ED in the Younger Patient
Submitted By Dr. Marc Gittelman to the Miami Herald
Question: My partner and I have been together for five months now and we have never had sexual intercourse. He believes that he has erectile dysfunction since he can’t maintain an erection for intercourse. He can however maintain an erection in such things as oral sex but when it comes to intercourse he can’t. We are only 21 and I know there is no pressure from me on him but I know it gets him down and is possibly causing some increased stress that is worsening the ED. Although I know it’s psychological, I don’t know how it can be treated.
Answer: You are correct in that this is very likely to be a psychological problem. However, don’t forget that there are some serious medical issues such as diabetes, thyroid problems and even hormonal problems that can first show up as erection failure. My advice to even the young person with ED (erectile dysfunction) is to start at your physician’s office for a general checkup to be sure that some of these problems aren’t the true cause. Once that is off the plate it may be worthwhile to seek help from a sex therapist. They can help to pinpoint some of the potential psychological blocks that are making intercourse difficult. As you mentioned, these often include stress, but there may be many other factors involved such as alcohol, drug usage, or even a history of sexual abuse in the past that may make it difficult for him to perform in what seems like a “natural environment”. There may even be cultural or religious differences creating sexual tension in the relationship. These are typically things that young patients are very uncomfortable speaking about especially in relatively new relationships. Or he may have something as simple and common as performance anxiety making intercourse seem like “the impossible dream” for him. A good sex counselor can often be helpful in sorting out these problems and they can teach you and him how to use certain techniques to decrease this anxiety and make vaginal penetration an option. The use of oral medications such a Viagra, Levitra, or Cialis might even be used as a temporary crutch until he can feel that he is back on his feet again and eventually go forward without the need of medical intervention.
My advice is to go back to your Don Quixote and give him encouragement to follow through with my suggestions. Perhaps soon both of you can fulfill that impossible dream that once seemed so far out of reach.