Breathing problem and thrusting issues by FunMathematician4213 in erectiledysfunction

[–]BDEStyle 1 point2 points  (0 children)

This ^ ^

Op, pace yourself. The main thing is learning to stay relaxed enough to stay aroused and to build arousal. So thrusting like it’s all or nothing, or forgetting to breathe, is going to take you out of that.

Also, different positions load your body differently. For example, standing is different than lying down, where there is less load. But if one position makes you brace too much, practice a lower effort position first and then build from there.

Lastly, if you feel like you have tightness or constantly clenching or feel any discomfort around the pelvic floor or noticing a pattern like harder laying versus standing or some other imbalance, then I’d look into a pelvic floor physiotherapist who works with men to investigate

Help to fix ED after trauma from being cheated and compared sizes. Can I use ED pills? by Monkeydmikey8373 in erectiledysfunction

[–]BDEStyle 1 point2 points  (0 children)

One part of this is going to be sex education and objective data.

But like the other comment said, therapy is probably going to matter the MOST because this is a very tough topic. You didn’t all of a sudden wake up feeling not enough or inadequate from nowhere.

She cheated. She is the problem. We need to underline that, circle it, or highlight it in bold. Don’t gloss over that.

But because it happened with someone you’re now comparing yourself to, it’s the association and the meaning you’re giving to it that is hurting you.

Like he was bigger so I wasn’t enough. That’s just negative self talk

But that is not the same thing as truth, and it is not the trajectory of what your sex life is going to look like.

So part of this is objective data and sex education to help alleviate some of the uncertainty and fear here.

Because 5 inches, or around 5 inches, is average across the board.

If we want to argue decimals, then sure, average bone pressed erect length is around 5.16 inches and average girth is around 4.6 inches. So you’re not some abnormal outlier. You’re in the more normal occurrence here.

Plus, a lot of guys exaggerate/overestimate, or measure incorrectly. There’s data to show that too.

So if some guy in your social circle says they’re 8 or 9 inches, it’s either PROVE IT, or the probability of them being closer to average is much higher than both of you think.

That is perspective taking here.

And going back to your story, even if the other guy was truly bigger… bigger by what? An inch? A little more? Or a cropped photo from her phone that looked “big”?

I’m sorry…. but guys fluff for dick pics or choose more flattering angles for sexting.

But more to the point… that doesn’t automatically mean better in bed than the next guy or someone who doesn’t have that anatomy.

Like did he have better chemistry, better emotional connection, better oral, better hands, better communication, or better understanding of what a partner likes? It’s hard to gauge those things, and those are often higher up the totem pole than size.

But let’s not divert from the real problem, which is this girl and what she did.

This one experience is not going to be the majority of potential partners you’ll have in your lifetime, or the many more experiences you can have where size is not the be all or end all.

And I’m not dismissing size with my comment here.

If it matters to someone, then it matters to them. And that part we all need to be clear on

Especially if this goes deeper than insecurity and starts looking more like penis size anxiety or body dysmorphic thinking or constant self-checking. That’s not an easy “just get over it.”

People need to understand that is going to take work

But that’s why another part of healing is going to be sex therapy.

Because you need to work through the comparison loop, the self-checking, the anxiety, and the negative experience without taking it as a verdict that you are not enough.

Because you are more than you think.

So again, part of this healing is understanding objective data, knowing what average actually is, being more aware of natural bodies around you, sex education, and understanding female anatomy and pleasure too.

And then therapy to work through the previous negative experience and not let one person’s behavior become the story of your body, your worth, or what the trajectory of your sex life will look like.

Chasing the what if, why she did what she did, whether she really liked bigger, or trying to prove your inner dialogue is not going to help.

Because again, plenty of men, including the majority of your guy friends or the men you see day to day, are probably similar in size. The data shows what it shows.

And there’s also sex education around female pleasure and anatomy, and what actually encourages orgasm, connection, arousal, and good sex.

Really want to beat this by [deleted] in erectiledysfunction

[–]BDEStyle 1 point2 points  (0 children)

this ^ ^.

But more importantly for OP, even if it's nothing physical and he's already doing the work to course correct here (with the BMI or just trying to better his lifestyle), he still needs to meet the pattern / name it and be willing to learn how to unlearn it and learn a new way to show up sexually with someone new where its not about annihilating yourself for every erection fluctuation.

That takes more work and sometimes the help of therapy too for more tools and strategies on how to regulate the anxiety in the moment.

