At a crossroads as a young man (31) - How to psychologically prepare for the possibility of an implant?

[CuriosDK]

Hi all,

Long background so if you want to skip to the q's they're at the bottom.

I first posted here around a year ago. I'd been struggling with ED since I became sexually active at 24 (has since been an issue in all of my sexual experiences, all hookups), and linked it to performance anxiety. In January I got a doppler and it showed blood flow into the penis at a level 4 times lower than would be expected for someone my age, and blood flow out at suboptimal levels. The diagnosis was severe vasculogenic ED however I had my doubts as the anxiety of being injected and the experience as a whole dampened my ability to get an erection and the test was performed on a semi that was weaker than the erections I could attain on my own. The urologist said it was irreversible and tried to sell me shockwave therapy and then an implant, it seemed a little salesmany and a urologist I'd consulted before told me it shouldn't be considered so soon, so medically there was no consensus.

I decided at the beginning of the year to try every alternative route before making the decision. I started psychoanalysis, my therapist didn't explicitly say so but he was very much against the implant and said it was in my head but after six months of getting nowhere I stopped sessions. I quit porn. I've been routinely exercising. I was responding to 100mg Viagra and so used this and had mixed success. For the most part I can achieve an erection strong enough for penetration but its a struggle to get there and it's led to some confusion:

- All of these were drunken hookups. I'm not sure what effect the alcohol and lack of emotional connection played in having trouble getting erect.
- I've noticed I need constant stimulation to get an erection strong enough to penetrate. The issue with this is that the stimulation takes me closer to climax, so sometimes I'll have trouble getting it up, switch to foreplay whilst grinding/stimulating myself, then by the time I penetrate I end up ejaculating prematurely. Both ED and PE with the same woman in the same night is not fun.
- On the other hand I had one experience where I was staying erect just fine but couldn't finish in missionary, she suggested switching positions but when we tried I lost my erection and was unable to get hard enough to penetrate again.

Now I'm in erectile no mans land. I don't know if I get morning wood sufficient to penetrate or just morning semis. When I'm masturbating I lose an erection without constant stimulation and only feel fully erect (if its even sufficient for penetration) when I'm close to climaxing. If I do have physical ED I might have grown so used to this that I wouldn't even recognise how weak my erections actually are. Of course I have no erections to compare mine to so I'm clueless.

Perhaps its psychological and years of avoiding sex due to ED and never having been emotionally connected to my partner is the main issue. But I don't know if there is a resolution to that, therapy didn't work and whilst some women have been understanding at first, after staying limp and orgasming in a semi-erect state whilst they're left wanting a couple of times they've tended to lose patience. I don't want to spend more years wreaked with anxiety about ED which is getting in the way of me emotionally connecting to partners in the first place, but making an irreversible decision also seems daunting.

I'm now mentally preparing for the possibility of an implant and wanted some insight into how (especially younger) people have managed to bridge that gulf. Part of me feels as if it's a no brainer to resolve this issue which has already robbed my 20s from me, another part feels like I'm quitting and taking a shortcut when working on my self-esteem and mental health might resolve things, though this is hampered by the anxiety ED causes. Have a few q's on the psychological impact of getting an implant:

- For those of you who weren't entirely impotent (eg could masturbate, become aroused to the point of an erection however weak, etc) how did you bridge being disconnected from your arousal response? Not feeling the blood rush into your penis seems like a strange concept, how long did it take to overcome this, if you ever did?

- When (if ever) were you mentally sure an implant was the right move and not an impulsive reaction to an issue that may be otherwise fixable?

- For those who dealt with surgery and recovery on your own how did you manage the psychological toll of it all without support?

- For those of you who are younger are there any moments of regret about going bionic so soon?

- What else would you recommend I try before going down the implant route? I'm a heavy vaper and that's been linked to ED so I'm working on quitting that, also considering seeing a sex worker who has worked with psychosexual disorders before in a sober state with Viagra to have a pressure-off alcohol-free attempt at intimacy and see if that makes a difference.

[Old Guy]

Well, I'm not a young guy like you asked for, but here's my 2¢.

