Our expert says:
Erectile problems may occur for a number of possible reasons, the most problematic of all could be serious health issues and so you need to have a physical check up. Not all causes are related to such problems however:
1. It could be a physical problem (e.g. diabetes, very overweight) it could be a complication of this problem - it would be important to know whether you have early morning erections. It could also be a side effect of medication.
2. As you appear to be able to become aroused some of the time, it could be that you have psychological blocks - this is where you may fear sexual failure/poor performance, and this essentially blocks the normal workings of the sexual response. If there is conflict in the relationship or have individual concerns (e.g. not feeling 'man' enough, etc), this could also affect your erection.
So it is possible that he could have erectile dysfunction and still have early morning erections.
There are treatment options for ED - both pharmaceutical and psychosexual.
You alos mention that you ejaculate early. It may be valuable to know that most men take on avaerage 2 minutes to ejaculate after vaginal penetration but due to the differences between men and women, many men choose to learn to delay their orgasm in order to try to give more penetrative pleasure to female partners. Whilst a low dose anti-depressant (SSRI) can help as one of the side effects of these drugs is to delay orgasm, the benefits will stop as soon as you stop taking the medication...so it is a short term aid. Perhaps you could learn to delay your ejaculation...?
The best way to learn this would be through masturbation where you learn recognise your physical signs of excitement (e.g. heightening sensation, a sensation in your testicles, heart rate) and at which point you need to ease off before it's too late (i.e. when the 'twitching' begins, it's probably too late). One way to help with this would be to try scoring your excitement on a scale of 0-10, with 8 being the point at which there's no turning back. When you get to about 5 or 6/10 you need to start using delaying strategies. For example: slowing or changing the rhythm of the friction, trying to take some deep and slow breaths, and try tensing your pelvic floor muscles as if you are trying to stop the flow of urine. Once your arousal has reduced somewhat (e.g. to about 3 or 4/10), you can resume stimulation and repeat this process several times before allowing ejaculation to take place.
A trusted partner could be a great help by coaching you through this, asking where you are on the scale, and encouraging you to use the strategies suggested. You stimulate yourself for the first few practice rounds (i.e. over days or weeks) and then once you have had some success, perhaps your partner could stimulate you, but she must slow down as and when you says to do so. Once you've gained confidence like this, you could move onto trying this intravaginally. This is likely to be much more difficult because of the sensations (warmth, moist) of the vagina so you should maybe slow your arousal down earlier than 5 or 6/10 to begin with. The best position to learn this would be with your partner on top so that you can focus all of your attention on your sensations, but you must remember to direct your partner to slow, stop, or start again as you need.
It's really important that these are 'exercises' though, and not 'sexual acts' as normal, otherwise you will feel more pressure to perform and your partner may feel frustrated - neither of these will help you with this learning process.
As a first recommendation - try to get checked out physically by a GP or urologist. If you get the all clear, perhaps see a health professional with experience in this area.
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal
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