Posted by: James | 2010-09-19


I desperately need some advise on ED. I notice that there are many queries on this site regarding ED, and much written on this site as well as throughout the web. The definition is given over and over that it is the inability to get an erection or maintain an erection. While this definition broadly covers my query, I can not ascertain if my problem is classic ED, or if there is more to it.

As a 57 year old male, who suffered high blood pressure a few years ago, I was treated with blood pressure tablets. A change of lifestyle saw my BP reduce and I was taken off the tablets about two years ago. About two months after I was put onto the tablets I started with ED. Stopping the tablets has had little effect on the ED. For a few months I am normal, and then got through period where I need medication for the ED, until my confidence returns.

What I am concerned about is the fact that I have no problem getting an erection. I can get an erection within about 15 to 30 seconds of my wife touching me. I can then maintain that erection for at least 30 minutes (that I have measured –  could have probably gone longer). The erection will remain hard while she touches. The pressure exerted can be strong or very light –  and sometimes by not even touching for a few minutes.

The problem comes just after I enter her. After about 10 to 20 seconds I suddenly loose sensation, and go soft. It is almost like a switch is turned off in my head. She is reasonably tight, so that is not the problem. We are both very wet. I is almost like some form of premature ejaculation, but there is absolutely no feeling of orgasm, and no evidence of semen etc.

ED medication usually helps to keep it hard, but they cost and time factor often affect the decision on whether to take it or not (i.e I never know before hand if I will be up to the job without medication, or if we should not take a chance, and take a tablet and wait an hour). Quite often I can manage without any medication, am rock hard to the end.

Questions :

1 - Why does it suddenly go soft on penetration, when it is fine by manual stimulation ?
2 - Is this a form of performance anxiety ?
3 –  Is this a form of premature ejaculation ?
4 –  What can I do to fix this ?

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Our expert says:
Expert ImageSexologist

Thank you James for the detail in which you have described your concerns and helping me to better understand what you are going through.
Firstly, based on what you describe, it is very unlikely that you are experiencing premature ejaculation.
Now i need you to understand a bit of the physiology involved in erectile dysfunction: the erection hardness you experience on manual stimulation is as a result of stimulation of the nerves on your penile skin, and increased blood flow to the penis which is mediated by activation of certain parts of the brain. once penetration occurs erection hardness depends alot on the vascular (blood) channels and the lining of these blood vessels which is supposed to keep blood in the penis(in the veins). if there is a problem with the vasculature or its lining (endothelium) than this can cause you to lose your erection. even though your blood pressure is now controlled, it may have caused some damage to your endothelium. You should also be screened to exclude other medical conditions that can affect the endothelium eg. diabetes, thyroid, cardiac conditions etc. My advice to you would be to seek the expertise of a urologist or a sexologist for a further work up. performance anxiety can definitely also contribute to the above but i would suggest first going the route of excluding a medical reason for it

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