Relax during your first sexual experience: Overcome premature ejaculation and erectile dysfunction caused by tension.

**Part 8**

**Relax during your first sexual encounter.**

**Case Study**

**Name: Feng Shan (pseudonym), 28 years old**

**Region: Beijing**

**Occupation: University Teacher**

Feng Shan is a handsome 28-year-old university teacher. Three years ago, he met a girlfriend, and as they got to know each other better, they began having sexual relations. His first sexual encounter was marked by extreme arousal, but to his dismay, he ejaculated before penetration, leaving his partner unsatisfied. After that, he felt tense during every sexual encounter; it seemed the more he tried to control ejaculation, the faster it occurred. Later, he even struggled to achieve an erection, or if he managed to get one, it wasn't firm enough for penetration. His girlfriend frequently blamed him and broke up with him, citing disharmony in their sex life.

Now, Feng Shan, whose job is relatively stable, is married. However, his erectile dysfunction has not improved; he often cannot penetrate or becomes flaccid before ejaculation. He is very distressed and worries that if this continues, his marriage may not last. When discussing his lifestyle, Feng Shan mentioned that he occasionally masturbates and experiences good erections during masturbation.

Zhang Guoxi, Deputy Chief Physician of the Department of Andrology at Peking University People's Hospital: Cases like Feng Shan's are common among our patients. Most men's first sexual experience ends with either inability to penetrate or premature ejaculation. Some men ejaculate without an erection or with an incomplete erection, often due to excessive tension. Over time, as the couple deepens their understanding, their sexual life gradually transforms from unsuccessful to successful and becomes harmonious.

Some men also experience the same problem as Feng Shan: excessive worry about sexual failure, leading to anxiety during sexual activity. If the woman blames them, it only exacerbates the situation. The heavy mental burden and guilt towards the woman not only affect the man's sexual desire and erectile function but can also cause premature ejaculation, where ejaculation occurs almost immediately upon achieving an erection.

Anxiety is an excessive focus on a particular phenomenon or undue worry. Why does it affect sexual function? Medical experts have conducted extensive research on this. First, anxiety can affect sexual function through the nervous system. Nervous system excitation causes vasoconstriction, just as anxiety can raise blood pressure and increase heart rate. Vasoconstriction in the blood vessels controlling the corpora cavernosa of the penis leads to difficulty in penile engorgement (i.e., erectile dysfunction) and faster flaccidity. Furthermore, recent studies have shown that anxiety can also increase blood concentrations of glucocorticoids, which can inhibit the production of androgens by the testes. Although androgens do not directly stimulate erections, long-term low androgen levels have adverse effects on libido and erectile function.

Based on Feng Shan's medical history, his erectile dysfunction is clearly related to the failure of his first sexual encounter. Since he experiences strong erections during masturbation, at night, or in the morning, we can conclude that his erectile dysfunction is psychogenic, caused by anxiety. So how do we address this erectile dysfunction? The primary measure is stress reduction, which requires cooperation from both partners. A man's erection is influenced by many factors, and occasional failures are normal. The woman should offer understanding and encouragement to build the man's confidence.

For men with severe anxiety, medication may be used as an adjunct to help build their confidence. For those with a short duration of anxiety (such as newlyweds), Viagra-like medications can be taken temporarily, with the dosage gradually reduced or discontinued depending on the condition. If the illness has been present for a longer period and Viagra alone is ineffective, anti-anxiety treatment may be considered if the patient is excessively anxious.