If you cannot get an erection using pills or injections, it's time for an implant. Yes, it is a final step, no going back.
As a young guy you shouldn't have to put your life on hold or go sexless because of a problem that can be fixed.
Prepare psychologically? Just knowing that after the surgery and you heal, you will never have an issue with erections. You will be able to have sex anytime and will probably outlast any female.
If the thought of needing a revision in 10-15 years is holding you back, implants should only get better with advanced technology in the future.
Vaping may be a small part of your ED, but I smoked cigarettes and weed for 40 years before my ED started. Not sure if there are any studies done connecting smoking with ED. My thought is yes, but long-term smokers only.

Good luck moving forward.

[FMLFML85]

- For those of you who weren't entirely impotent (eg could masturbate, become aroused to the point of an erection however weak, etc) how did you bridge being disconnected from your arousal response? Not feeling the blood rush into your penis seems like a strange concept, how long did it take to overcome this, if you ever did?

The arousal response was diminished before the implant, during ED. There is still engorgement post implant that provides stimulation. The skins nerves cells also provide stimulation as they are stretched during a erection/inflating. I can even feel tendons being used to suspend my erection like I did before the implant. I don’t have as much sensation as I did before I got ED but I still have several ques that I have a erection.

- When (if ever) were you mentally sure an implant was the right move and not an impulsive reaction to an issue that may be otherwise fixable?

Once the injections no longer worked. It was a comforting thought that I would get a implant once the injections stopped working, so when that time came I felt good about moving ahead with the implant.

- For those who dealt with surgery and recovery on your own how did you manage the psychological toll of it all without support?

I had some worries about complications but I also felt great about the surgery and functionality I gained right away. I was able to use it the 3rd day after surgery and I was thrilled.

- For those of you who are younger are there any moments of regret about going bionic so soon?

Regret I wasn’t normal and had to worry about something others did not have to worry about. But I also wish I had this done sooner because like you I had horrible psychological ED for years before my organic ED happened. What if i were able to preform during early years and not have to ever experience failure with women.

- What else would you recommend I try before going down the implant route? I'm a heavy vaper and that's been linked to ED so I'm working on quitting that, also considering seeing a sex worker who has worked with psychosexual disorders before in a sober state with Viagra to have a pressure-off alcohol-free attempt at intimacy and see if that makes a difference.

This is a personal question and I have a bias. Some will recommend you do shots until they don’t work. I experienced priapism for 24 hours before and it hurt so bad. I imagine I lost a lot of sensitivity from it. It wasn’t the only time I had it but it was a the worst. Other men report getting narrowing of their erections and internal scarring. IMO get a sex worker after you get implanted and know that your erection will work. Also work on your self imagine, fitness, stress. You should get to a place where you feel attractive and at a point of your life you would enjoy being with someone. Don’t train your dick to ejaculate from too much stimulation while soft.

I was 34 when I got implanted.

[AmansinCali]

Curios,

Like Old Man, I don't feel qualified to answer your questions, but for my situation the implant changed everything. I am 78 years old and have had a great sex life, when things began to fail, pills worked great, then injections which worked great too until they became unreliable.

I think the question you need to ask yourself is, what do I have if I don't get an implant, not what am I going to lose? It doesn't sound to me like you would be giving up a lot in exchange for something that does work with a 98% satisfaction rate. To my knowledge there are not any break-through technologies on the way that would make waiting a better choice.

I am newly implanted, 6 weeks out from surgery, and my wife and myself could not be more satisfied. At my 6 week check this week, my wife told the PA, "It's perfect, I couldn't tell he has an implant." Everything worked normally, penetration, orgasm and ejaculation while my wife had her orgasm. What more could I ask for?

The other thing the implant does for you, is make you feel like a complete man again. I think this would be very important to you because as I read your post you didn't sound real confident to me. If you get an implant you will know in your head that every woman you see you would know you could have sex with her until she cried uncle. That, I think, would change your entire outlook on life.

[wolfpacker]

I got my implant last year at age 31, was in a similar state as you, could still get erections but they were weak and faded quickly. Maybe could have sex with a semi erection for a few mins before it started to fade.

Now having the implant is awesome. I definitely still feel the blood rushing into my dick when aroused, that does not go away. The implant just keeps you hard when you would've otherwise gone soft after a few mins. Have had sex with a decent number of women since getting the implant, none of them knew about it or noticed it (as far as I know).

