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What Causes Erectile Dysfunction?
I think I have erectile dysfunction, and have no idea what caused it. I am able to get an erection during oral sex, and when it comes time for sex I lose my erection. I believe it may all be in my head, but am not sure. I am 22, and just got out of a serious relationship to give you some background. How do I fix this?
posted on
Fri, 14 Mar 2014
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sun, 12 Jul 2015
Answered on
Mon, 6 Jun 2016
Last reviewed on
Hello,
Thanks for asking your query at health care magic.
I understand your concern. I am Dr Alok Sinha, MD Psychiatry from India. I will try to help you with best of my effort.
As you accept that you can have sufficient erection while getting oral sex, this signifies that you do not have any permanent serious problem.
Then the question arises that, why you lose erection at the time of real sex.
Let me first educate you about physiological mechanism of erection. Each sexual activity begins in brain. In a relaxed mind when ever there is desire for sex, it activates certain nerve cells in brain which in turn send signal to spinal cord and ultimately reach at penis. Penis has erectile tissue which acts on getting signal from brain. If brain is not relaxed, is pre-occupied with memories of past stressful experiences, is worried about future, having fear of failure, or under pressure of performance, it triggers sympathetic system of the body. Sympathetic activation goes against erection as due to this the brain fails to send desired signal to spinal cord and finally to sexual organ.
Apparently it is happening in your case. Already you are recovering from a relationship failure. So, your mind has experienced some amount of stress, whether you accept it or not.
Secondly at the time of passive sexual gratification, when someone is working on your genitalia and you are passively enjoying, there is little performance pressure, but when you are at real work you face low confidence due to memories of past failure and you face an intense pressure to perform well in front of your partner along with fear of failure in the back of mind. This causes a lot of anxiety and again activation of sympathetic system causing failure of erection.
Rightly you accept that it is all in your head. Believe me, if a person like you comes to my clinic, I assess him first for anxiety disorder and then give him psych-education about the illness, few anxiolytic medicines to relax and psychotherapy to alleviate the fear of failure and boost confidence. It works well. At your age and in this background there is unlikely any other cause of failure of erection.
You just need to get control of your fear and anxiety. I suggest you to consult a psychiatrist, who may assess you in detail and may bring cure.
Thanks for asking your query at health care magic.
I understand your concern. I am Dr Alok Sinha, MD Psychiatry from India. I will try to help you with best of my effort.
As you accept that you can have sufficient erection while getting oral sex, this signifies that you do not have any permanent serious problem.
Then the question arises that, why you lose erection at the time of real sex.
Let me first educate you about physiological mechanism of erection. Each sexual activity begins in brain. In a relaxed mind when ever there is desire for sex, it activates certain nerve cells in brain which in turn send signal to spinal cord and ultimately reach at penis. Penis has erectile tissue which acts on getting signal from brain. If brain is not relaxed, is pre-occupied with memories of past stressful experiences, is worried about future, having fear of failure, or under pressure of performance, it triggers sympathetic system of the body. Sympathetic activation goes against erection as due to this the brain fails to send desired signal to spinal cord and finally to sexual organ.
Apparently it is happening in your case. Already you are recovering from a relationship failure. So, your mind has experienced some amount of stress, whether you accept it or not.
Secondly at the time of passive sexual gratification, when someone is working on your genitalia and you are passively enjoying, there is little performance pressure, but when you are at real work you face low confidence due to memories of past failure and you face an intense pressure to perform well in front of your partner along with fear of failure in the back of mind. This causes a lot of anxiety and again activation of sympathetic system causing failure of erection.
Rightly you accept that it is all in your head. Believe me, if a person like you comes to my clinic, I assess him first for anxiety disorder and then give him psych-education about the illness, few anxiolytic medicines to relax and psychotherapy to alleviate the fear of failure and boost confidence. It works well. At your age and in this background there is unlikely any other cause of failure of erection.
You just need to get control of your fear and anxiety. I suggest you to consult a psychiatrist, who may assess you in detail and may bring cure.
I find this answer helpful
Dear service user,
Thanks for writing to healthcaremagic.
I got your concern regarding inability to have erection during sexual intercourse. The ability to have erections during oral sex indicates that there the problem is less likely to be physical and more likely to be psychological nature in your case.
There are several reasons for it; the common reasons are performance anxiety, partner specific problems, relationship issues, fatigue.
As you mentioned correctly, sex is largely everything what happens between your two ears (Mind) and little something what happens between two legs.
To fix it, I recommend you to see psychiatrist well versed in psycho sexual therapies. He will definitely assist you by counseling and behavior therapy.
Feel free to ask anything again if you have any queries.
Warm regards.
Thanks for writing to healthcaremagic.
I got your concern regarding inability to have erection during sexual intercourse. The ability to have erections during oral sex indicates that there the problem is less likely to be physical and more likely to be psychological nature in your case.
There are several reasons for it; the common reasons are performance anxiety, partner specific problems, relationship issues, fatigue.
As you mentioned correctly, sex is largely everything what happens between your two ears (Mind) and little something what happens between two legs.
To fix it, I recommend you to see psychiatrist well versed in psycho sexual therapies. He will definitely assist you by counseling and behavior therapy.
Feel free to ask anything again if you have any queries.
Warm regards.
I find this answer helpful
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