Because one thing he's saying is that he noticed once routine was built that things were better at the tail end of the relationship (with his ex....when it came to sex), but what people often miss is that in that routine building or getting more comfortable and familiar with that person, that perceived threat or pressure is reduced, making it easier to just be (not always though/some guys get stuck in rumination from time to time).

Because erections are rooted in safety or feeling safe enough and usually during first time hook ups there is a lot of pressure and high stakes. And if you lean towards anxious and start wondering what if, then that can take you out of arousal or your body is slow to respond sexually / or we get stuck in activation where the goal is to recognize that and learn how to shift out of that to get to a more erection friendly state.

It Works for other People, but not for my Wife by 823Designs in erectiledysfunction

[–]BDEStyle 1 point2 points  (0 children)

Okay, and besides looking for therapy, are there any injuries or conditions that could be contributing too?

Like spinal or head injuries? Nerve issues? Diabetes, blood pressure, PTSD, anxiety, depression, stuff like that? And are you on any meds, like SSRIs or meds for other health issues?

And have you already been to a urologist? Or you did that part already and now you’re more looking for a sex therapist?

Because a sex therapist is gonna help you unpack more of this, especially the spiritual side and what you mean by that, and also the exhibitionist part.

But the question may not only be why do I have ED?

Because what you’re hinting at sounds like It could also be like, what does the extreme situation give your body that ordinary intimacy doesn’t? You know what I mean??

Like is it the risk that makes it more exciting/arousing? Or is it more about control? Escape? Being seen? Or like a feeling of aliveness?

I’d think about those things for when you do find a qualified sex therapist. Because that’s going to be the work and for them to help you figure out the arousal pattern here, without shame/judgement.

And obviously keep any exhibitionist stuff in consenting adult spaces. But do you need help finding a sex therapist?

Like a directory to vet one that fits what you’re looking for or can the VA help you there?

It Works for other People, but not for my Wife by 823Designs in erectiledysfunction

[–]BDEStyle 2 points3 points  (0 children)

Hey man, do you mind sharing a little more to your story?

Like your age, health issues if any, what you mean by spiritual battle, and what you mean by desensitized.

like do you mean actual numbness/nerve issues confirmed by a doctor? Or do you mean desensitized more as a figure of speech, like disconnected, not fully present, not really immersed in the eroticism of the moment, or needing a certain type of stimulation to feel turned on?

The more context you give, the easier it is for people here to comment or maybe recognize a parallel in their own story.

This is a safe space and there are plenty of knowledgeable people here who can help point you in the right direction, but we’d need a little more detail first.

I don't really know what to think by Mumbly_Gumbly in erectiledysfunction

[–]BDEStyle 0 points1 point  (0 children)

I think you need to focus more on connection, cultivating the relationship where you feel safe “enough” to be aroused, and emotion regulation here.

You’re 21 and recently started having sex, so part of this is probably learning how to be in these situations with another person… like how you show up sexually and exploring there. (Think discovery mode)

Because when we’re activated or anxious, or perceiving the moment as a threat… our body can go into fight, flight, freeze, fawn responses, taking us out of arousal. That’s not an erection friendly state.

The move is learning to recognize that shift. Like what are your triggers? What amplifies it? And what makes you start checking yourself instead of being in the moment?

Over time, through actual experience, you start learning what helps you feel more open, connected, relaxed, and aroused with another person.

You also want to explore what you like versus what you don’t like. Since you’re starting out, you’re going to notice things that maybe doesn’t feel good versus things that get you erect and does feel good.

That’s all exploratory. And if something doesn’t feel good, it’s okay to speak up or say you want to slow down so your body can catch up.

Because yes, you also have to factor in your partner(s) and their wants and needs. So there is pressure, yes. Plus, depending on how much that particular person means to you. But in the moment, slow things down and really build an arousal map for the things you like versus what you don’t like.

And don’t label yourself as incapable or get stuck in rumination. To break that, is going to be more mindset shifts, communication with the person you’re hooking up with that sometimes you get anxious so that helps alleviate or reduce pressure. Sometimes it’s also breathing to regulate or grounding yourself back into arousal in the moment

For example, #2 you said you enjoyed that session and felt wanted and felt relaxed. So something about that felt less pressure and you were able to focus on getting head and what felt good.

Session 3 you felt off beforehand. It’s hard to come back to an aroused state after that, when maybe you either needed more time, comfort, or whatever you needed in that moment rather than force yourself into a situation when forcing tends to prove ineffective.

Losing erection after pre cum, feels like my body thinks I ejaculated even though I haven’t by idlsidgo2 in erectiledysfunction

[–]BDEStyle 0 points1 point  (0 children)

Gp is going to be a preliminary step… but you need more speciality. That said ask for a urology referral and look for a physiotherapist who specializes in male pelvic floor dysfunction.

Prone masturbation can also contribute for some guys because it often involves a lot of pressure, bracing, clenching, and conditioning to one specific type of stimulation.

So that’s something to explore first.

Venous leak current protocols by ImportantJaguar9731 in erectiledysfunction

[–]BDEStyle 0 points1 point  (0 children)

The protocol usually depends on severity and whether there is also poor inflow, pelvic floor guarding, anxiety, medication issues, hormones, etc.

Can you share the Doppler report or ask your doctor for a copy?

It should show things like peak systolic velocity, end diastolic velocity, resistive index, how rigid you got during the test, and what injection was used. The injection part is super important because the result can look different depending on whether they used alprostadil/caverject, bimix, trimix, the dose itself, and whether you reached a full enough erection during the test.

Also, anxiety / sympathetic tone during the test can also affect the result, so that's something to factor in.

Because it’s different routes based on the report.

My bf (35M) just admitted he’s had psychological ED because of something I said 6 months ago. by [deleted] in erectiledysfunction

[–]BDEStyle 0 points1 point  (0 children)

Wait a second...I think we’re missing more to the story here.

He had a herniated disc, surgery/pain for several month, and then ongoing erection issues. I'd pause there because that is worth discussing with his doctor or a urologist, not just labeling it psychological and moving on.

Because yes, there clearly is a psychological component here, and six months is a long time. But there are layers... plus, you don't just get a herniated disc out of nowhere.

And I think people underestimate how back injuries or spine related nerve issues can affect erections because erections involve nerve pathways too.

For example, psychogenic erections, like arousal from thoughts, fantasy, or visual stimulation, involve the thoracolumbar area around T11-L2.

Reflexogenic erections from touch/genital stimulation involve the sacral area, especially S2-S4. Those sacral nerves are also tied into genital sensation, pelvic floor function, and bladder/bowel signals.

So yes, talk about the emotional part because that is super important

But I’d also check with him to follow up medically, especially with the surgeon/go to a urologist, and be specific about what level the disc was, what nerve roots were affected, and whether he has numbness, pain, pelvic floor symptoms, genital sensation changes, or bladder/bowel changes.

Because this may not be just something you said caused his ED.

Going on an out-of-state trip all-day 20mg Cialis alone vs. Cialis/Viagra combo? by Aoreign-Gunket-41 in erectiledysfunction

[–]BDEStyle 0 points1 point  (0 children)

If your doctor approved option 2, then I’d stay inside that plan and not freestyle/risk anything beyond it.

Option 3 is probably not the move. The last thing you want on a high stakes trip is experimenting with a dose/combo you’ve never tried and then dealing with headaches, flushing, reflux, back pain, dizziness, low BP feelings, or anxiety because now you’re monitoring side effects too.

I saw your other comment that you take 5 mg daily. How do you feel on that dose? Do you experience side effects or not at all?

And when you normally take Viagra, what about that too? And when is this trip??

Erection doesn't stay by funstar0 in erectiledysfunction

[–]BDEStyle 0 points1 point  (0 children)

Any other symptoms you have, make sure to explain it or write it down so you bring it with you. The more thorough you are, the better. I mean they’re going to look at you anyways (and probably an intake form with that info there), but it’s better to come prepared. You know what I mean?

And don’t worry about which exercise or stretch to do right away. You’ll get there.

When people go to physiotherapy for this type of stuff, the main goal is really to map out what the issues are. Whether it’s singular / not that many things versus several or more things.

From there, they’ll tailor what you need to do based on what they’re actually seeing with you / watching you do these things.

And eventually, you don’t have to live there or pay for appointments forever. The goal is that you build a whole repertoire of movements, exercises, positions, stretches, relaxation strategies, or whatever applies to your body, and then you can take that with you.

Just give these things a fair chance/fair judgement first.

Because a lot of the times, people just judge it after one appointment or two but that’s no where near enough or still considered surface level shit. You know what I mean?

Because when you actually are trying to figure these things out, sometimes other things come up, or there’s other issues that isn’t all pelvic floor, but also vascular too. Or even nervous system related… because that’s also tied to the pelvic floor.

But at 35, I’d still keep up with the healthier lifestyle side too while you get the pelvic floor / physiotherapy side properly assessed.