Your therapist doesn't know crap about whether it's all in your head or not. Even a urologist can barely determine the underlying causes of ED most of the time. Bottom line is: if your dick isn't working right and it's been in the same condition for years (ie not a short term transient state) and your lifestyle and sleep/diet and reasonable healthy, and you've tried the pills, only injections or implant are left. Don't waste your life away worrying about this, just get it it done and get back out there and start living.

[Lost Sheep]

tried to sell me shockwave therapy and then an implant, it seemed a little salesmany and a urologist I'd consulted before told me it shouldn't be considered so soon, so medically there was no consensus.
.

You were wise to follow your instincts. Shockwave is unproven with a spotty record of results which seem to be only temporary even when successful. If the urologist's conclusion that youth is a based solely on your age, that too is suspect. But it is based on a lack of compelling medical evidence, his recommendation (in my opinion) is sound.

I decided at the beginning of the year to try every alternative route before making the decision. I started psychoanalysis, my therapist didn't explicitly say so but he was very much against the implant and said it was in my head but after six months of getting nowhere I stopped sessions. I quit porn. I've been routinely exercising. I was responding to 100mg Viagra and so used this and had mixed success. For the most part I can achieve an erection strong enough for penetration but its a struggle to get there and it's led to some confusion:

Again, wise choices. Laying off porn, exploring psychological solutions, getting healthy exercise (aerobic deconditioning is a contributor to low blood flow which is the quintessential definition of vascular inadequacy in erectile function)

All of these were drunken hookups. I'm not sure what effect the alcohol and lack of emotional connection played in having trouble getting erect.

Alcohol is a killer for erections. A little bit can desensitize a penis so a man can maintain an erection (often by creating temporary anorgasmia, allowing extended stimulation without orgasm and the refractory period). A little bit more desensitizes to the point where an erection is impossible. Finding the "sweet spot" in between is a fool's errand.

Having an emotional connection with your partner is a powerful aid to erection. Also, having a partner who is emotionall conneced to and supportive of you is a tremendous aid. Not only to erection, but to the enjoyment of the experience.

- I've noticed I need constant stimulation to get an erection strong enough to penetrate. The issue with this is that the stimulation takes me closer to climax, so sometimes I'll have trouble getting it up, switch to foreplay whilst grinding/stimulating myself, then by the time I penetrate I end up ejaculating prematurely. Both ED and PE with the same woman in the same night is not fun.

- On the other hand I had one experience where I was staying erect just fine but couldn't finish in missionary, she suggested switching positions but when we tried I lost my erection and was unable to get hard enough to penetrate again.

That was my experience for decades. The window between enough stimulation to keep me erect and and less than the trigger level for ejaculation became narrower and narrower from my mid-20s to my mid-60s.

Changing positions was NEVER an option during the entirety of my sexual life. Early on, from inexperience, of course. Later because disengaging from my partner stopped stimulation and led to collapse and loss of interest on her part.

Now I'm in erectile no mans land. I don't know if I get morning wood sufficient to penetrate or just morning semis. When I'm masturbating I lose an erection without constant stimulation and only feel fully erect (if its even sufficient for penetration) when I'm close to climaxing. If I do have physical ED I might have grown so used to this that I wouldn't even recognise how weak my erections actually are. Of course I have no erections to compare mine to so I'm clueless.
.

Yep. Back when I was in my teens and mid-20s I had no idea I had ED. No valid comparisons. I attributed the stories I heard of other men's experiences to be braggadocio.

I thought I was NORMAL and the women I was with were either as clueless as me or did not tell me out of kindness. (All my relationships were pretty good in all other aspects than sex).

Perhaps its psychological and years of avoiding sex due to ED and never having been emotionally connected to my partner is the main issue. But I don't know if there is a resolution to that, therapy didn't work and whilst some women have been understanding at first, after staying limp and orgasming in a semi-erect state whilst they're left wanting a couple of times they've tended to lose patience. I don't want to spend more years wreaked with anxiety about ED which is getting in the way of me emotionally connecting to partners in the first place, but making an irreversible decision also seems daunting.
.

I never married. Perhaps sexual disconnection with my partners overcame emotional connection. I don't know. I hope that fate does not befall you. I encourage you to level with anyone you become physically intimate with. Women are incredibly supportive if they feel loved, trusted respected and safe. Count on that.

