What are the reasons for erectile dysfunction during sexual activity?

Patient's question:

Dr. Qin: Hello!
I am a male. Normally, my penis gets erect without any reason, and sometimes it can stay hard for several minutes. However, when having sex with my girlfriend (both of us are virgins), it doesn’t get erect automatically—I need to do it manually. What’s even more frustrating is that my penis always struggles to enter her vagina, and after touching her outer lips a few times, I lose my erection prematurely. I’ve tried many times, but it always happens the same way, which makes me very upset. Can you help me with this?
Thank you!

Doctor's answer:

Hello: It is normal to start experiencing symptoms due to poor coordination between you, so don't be nervous. In the future, you should relax and choose the timing of sexual activity. If you have sex in the morning after waking up, you will have more energy; if you sleep first and then have sex, you can avoid tension. After one ejaculation, you can have sex again that night, and the time will definitely be extended. Methods such as masturbating first to ejaculate and then having sex after the refractory period has passed can also achieve the effect of prolonging sexual activity and controlling ejaculation.
Cold and hot sitz baths can improve the ability of the posterior urethra to inhibit ejaculation.
If premature ejaculation occurs frequently, it is best to stop sexual activity for a period of time, avoid sexual stimulation, establish a regular lifestyle, ensure adequate sleep, and appropriately increase nutrition to enhance physical fitness. At the same time, you should also quit smoking, drinking, and other substances.
Wearing a condom during sexual activity can reduce the sensitivity of the penis head during male sexual excitement, thereby prolonging the duration of sexual activity.

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