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Wednesday, July 23, 2014
Erectile Dysfunction (ED)
Cycling and ED
I am a 27 year old male, 6`4", 167 lbs and in excellent health. For the past two months, I have been unable to achieve a full erection. At times I become partially erect, but in the past I would achieve erections regularly and often spontaneously. For religious reasons I am not sexually active and I generally do not masturbate (although I have in the past, as recently as a few months ago).
To ease my anxiety about the issue I have tried to give myself an erection, but with no success. About 6 weeks ago I tried unsuccessfully to give myself an erection through manual stimulation, although I did have an orgasm and I became semi-erect at the moment of ejaculation.
I believe (but am not sure) that the onset of the problem was sudden. Additionally, I have been under a great deal of stress and anxiety concerning the issue, and my drive seems to be diminished, which I suppose would limit my ability to achieve an erection. Because of this, I suspect the issue is psychological. However, there are a few factors (including the experience mentioned in the previous paragraph) that make me worry that the problem may be primarily physically.
First, I am a competitive cyclist and have been for approximately 5 years. Although I am careful to avoid discomfort, numbness is a part of the game. I fiddle with my saddle position and try to stand when I feel I need to relieve pressure. Sometimes I become mildly uncomfortable, and sometimes I become completely numb, although the numbness goes away quickly. Also, I experience a great deal of shrinkage, which I always assumed was caused by the often-sweaty lycra shorts, but I recently read that this is an indicator of limited circulation.
I consulted with my physician, who is a friend through cycling, and I visited a urologist. Neither suspected that cycling played a role in my problem, and both were convinced that the problem is in my head. However, I do not experience morning erections, which I am told is a sign of physical problems.
I have also tried to test for nocturnal erections, by placing a ring of paper around my penis at night and seeing if it is broken in the morning. It usually breaks, but not always, and it hasn`t broken for the past few days. This increases my anxiety, because I`m told that I should have multiple erections while I`m sleeping, and it seems like sometimes I have none.
My questions are the following. Is it possible that I have slowly and gradually done damage to my nerves or arteries by riding a bicycle. If it is possible, is there any way to conclusively diagnose such damage? And would such damage be permanent? If reversible, would it go away on its own if I quit riding, or would it require surgical intervention.
Secondly, is it possible for psychological issues to affect both night-time and morning erections? Or does a lack of both conclusively indicate a physical problem.
Finally, do decreased drive and urges prevent me from achieving an erection, or does the inability to achieve an erection suppress my drive and urges? Perhaps it`s a silly chicken or the egg question, but it seems relevant.
Thank you in advance for your help
You have brought several excellent points about your sexual dysfunction and you appear to be very knowledgeable in the topic as well. But based on your history I have to admit I favor psychological cause for your erectile dysfunction. Having had no sexual relation with any partner also adds to your agony of not knowing how you would do if it happens one day. To give yourself a piece of mind there are several test that can be done to assure the arterial circulation is intact. It is done by ultrasound of the cavernosal arteries before and after intracorporeal injection of PGE1.
It is true that one of the causes for erectile dysfunction is arterial occlusion but the role of bicycle seats are very debatable. Irwin Goldstein, who publicized the event no longer talks about it. The sudden onset of your problem also indicates psychological cause as arterial insufficiency is a gradual event. You do not need to stop your sporting activities but try to overcome your religious misunderstanding.
Ahmad Hamidinia, MD
Formerly, Professor of Clinical Surgery
College of Medicine
University of Cincinnati