I'm now mentally preparing for the possibility of an implant and wanted some insight into how (especially younger) people have managed to bridge that gulf. Part of me feels as if it's a no brainer to resolve this issue which has already robbed my 20s from me, another part feels like I'm quitting and taking a shortcut when working on my self-esteem and mental health might resolve things, though this is hampered by the anxiety ED causes. Have a few q's on the psychological impact of getting an implant:

It became a "no brainer" for me when my ED was bad enough that penetrative sex was guaranteed failure. Fellation and cunnilingus sufficed for a very long time but I wanted rigidity again. And -here is the deciding factor for me- if the implant failed, I would not regret losing what little I had.
If you WOULD regret losing what you have now, perhaps waiting (and enjoying what you can do now-which is a lot more than you might think provided you have a partner who is supportive) is appropriate.

- For those of you who weren't entirely impotent (eg could masturbate, become aroused to the point of an erection however weak, etc) how did you bridge being disconnected from your arousal response? Not feeling the blood rush into your penis seems like a strange concept, how long did it take to overcome this, if you ever did?

- When (if ever) were you mentally sure an implant was the right move and not an impulsive reaction to an issue that may be otherwise fixable?

See the above discussion for those answers. Masturbation, fellatio (and the emotional and sexual connection that cunnilingus provides) were enough to bridge the disconnection between my partners and me. I was never disconnected from my arousal response - I always had that even when there was no erection. Feeling blood rush into my penis was never a sensation I detected. Feeling rigidity and the weight of my phallic wand waving in front of me was missed, though. It was never a question of overcoming that loss of feeling. I really only noticed it when it returned upon my implantation.

I was mentall sure (as I wrote earlier when I knew my erectile function was so slight that I would not miss it if the implant was unsuccsessful.

The certainty of complete 100% impotence after a failed implant was less disturbing to me than dealing with the uncertainty of "will I get hard or won't I?" So I was mentally prepared for either outcome. I had not a moment of doubt, either before on in the days after surgery (as many men have testified, "What the fuck did I DO to myself?") Not me.

- When (if ever) were you mentally sure an implant was the right move and not an impulsive reaction to an issue that may be otherwise fixable?

- For those who dealt with surgery and recovery on your own how did you manage the psychological toll of it all without support?

- For those of you who are younger are there any moments of regret about going bionic so soon?

- What else would you recommend I try before going down the implant route? I'm a heavy vaper and that's been linked to ED so I'm working on quitting that, also considering seeing a sex worker who has worked with psychosexual disorders before in a sober state with Viagra to have a pressure-off alcohol-free attempt at intimacy and see if that makes a difference.

- When (if ever) were you mentally sure an implant was the right move and not an impulsive reaction to an issue that may be otherwise fixable?
.

When I knew for certain that going forward was the only choice because going back was no way to have an enjoyable life. Asexuality was never an option. Oral sex or even masturbation would (most likely) still be available, going back. Going forward a couple more decades of penetrative sex was the right move, no matter the odds. I am not an impulsive man by nature and there were no viable other options on the horizon.

Implant is not a cure for ED. It guarantees 100% impotence for the rest of your life. It is tantamount to this

You can hobble a mile in 30 minutes on your natural feet. But if you amputate your ankles for prosthetics you can do a 5 minute mile.
But if the prosthetics fail, you are in a wheelchair until you get the prosthetics replaced.

So it is with the current technology with penile implants. You hobble through sex wondering if you will get to the finish line and always with great difficulty (both you and your partner troubled with the question, "will I get hard enough to orgasm? Will I stay hard enough for HER to feel good or perhaps to orgasm? If you hollow out your erectile tissues an install an implant, you can perform like a porn star. But if it fails, you are (coitally) useless (wheelchair bound) until a replacement.

- For those who dealt with surgery and recovery on your own how did you manage the psychological toll of it all without support?.

I had a supportive girlfriend to help me during recovery (changing bandages, cooking, etc) in the couple of weeks I needed to becomse self-sufficient after surgery. Still, with planning I could have done it alone. But it was a comfort and a blessing to have a helpmate.

I never had any psychological toll. I do not understand where your question comes from. Could you elaborate on what you expect or what prompted you to wonder?

- For those of you who are younger are there any moments of regret about going bionic so soon?
.

I don't meet your criteria for "younger" chronologically. But I think I do meet it in my self-image.

Never a second of regret or thinking I might have done it too soon.