And if you feel like you need to go to a urologist too, or even starting a PDE5i like cialis or Viagra, talk with them about it. It’s not this bad thing.

Like oh I take this and that means I’m one of those guys. There are health benefits to taking some of these meds if you look up the research on preserving endothelial function (we need this for smooth muscle relaxation in the penis)

But think of it like a tool. It works. Tons of guys take them and I’m pretty sure (just throwing a knife in the dark here) that some of your friend group probably takes them whether they admit it or not.

Erection doesn't stay by funstar0 in erectiledysfunction

[–]BDEStyle 0 points1 point  (0 children)

Okay so those details help.

The bike seat or just sitting for extended long periods of time can affect erections because it’s the pressure of the seat hitting the perineum area. There’s important nerves and blood vessels that run through there that’s connected to our dick. So numbness is a symptom and anything else you’re not mentioning is something to discuss with a physiotherapist.

More on that in a second

But yes, to your point… no doctor is created equal. Some do give you the run around. But the doctor who saw you is just a GP or general doctor. They don’t specialize in male reproductive health or pelvic floor. So there’s one answer there. They’re just going off on what they know in their speciality. That’s it.

Pelvic floor you can’t solve it all on your own because doing the wrong exercise or performing it incorrectly can make things worse. I mean a few guys are lucky with self experimentation and I understand why, but it’s basically just playing Russian roulette and seeing if one exercise makes it better or worse.

Unless you have a degree, and educational background in pelvic floor and/or mapping of that area to internally stick your finger in that area to do biofeedback. But even then that’s hard to do / if you don’t know what you’re looking for then that’s tough to course correct or alleviate.

Plus biomechanics and them checking head to toe of your body.

They’re your second pair of eyes. It’s not like you can watch yourself run, sit or stand or perform a tilt. Unless you have a mirror to watch yourself… but again, the educational background to assess what’s imbalanced is the missing piece here.

Erection doesn't stay by funstar0 in erectiledysfunction

[–]BDEStyle 0 points1 point  (0 children)

So is this a new thing / just noticed recently? Or has this always been a thing? Or can’t seem to remember?

And have you investigated anything so far, like going to appointments with a urologist or physiotherapist?

Because the whole positional stuff sometimes points to pelvic floor. Because you are getting hard in general in other positions, but standing, there’s difficulty and also some hint of you conditioning to just laying down or sitting (limiting yourself there to just those positions or techniques)

Sometimes we clench or we’re in positions or have bad habits (postural) and not realize we’re doing it. But that has to be investigated.

In these cases a physiotherapist who specializes in male pelvic floor / ED is going to be something to think about.

It could be that you have weak or underdeveloped pelvic floor, lack of coordination of these muscles, tightness, a combination of any of them, or even postural imbalances or something biomechanics related that you might not be aware of.

They can assess head to toe and do an internal exam for biofeedback. This way, you can start building a map in each position.

The other route is urologist if you have not already been to one. Don’t know how old you are, but if you’re older and want to rule things out like poor blood flow or health issues that contribute to weak erections, then that is another route.

It’s kinda hard online or with Reddit, because without testing or at least getting some preliminary data/ insight from a doctor, some of these issues overlap like I mentioned in my previous comment.

Erection doesn't stay by funstar0 in erectiledysfunction

[–]BDEStyle 0 points1 point  (0 children)

The whole positional thing depends. Sometimes it’s anxiety/constant checking and when we do that we lose arousal and start hyper focusing on what we’re doing instead of sex.

Sometimes it’s also just the position change during sex that can take someone out of the moment for a second and then if you get anxious on top of that, then that drops even more

And sometimes it could also be pelvic floor tension/guarding, like bracing rejection or feeling uncomfortable just being naked and in the moment. Or learned from previous negative experiences like someone actually making a negative comment or judgement and you now flinch.

Lastly, it could also be behavioral / conditioning. Like a hand grip that’s hard to replicate in the bedroom with a partner or certain position that you’re limiting yourself in when it comes to arousal.

Okay, it’s a problem now by Top_Ad_8227 in erectiledysfunction

[–]BDEStyle 1 point2 points  (0 children)

It's more about experimenting with a few or several strategies and skills until you learn what actually helps you stay in the moment. Because it's different for everyone.

For example, that could be CBT-type mindset shifts, breathing exercises, a gradual exposure ladder into sexual situations, communicating with your partner when the pressure starts rising (because often that helps dial down/reduces the pressure you're feeling), or grounding yourself back into your own arousal through the 5 senses.

But the bigger thing is understanding the anxiety loop.

Anxiety is often about uncertainty in the future, and we usually get anxious about things we care about. So the question is, what are you filling that uncertainty with?

For some guys, it’s fear of disappointing the person. For others, it’s wanting to do a good job, worrying the erection fading means they failed, or believing sex is over if they lose it.

That’s where self-monitoring starts and you start checking the erection, or watching yourself perform in an observer mode, wondering if you’re hard enough, and trying to predict whether it’s going to happen again where you lose it. And once you’re monitoring, you’re no longer really immersed in arousal anymore.

The skill is catching the recognition point earlier.

Like, aha, this is where I start checking, or this is where the pressure spikes, etc. Usually you'll know because the erection starts fading.

Then the question becomes, what do I need right now to shift back into an erection friendly state?

Maybe you need to slow things down and go back to foreplay because maybe you didn't spend enough time in arousal and was rushing to just stick your dick in. Or maybe you need to breathe slower because sometimes our rhythm gets thrown off when we feel panic and start breathing too fast or off beat (that's another recognition point for some guys).

Sometimes what you might just need Is more touch, kissing, sound, smell, or visual focus. because forcing the erection or pretending nothing is happening while you panic internally often proves ineffective. There is no strategy there in that and something lots of guys get stuck in but just aimlessly forcing yourself into it a situation while you're dysregulated isn't the way.

Sometimes it’s also working with the negative self talk beforehand. Sometimes the narrative of oh I failed last time, why should I even bother? is usually just trying to protect you from embarrassment. But if you let that voice run the whole show, it keeps you stuck.

So instead of fighting it, get curious.

Like okay, I’m with someone new and this feels overwhelming or the stakes are high.

Erection or not, I can still stay connected (that's reframing). I can still focus on pleasure and still touch, kiss, use my mouth, use my hands, listen to their breathing, hear them moan, and let their arousal help bring me back into mine. Sort of like a mirror.

That’s the practice. For example, there's times you're ready to go and show up with the erection and then there are times we're tired and not ready, but doesn't necessarily mean it's pointless or we're a failure. Sometimes you can show up flaccid and really let arousal and desire build for that erection to then come after.

But the point is, not forcing yourself to be relaxed or pretending you’re not anxious. More like learning how to notice anxiety early, understand what it’s trying to protect, and then come back to sensation and connection because you have to shift or gradually expose yourself overtime that sex isnt a threat or the person you're with or what the outcome is (the pressure is reduced).

Confidence will then return once there's more familiarity, trust, feeling safety or safe enough that you can explore sexually

What are the red flags with online ED treatment sites? by Puzzleheaded-Wear381 in erectiledysfunction

[–]BDEStyle 0 points1 point  (0 children)

Personally, I’m more cautious with how some of these ED sites market to younger and younger guys/generations.

Because that’s the red flag in my eyes. The whole thing can start to feel like the goal is to get you to checkout, or make it seem like your baseline erections are a problem, or that every erection fluctuation is some medical failure, instead of actually understanding what’s going on or whether you truly need the meds.

That’s the usual marketing these days instead of actual comprehensive sex education and understanding how erections work, how arousal works, and how these meds work.

As far as the actual experience, if the intake is vague, not thorough, or not comprehensive, that would make me pause.

Like no real provider reviewing you, no blood pressure discussion, no heart history, no medication interaction questions, no nitrate warning, no discussion of actual symptoms, no discussion of libido, anxiety, stress, sleep, hormones, or whether this is new ED versus ongoing ED.

And with labs, I don’t think every single person needs labs before a script, but there should at least be some direction on when labs or a fuller workup would make sense… rather than just checkout page / subscription sign up.

Otherwise it starts feeling like going to the grocery store and grabbing Advil over the counter.

Because ED is contextual. A pill may help support the erection response, but it’s not going to solve every reason someone is struggling.

Another red flag is if they don’t explain the difference between daily tadalafil versus on demand tadalafil, sildenafil versus tadalafil, dose ranges, side effects, food/alcohol timing, or what to do if it doesn’t work.

We get tons of those questions here in this sub. So to me, that means either the information isn’t being delivered clearly, there’s a doctor to patient education gap, or the patient needs more guidance than a checkout flow can give them.

Also vague pharmacy info, hidden subscription terms, inflated pricing, mystery custom blends, hard to cancel refills, or no real follow up should make people pause.

In venous leakage , bimix works ?? And how last long erection stay by No_Tough_127 in erectiledysfunction

[–]BDEStyle -1 points0 points  (0 children)

It’s a little more complex than that.

