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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can I Manage Erectile Dysfunction Causing Difficulty In Penetration And Long Self-stimulation Periods?

I have erectile dysfunction (psychological) and I am taking tadalafil 10 mg for it. I get an erection after some self-stimulation with hands but the problem is that when my wife has lubrication, i feel like I am not penetrating - I can t feel anything so the exciton goes down. If she is not as lubricated, then i feel tightness around my penis so the erection stays. However, for my wife this is a bit painful. I am not sure what needs to be done - is it because my penis size is not enough or her vagina is too big (does not feel so when it is not very wet but ony when wet)? Also some times the self-simulation takes a lot of time for me to get erection.
Fri, 3 May 2024
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General & Family Physician 's  Response
Hello,

Do continue to take tadalafil, you have to take it at least two hours before having sex, PDE5 inhibitors help blood flow into the penis. Get clinically examined by a Urologist, along with tadalafil you will have to get done testosterone therapy for normal erection. ou are advised to penetrate when your wife is optimum wet, it will be helpful. Excessive lubrication is also not good.

You can make the use of vacuum erection devices. Your treating doctor may suggest you self injection therapy with alprostadil shot, it is very helpful. Also maintain healthy weight, obesity interferes with erection. Deposition of fat layer in the penis causes inadequate blood circulation, hence affecting erection. Do pelvic floor exercises, aerobic exercises, Kegel exercises, pause and squeeze technique for stronger erection and for longer prolonged erection.

You should get a stronger erection with all the said exercises, medicine & therapy. If not, then your treating doctor may recommend treatment with implant by surgery. Avoid watching pornography or any similar stuff that triggers you visually. Visual seduction affects your performance with your partner. It may cause PE or ED.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Nupur K, General & Family Physician
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How Can I Manage Erectile Dysfunction Causing Difficulty In Penetration And Long Self-stimulation Periods?

Hello, Do continue to take tadalafil, you have to take it at least two hours before having sex, PDE5 inhibitors help blood flow into the penis. Get clinically examined by a Urologist, along with tadalafil you will have to get done testosterone therapy for normal erection. ou are advised to penetrate when your wife is optimum wet, it will be helpful. Excessive lubrication is also not good. You can make the use of vacuum erection devices. Your treating doctor may suggest you self injection therapy with alprostadil shot, it is very helpful. Also maintain healthy weight, obesity interferes with erection. Deposition of fat layer in the penis causes inadequate blood circulation, hence affecting erection. Do pelvic floor exercises, aerobic exercises, Kegel exercises, pause and squeeze technique for stronger erection and for longer prolonged erection. You should get a stronger erection with all the said exercises, medicine & therapy. If not, then your treating doctor may recommend treatment with implant by surgery. Avoid watching pornography or any similar stuff that triggers you visually. Visual seduction affects your performance with your partner. It may cause PE or ED. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician