Our third question is another problem I encounter commonly in my practice. “Hello, I am 22 year old and have a problem. I'm not really sure what's wrong, but I can't get an erection with my girlfriend. I can fine by myself. Sometimes I can get it up just fine with my girlfriend, but other times it never happens. And it's not like this problem just started, I've had this problem for a while. 2-3 years or so. I went to a urologist but he just told me I was too young for this type of problem and gave me my money back and made me leave his office. I don't know what to do, or who to turn to. Please help!”
Dr. Knowles: This is a very common problem in young men. I see many patients in my office with the exact same problem. I never turn these patients away as the other urologist had. This problem with erections is often called situational ED and is more common than most men will admit. He doesn’t appear to have primary ED because he is able to achieve normal and functional erections alone but is having problems with his partner. Situational ED is psychological and not physiological. This means that the problem probably lies within the head and not in the penis. The best place to start with treatment is to solve the underlying problem, the relationship with the sexual partner. There are many underlying causes why one may be having relationship issues with his sexual partner. One may be uncomfortable having sex with a particular partner or one may not have sufficient emotional sexual excitation with a partner. These psychological issues must be identified, addressed and resolved, which may be very difficult.
Unfortunately, experiencing problems with erectile function often compounds the problem. This can bring about even more psychological problems with erectile performance and only makes the problem worse. It is typically necessary to address the underlying psychological issues at play that are causing the emotional distress but medication can often help these patients. By using the oral ED medications for this problem the patients are often able to achieve satisfactory erections while still having these psychological problems. These medications allow the user to achieve an erection more easily without as much stimulation both physically and emotionally. As well by allowing the patient to regain his sexual ability, it will usually help eliminate the added problems associated with the erectile performance anxiety. In most cases, the patient is usually able to stop using medication and resume a normal, healthy sexual relationship with good erectile function without the medication after the emotional issues are identified and resolved. The medication should not be used without addressing the underlying psychological problems which are likely the main cause of the problem with erection.
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The Basics of Erectile Function