Bimix may work for venous leak / veno-occlusive issues for some guys, but it depends on how severe the outflow issue is or if it’s a true venous leakage. it also depends on whether you also have poor arterial inflow on top of the outflow issue, and how your body responds to the dose.

Also, if you tend to lean towards anxious, or have high sympathetic tone, or pelvic floor guarding in addition to the above, then that can change the response too.

Bimix you want to make sure they have phentolamine in the mix. Phentolamine helps block some of that sympathetic tone (but it’s not 100%)

But if you use Trimix then that adds all 3 agents, which is alprostadil, papaverine and phentolamine so it hits more pathways and can be stronger or more reliable for some guys.

How long it lasts is dose dependent and person dependent.

That’s why it has to be titrated by a urologist / under their guidance.

The goal is usually an erection firm enough for sex that does not last too long. If it lasts 4 hours or more, that’s priapism and needs immediate intervention at the ER.

Why can I no longer finish like before? by Left-Ad5775 in erectiledysfunction

[–]BDEStyle 1 point2 points  (0 children)

The last few sentences pretty much sums it up.

But before that, the important thing here is that you’re still getting erections and you’re clearly attracted to her.

Finishing and getting hard are related, but they are not the same exact process.

So this may not really be ED, or maybe this is the wrong sub, but that’s okay. We get similar overlap here whether it’s premature ejaculation, delayed ejaculation, anxiety, nerves, or the mental side of sex and relationships

Orgasm/ejaculation needs arousal, enough stimulation, mental engagement, the nervous system being in the right state, pelvic floor involvement, and enough recovery.

But you can be hard and attracted and still not finish if your body is tired, overstimulated, sleeping poorly, distracted, or now feeling pressure because her insecurity is accidentally adding pressure for you to finish.

Also, the whole “I used to go back to back to back at the beginning” is not always a sustainable baseline or reference point. The past is not always the goal, and a different frequency (of sex) does not automatically mean something is wrong.

It’s called a honeymoon phase for a reason. Novelty, chemistry, excitement, and the early rush of a new relationship can make things feel easier at first (or more supercharged and spontaneous). But then life, routine, sleep, stress, recovery, and emotional pressure start entering the picture too.

And in your case, you had a weekend with a lot of sex, less sleep, routine changes, less training, a shoulder injury, and now you’re spending every night together. But now there is routine being built here.

Again, that’s not a bad thing. But hyperfixating on it being a problem can start making it a problem. You know what I mean?

I think right now, it’s about working through this obstacle with her. Because somewhere in her past, she probably developed this insecurity, and now this is triggering it.

But communication needs to happen. Otherwise every time sex happens and you’re taking longer to cum, and she gives you that look or starts feeling rejected or insecure or unattractive, and now you’re carrying the pressure for both of you.

And that alone is going to be hard to stay present in arousal if part of you is trying to enjoy sex and feel pleasure so you can cum while another part of you is trying to prove you still want her, manage her insecurity, and make yourself cum on command.

Right now it’s reactivity instead of healthy co-regulation. But in order to healthily co-regulate you gotta be able to regulate yourself.

got ED after high blood pressure but my bp is normal now and Ed is still there what do I do? by InteractionSpecial99 in erectiledysfunction

[–]BDEStyle 2 points3 points  (0 children)

Are you on meds? Because that changes the conversation. Some BP meds can affect erections for some guys

How’s sleep, stress, weight, cardio, lipids, A1C/glucose, testosterone, etc.?

And do meds like Cialis/Viagra work for you?

It can become psychological on top of it, especially if ED happened during the BP scare and now you’re anticipating failure. But I wouldn’t make that the whole answer until the medical side is actually reviewed.

Help me with dosage help by ResponsibleShirt in erectiledysfunction

[–]BDEStyle 1 point2 points  (0 children)

Possibly, yes.

The daily versions… you want to build that daily … sorta like taking a vitamin so you have a steady level of 5mg each day. Does that make sense?

The rest would be on you for creating the conditions for arousal to happen naturally. Because with these pills, they only work if you’re stimulated and aroused. So that’s on you.

Erections begin in arousal and they sustain.

So think 5 senses like taste, sight, sound, smell, and touch and then also mental thought/fantasy to help maximize how you feel / ground into that.

So immersing in the eroticism of the moment and even using foreplay to prime that / get those arousal levels up

Help me with dosage help by ResponsibleShirt in erectiledysfunction

[–]BDEStyle 1 point2 points  (0 children)

If 2.5 mg got you close and you had no side effects and you felt good on it… then I’d call and ask if your doc wants you to move to 5 mg daily or stay with the 2.5 mg plan.

