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Urology/Erection, pelvic floor?


I have had low libido lately and the problem is that It's hard to keep an erection especially when standing and masturbating. I think that's because I'm not aroused enough. I have a habit of squeezing my legs, stomach and pelvic floor muscles to make me more aroused and to orgasm more easily and to make an erection stay more easily.

When I'm standing up and I masturbate, I have to constantly squeeze my legs, stomach and pelvic muscles or otherwise my erection fades away and I think it feels like my arousal fades away as well if I dont squeeze them. It's as if I dont suddenly feel any arousal at all.

I had good erection with 5mg Cialis couple of weeks ago when I was with a woman and I have had some morning erections. I even think I stayed erect at least 7 minutes couple of days ago when I took time, but at that time I was lying in bed and I'm not sure if the erection was 100% all the time. Might have been between 80%-100% I can masturbate to orgasm but usually I have to constantly stimulate my penis that it stays erect and usually it takes less than 5 minutes.

So my question is: is it possible that I might have venous leakage? Could it mean that squeezing those muscles and body parts might help the leak somewhat that I can stay erected but on the normal situation - when I dont squeeze them - I would still have the leak? Or is this just my bad libido? On another words, is it possible that by squeezing your pelvic muscles, legs and stomach you could somehow overcome the venous leak and stay erect better but without doing this you would have the leak?

Thanks for your reply!


Venous leakage is possible but unlikely from the available information.  Since it makes little difference in the prognosis or treatment, it's mostly an academic question anyway.

True venous leakage is not amenable to squeezing any muscles or anything else you can voluntarily do.

Low libido can be due to depression, low testosterone level or performance anxiety.

You should talk to your primary physician or consult a local urologist for more help.  If the Cialis worked well for you, I see no reason you can't continue with it.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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