Patient's question:
Why do I always lose libido and have a soft penis when I want to have sex with my girlfriend, making it impossible to enter, while I can normally get a hard erection when it's not the time? I'm 20 years old and have no sexual history, but I have a long-standing habit of frequent masturbation. Is this considered erectile dysfunction? What does true erectile dysfunction look like?Doctor's answer:
Hello:Many men cannot determine whether they suffer from erectile dysfunction, but in fact, the nature of the condition can be judged from the nocturnal penile erection. Normal men of all ages can experience reflexive erections during sleep. During puberty, the average number of nightly erections is about 6, each lasting 20-30 minutes; young and middle-aged adults average about 4 erections per night; and healthy elderly individuals over 65 years old can still have a total of 1-1.5 hours of erections per night. Even children often experience penile erections during sleep.
Clearly, nocturnal penile reflexive erections are unrelated to sexual stimulation and are not influenced by psychological factors. Therefore, they can be used to differentiate whether erectile dysfunction is caused by psychological factors or by underlying medical conditions. If an erectile dysfunction patient has no nocturnal erections or if the degree of erection is below the normal range for their age group, it may indicate a medical cause, requiring further investigation. If an erectile dysfunction patient has normal nocturnal erections, it is unlikely to be due to a medical condition but rather to psychological factors.
Here are several methods for self-assessing nocturnal penile erections:
(1) Stamp Test: Place four stamps around the penis, overlapping them and sticking the overlapping sections together to form a ring. Sleep with the stamps in place. In the morning, check whether the stamps are torn at the overlapping sections. If they are torn, it indicates nocturnal erections. If the overlapping sections come apart due to poor adhesion, it is not meaningful.
(2) Penile Circumference Measurement: Use a commercially available tape measure (usually paper-based) with one end connected to a square buckle. Before going to bed, wrap the tape around the penis, and let one end extend through the buckle. First, record the baseline circumference of the penis in its flaccid state, then...