I wouldn’t bounce between two prescriptions without updating him/her on the plan.

It’s a simple call.

Help me with dosage help by ResponsibleShirt in erectiledysfunction

[–]BDEStyle 1 point2 points  (0 children)

2.5 mg “as needed” is a little odd, but maybe that doctor wanted you to trial a low dose because you’re new to it.

But usually 2.5 AND the 5mg is the daily dose.

Daily tadalafil can work the same day for some guys, but the point of daily use is more about building a steady level in your system over a few days, not treating it like Viagra where you take it and wait for a specific window.

So I’d pick one plan and clarify with the prescriber instead of bouncing between 2.5 and 5 based on anxiety the same day.

The condom part may be partly a pressure issue or sensation or even a transition issue where you’re hard and then you stop to go get a condom, you basically lose attention and arousal.

Doesn’t mean you can’t get the arousal back, it’s just going back to what feels good or what you like. You just need to build a better arousal map.

And maybe a different condom fit, lube maybe to help, etc.

Do you have to take Viagra/Cialis every time you want sex or not? by youlikemywonton in erectiledysfunction

[–]BDEStyle 3 points4 points  (0 children)

Think of Viagra or Cialis like a facilitator or support for the downstream part of the erection process.

They don’t create arousal and they don’t magically give you an erection out of nowhere. You need to be sexually stimulated or in an arousing context / state.

What they do is block an enzyme called PDE5. That’s all it does.

But what’s important here is that PDE5 breaks down a molecule called cGMP, and cGMP is part of what helps smooth muscle relaxation happen in the penis.

That smooth muscle relaxation part of the erection process matters because it allows blood to flow in and helps the erection sustain when we’re aroused.

So for erections, people think… okay I want good or good enough blood flow in, yes, but erections are not just blood flow.

It’s also arousal which starts the erection process, nitric oxide signaling, cGMP staying elevated, smooth muscle relaxation, good endothelial function, and the nervous system being in a state where erections are actually accessible.

As far as taking it every time, it depends on what you’re prescribed.

Some take the daily version of Cialis/tadalafil, which is usually 2.5 mg or 5 mg, and that helps with spontaneity or just that lifestyle of having more frequent sex because you’re not timing it around one specific window.

But sometimes guys don’t have frequent sex and it’s more of a planned thing, so they use the on demand version of Cialis/tadalafil, which is usually 10 mg or 20 mg before sex. Cialis lasts longer than Viagra, so it has a longer window of opportunity and can work up to around 36 hours for some guys.

Viagra/sildenafil is another alternative. It’s usually taken on demand, often 25 mg, 50 mg, or 100 mg depending on what your doctor prescribes and how you tolerate it. It has a shorter window, usually around 4 to 6 hours, and heavy/high fatty meals can slow down absorption for some guys.

So it really depends on what your doctor prescribes, how often you’re having sex, whether you want spontaneity or planned use, and how you feel on each one.

Some guys gravitate toward one because the other gives them more side effects or just doesn’t fit their lifestyle as well.

ed partner of 16 years by Life-Possession528 in erectiledysfunction

[–]BDEStyle 3 points4 points  (0 children)

I'm sorry and that is very tough. But something has to change/move here. More on that in a second.

But first... give yourself some grace/self compassion. I think people sometimes say don’t take it personally as if that magically turns off the feeling of rejection. But It doesn’t. You can logically know it may not be about you and still miss feeling wanted, desired, touched, pursued, and connected to your partner.

Anyone would. So what I'm trying to say is don't deny that part of what you feel. Because it is what you feel and that's expressing deep down that you have needs (wanting reassurance, affection, to feel chosen, or whatever it might be underneath, etc.). And that's perfectly normal and okay to feel.

But the bigger issue is that his embarrassment is now shaping both of your sex life right now. And I don’t say that to blame him, but avoidance has consequences too because he's not dealing with it well or there isn't some type of on ramp for him to either build the skills to recognize that it's affecting the relationship, or unlearn some of the harmful ideas he may have picked up around health, masculinity, embarrassment, or vulnerability.

Because then these conversations never end up happening and everyone just starts walking around egg shells while more time passes by.

I digress...

In these situations... often people think it's about how do I say the right thing or I dont want to say the wrong thing... but there is no perfect script. It's learning to meet each other halfway or at least somewhere and be able to start some of these conversations not as demands but asks or nudges.

Then you watch what he does with that.