- What else would you recommend I try before going down the implant route? I'm a heavy vaper and that's been linked to ED so I'm working on quitting that, also considering seeing a sex worker who has worked with psychosexual disorders before in a sober state with Viagra to have a pressure-off alcohol-free attempt at intimacy and see if that makes a difference.

The usual track is (please, kibbitsers, allow for some variation in the order. For omissions, please do comment.

Psychologial evaluation (this includes therapeutic sex surrogate therapy)

Physical causes; venous leakage, arterial insufficiency, hormonal imbalances such as testosterone, diabetes, blood pressure, poor diet or exercise routine, etc

Constriction rings to keep an erection whether induced by a VED (vacuum erection device) or natural stimulation

Oral medications (sildenafil, viagra, tadalafil, etc)\

Suppositories (e.g. alpostradil in the urethra)

Injections

Vascular surgery was, in the past, a treatment but has fallen out of favor. Look up "re-vascularization"

Implant.

DO NOT DISCOUNT the value of "coming clean" with a sexual partner. As I said before, women are INCREDIBLY supportive when they want to be.

Good luck on your journey. Be patiient. Find a surgeon who will accept you as part of your medical care team. (I took 14 months to find such a surgeon and do not regret that caution.)

[Juerhareb]

I got my implant last year at age 31, was in a similar state as you, could still get erections but they were weak and faded quickly. Maybe could have sex with a semi erection for a few mins before it started to fade.

Now having the implant is awesome. I definitely still feel the blood rushing into my dick when aroused, that does not go away. The implant just keeps you hard when you would've otherwise gone soft after a few mins. Have had sex with a decent number of women since getting the implant, none of them knew about it or noticed it (as far as I know).

Your therapist doesn't know crap about whether it's all in your head or not. Even a urologist can barely determine the underlying causes of ED most of the time. Bottom line is: if your dick isn't working right and it's been in the same condition for years (ie not a short term transient state) and your lifestyle and sleep/diet and reasonable healthy, and you've tried the pills, only injections or implant are left. Don't waste your life away worrying about this, just get it it done and get back out there and start living.

How did you get hard without them noticing?

[Captain1117]

Have you read Tangerine's two PDF documents?

[wolfpacker]

I got my implant last year at age 31, was in a similar state as you, could still get erections but they were weak and faded quickly. Maybe could have sex with a semi erection for a few mins before it started to fade.

Now having the implant is awesome. I definitely still feel the blood rushing into my dick when aroused, that does not go away. The implant just keeps you hard when you would've otherwise gone soft after a few mins. Have had sex with a decent number of women since getting the implant, none of them knew about it or noticed it (as far as I know).

Your therapist doesn't know crap about whether it's all in your head or not. Even a urologist can barely determine the underlying causes of ED most of the time. Bottom line is: if your dick isn't working right and it's been in the same condition for years (ie not a short term transient state) and your lifestyle and sleep/diet and reasonable healthy, and you've tried the pills, only injections or implant are left. Don't waste your life away worrying about this, just get it it done and get back out there and start living.

How did you get hard without them noticing?

Either use the bathroom and pump to 70% in there (dick can still go in my pants like this, and springs out nicely when she pulls my underwear down) or give oral and pump then, lots of different ways

[Juerhareb]

I got my implant last year at age 31, was in a similar state as you, could still get erections but they were weak and faded quickly. Maybe could have sex with a semi erection for a few mins before it started to fade.

Now having the implant is awesome. I definitely still feel the blood rushing into my dick when aroused, that does not go away. The implant just keeps you hard when you would've otherwise gone soft after a few mins. Have had sex with a decent number of women since getting the implant, none of them knew about it or noticed it (as far as I know).

Your therapist doesn't know crap about whether it's all in your head or not. Even a urologist can barely determine the underlying causes of ED most of the time. Bottom line is: if your dick isn't working right and it's been in the same condition for years (ie not a short term transient state) and your lifestyle and sleep/diet and reasonable healthy, and you've tried the pills, only injections or implant are left. Don't waste your life away worrying about this, just get it it done and get back out there and start living.

How did you get hard without them noticing?

Either use the bathroom and pump to 70% in there (dick can still go in my pants like this, and springs out nicely when she pulls my underwear down) or give oral and pump then, lots of different ways

Thanks for your answer. Can you hold it 70% in your jeans and still be in a bar for example? So that you dont have to go to the bathroom later.