20yo wondering if I have venous leak or psychological ED

[ScipioAlbanus]

Hello people, firstly it’s nice to be here with good hones people trying to help each other out. I have some questions on the symptoms of venous leak that cause ED. I will give some info on my problems and if anyone has experienced something similar I would appreciate your help.
Firstly, I notice that I have trouble remaining erect when standing up, but when I am laying on my bed I can get pretty good erections and have them last for some minutes with adequate physical stimulation.
Secondly, whenever I want to masturbate, it is very hard doing it while standing up, meaning with enough physical stimulation I slowly get erect but only get fully erect when I am about to ejaculate. As soon as I stop stimulating so I can stop ejaculation, my penis starts going flaccid again.
Thirdly, as for the psychological part of it, I wonder if it is so, since yes it is true that I have had failed intercourse before, but I actually never blamed it on ED, never even went through my mind (I would blame it on height since I’m pretty tall and one girl I tried having sex with was staying in doggy and I could put it in. I wasn’t fully flaccid but not enough erect for penetration, now that I reflect on it.) Second instance I was having sex and I would get hard with oral sex but when she would stop and I would get up to penetrate my erection would get weaker (I would still penetrate though).
I would ask if anyone has experience with this if they can help, since one doctor I went to insists that it is psychological, but I am not quite sure. If anyone has had a similar experience I would love to hear your thoughts.
And btw, all the times that I’ve tried or had sex with the women I mentioned before, I was very relaxed, had little to no performance anxiety or stress, and tbh I’ve never been really hooked that much into porn, but even if I was , that would mean that I would get erections from porn, but unless I’m laying on my bed and give it some physical stimulation, very small movement happens.
Much love to everyone and keep up the fight and brotherhood.

[ScipioAlbanus]

And I forgot to add, I am really considering an implant.

[Lost Sheep]

Implant is the "nuclear option". The operation to install the device pretty much guarantees you will never have another spontaneous, natural, organic erection ever again for the rest of your life.

Try less invasive remedies first.

You doctor seems uneducated about E.D. and sexual function problems. "It's in your head" is an old trope, now widely known to be misleading or downright wrong in a larger percentage of cases than it has been applied to in the past. Try to find a urologist who specializes in male sexual function. You may have to interview multiple doctors.

Once you have a doctor who knows what's what, you can actually get real, valid opinions.

I did research on line, reading medical journals (peer-reviewed, legitimate, not popular magazines, etc and not the wild advertisements and come-ons you will certainly be inundated with as you start your search). After experiencing months of sexy advertisements that were no help at all for solid information I found FrankTalk. One of the few places one can get reliable information and advice.

My primary care physician remarked to me once that I knew more about E.D. than he did. It was REALLY GOOD to have him as an ally and advocate when it came time to seek authorization for treatment.

Good luck. Don't give up. But do try oral medications and even injections or suppositories before an implant. There is research going on all the time that promises an actual cure and not a mechanical treatment. Having an implant is like amputating a poorly functioning foot in order to get a prosthetic foot. The prosthetic may work better than the bad natural foot, but if your own foot still works at all, it is probably better to keep it. Your foot (or penis) may get better with treatments, but not if it is amputated or damaged (as the implant does to your corpus cavernosum).

[WhiteCane]

The difference between your ability to get erections and maintain them between a prone and orthostatic position kind of points to this being physical… what kind of shape are you in? Are you on any medications that could affect your erections or alter your blood flow? Antidepressants, alpha blockers? Do you drink enough water? you can answer these questions to yourself… you seem like you have a good mindset on top of all of that stuff… I would definitely talk to a urologist who specializes in erectile dysfunction and fix things sooner than later… Best of luck, my friend! Welcome to the site, by the way!

[Greg1956]

The symptoms do sound like they could be a VL. I had similar issues and after years of many doctors telling me it was in my head or only wanting to write out prescriptions, I finally found a doctor who actually listened to my description of the issue and sent me for a Penile Doppler Test and it confirmed a severe VL.

Erections with VL’s are often position dependent. I was only able to get hard while flat in my back and with very little moving around. You may have a different issue, but symptoms are very reminiscent of my own.

I suggest you seek another opinion. Do not go to a Primary Care Physician or even a Urologist who has a general practice. Look for a Doctor who specializes in male sexual
dysfunction. They are the ones with specific knowledge in this area.

Best wishes. Stay strong and stick with it to find a solution. Hopefully you will not have to go the route of an implant yet, but if you do it can be a beautiful thing. I have had mine over two years and love it. It is great to know I can get hard and stay hard whenever I want to. It is a true ego boost and confidence builder.

[oneperson]

As some mates has pointed, the descriptions of your sympthoms go in the VL direction. Every ED has a phycological component. But this component, though can be the root cause of some ED's, normally is a consequence of other factors, and contributes to make ED worse. So lets say a person has an ED of score 6 over 10 caused by physical factors. The psycological component can make it score up till 10, but the root cause is physical.

According with symthomps you describe, I would say there is a 80% chance that you suffer a VL. The degree of severity, that is something your doctor and a doppler eco have to determine.

If your doctor tells you that your ED is psycological without making tests (blood analysis for testosterone, doppler eco, etc), go to another doctor.