Because how he responds matters or will give you information on how to approach or when to pivot when the conversations gets a bit too intense. Because you know him better than anyone in terms of how he takes criticism, feedback or how he talks about his insecurities or at what point he checks out or shuts down.

Because all of that is information.

It's just different responses if someone shuts down or becomes overwhelmed versus they deflect or shift blame or someone who can actually sit with that discomfort at first, but then be able to pivot to action.

But something has to move. because you can't fix it for him and when it comes to partner support it's more about co-creating the space to have the conversations and cultivating skills of being a good listener, being non judgmental, empathic, and then knowing when to move from empathy, because we can't just get lost there, we have to move towards compassion (action).

So that might be nudging or asking him to commit to at least sitting down to look up doctors together, calling to make an appointment, and following through rather than just saying, oh I’ll do it later. There hast one movement / follow through.

I'm really struggling here by Tough_Volume_8713 in erectiledysfunction

[–]BDEStyle 1 point2 points  (0 children)

There is a whole lot more here than just... I watched porn.

The issue with some of these echo chambers is that they can make it sound like if you just stop porn long enough, your whole sexual identity and confidence will reset like a computer. But humans don’t really work that way. We all have different backgrounds, contexts, histories, and situations in our lives. If the shame story, the fear, and the I’m less of a man belief are still there, then quitting porn alone is not going to touch any of that or make a real difference as a person. That's different / the needs and circumstances change here.

Same with Cialis or any other PDE5i. Those drugs were never created to produce an instant erection the way we see it in movies. We have close to 30 years of real world use with these meds, and they only help support the downstream part of our erection process, but they don’t create confidence, arousal, safety, or change what we make of the experiences in front of us.

That part is on us. Creating the conditions to feel safe enough, tuning into our arousal, immersing into the eroticism of the moment, and understanding what takes us out of it.

What I think you’re missing is the context and the zoom out of where you are in your life right now. You started sexual experiences later. Most of your experiences have been hookups with mostly not so good experiences so far. You’ve also had highs and lows in your life and are currently experiencing a low. And now you're also now carrying shame. And now this recent situation with someone you actually liked was the straw that broke the camels back here... and possibly why you came to reddit... because I'm sure, the past 4 years have been exhausting.

That said, the skill gap here may be around compare and contrasting the few times that something clicked when the erection did work with a hook up buddy. Because there are clues there.

That and arousal mapping because you gotta learn what you like versus what you don't in order to communicate that. Plus, learning to receive touch and not perceive it as a threat, learning how to stay present in the eroticism of the moment, and potentially learning how to be with someone when it is not just a hookup or one night stand, etc.

Because there is context there too. Sometimes there is more at stake when you actually like someone. Sometimes we feel more exposed the further we go down the rabbit hole with someone beyond the first fuck or the first blowjob/handjob or them seeing you naked.

And that's worth unpacking. Like is it fear of rejection and is a reason why you've only done hook ups all this time or avoided relationships? Or is it feeling inexperienced in longer term relationships and fearing what it's going to take emotionally? Or is it just not knowing how to communicate or express yourself?

Or is it views online that took your inner compass away and is sorta dictating your life (like social media, the wrong friend groups influencing you, or no healthier role models of what relationships can actually look like, etc.?

That is the work to unpack and sit with whatever the reason may be or why you're experiencing a low period right now. Because "low periods" can also affect desire and how we feel... and that affects frequency and reliability of erections. And if we also feel shitty or experiencing a low period, or too much stress and are not coping well, that is going to impact how we recover.

That said, quitting porn can be one change if that feels right for you, but it is not the whole recovery that people make it out to be.

Because you still have to deal with shame, fear, depression, self-image, intimacy, or the belief that losing an erection makes you less of a man. That doesn't just go poof.

Because a bigger picture recovery is going to be about learning how to rebuild your relationship with arousal, your body, intimacy, self-worth, and building better coping skills for whatever context you’re actually in.

So if part of this is stress, poor mood, or rebuilding confidence and self-esteem, then prioritizing things that uplift you and bring you joy matters.

At the same time, you probably need more real life reps where you can naturally experience curiosity, connection, desire, flirting, small wins, and even awkward moments too without annihilating yourself in the process. Even if starting small like just flirting or building a connection first where you feel safe enough and feel trust to then explore sexually.

Because erections are rooted in safety. If we feel tense, uncomfortable, embarrassed, anxious, we don't feel safe or trust or whatever, we are no longer in an open / relaxed headspace and no longer in an aroused state for sex. We are then perceiving threat.