesions at the right and mid-dorsal regions. - The most significant lesion appeared at T5–T6 on both the central and left sides with patchy enhancement, while T8 was noted as mid-dorsal. - There was no compression observed on the spinal cord. - **Second Emergency Room Visit & Neurology Admission (August 18)**: After returning from travel, I was admitted for a comprehensive evaluation. Numerous tests, including a brain MRI, lumbar puncture, and autoimmune antibody tests, yielded negative results. The brain MRI appeared normal with no signs of oligo bands. - **Follow-Up MRI**: A subsequent spinal MRI indicated multiple T2 hyperintense lesions from T3 to T8, showing a slight decrease in both size and quantity compared to the July scan, and no longer indicating enhancement (suggesting no active inflammation). - **Treatment Adaptations**: I underwent three days of IV steroid treatment, which resulted in minimal symptom changes. In stark contrast, I noticed that stopping B12 injections led to a notable intensification of numbness and tingling. - **Treatment Complications**: I had to suspend my B12 injections due to experiencing a spinal headache post-lumbar puncture, necessitating a blood patch that ultimately alleviated the headache. Currently, I am dealing with back pain which has delayed my return to B12 treatment. - **Present Symptoms**: I continue to have numbness and tingling that improve with B12 but worsen in its absence. Recently, I've encountered sporadic twitching around my cheek near the nose and intermittent tingling in one finger. ### My Inquiry I am wondering if a vitamin B12 deficiency could potentially cause transverse myelitis. My neurologists have indicated that this level of spinal cord damage is unlikely to stem from B12 deficiency alone. However, given that my symptoms significantly improved during the 7 weeks of B12 treatment before my MRI and intensified upon discontinuation, I wonder if there is a potential connection between my low B12 levels and the observed spinal cord lesions/neurological symptoms. I have been referred to a specialist at an MS clinic for further assessment, but the appointment is scheduled four months away. This wait has been incredibly frustrating as I seek answers to my condition.