Patient's question:
I have a problem and I don't know if I have erectile dysfunction or if it's just nervousness.I'm 22 years old and I often have sex with my girlfriend, but it always gets soft at the critical moment, or even prolonged foreplay doesn't achieve hardness, or sometimes it does achieve hardness but I can't complete the entire sexual process. I'm very worried... I have had signs of masturbation, but not very frequently... It seems that as soon as I shift my gaze or don't think about certain things, my penis becomes soft. I don't know if it's erectile dysfunction, and how to treat it? I'm very anxious because I'm only 22 and this is happening.
Doctor's answer:
Hello: Many men cannot determine whether they suffer from erectile dysfunction, but in fact, they can judge the nature of erectile dysfunction based on the nocturnal penile erection. Normal men of all ages can experience reflexive penile erections during sleep. During puberty, the average number of nightly erections is about 6, each lasting 20-30 minutes; young and middle-aged adults have an average of about 4 nightly erections; healthy elderly people over 65 still have a total of 1-1.5 hours of erection time per night. Even children often have penile erections during sleep.Clearly, nocturnal penile reflexive erections are unrelated to sexual stimulation and are not affected by psychological factors. Therefore, they can be used to distinguish whether erectile dysfunction is caused by psychological factors or by medical conditions. If an erectile dysfunction patient has no nocturnal erections or the degree of erection is below the normal range for their age group, it may indicate a medical condition, requiring further investigation to identify the root cause. If an erectile dysfunction patient has normal nocturnal erections, it is unlikely to be caused by a medical condition but rather by psychological factors. Here are several methods for self-assessing nocturnal penile erections:
(1) Stamp Test: Use four stamps to surround the penis, stick the overlapping parts together to form a ring, and then go to sleep. In the morning, check whether the stamp is torn. If it is torn, it indicates nocturnal erections. If the overlapping part comes apart due to poor sticking, it is not meaningful.
(2) Penile Circumference Measurement: There is a commercially available tape measure (usually paper-based) with one end connected to a square buckle. Before going to bed, wrap it around the penis, and let one end come out through the buckle. First, record the baseline circumference of the penis in its flaccid state, then the next morning