Why am I able to get nocturnal erections?

I’ve had PFS for nearly 4 years and for that time I have had a 0% libido with no spontaneous erections. I can get an erection through stimulation but it is weak and short lived - pretty much the run of the mill sexual sides.

Despite this, I still am able to get nocturnal erections which are much more similar to my pre-PFS erections. What is the explanation for this discrepancy? Does this rule out penile tissue damage for me? Does it point to a problem with dopamine or androgens?

Same here.
I had mostly no nocturnal elections for the first 2 months.
I’m now getting consistently except for a few odd nights.

Is your penis shriveled up when flaccid?

I can’t answer your questions but when i get morning wood let’s say, it is like, it is hard but not on its full capacity. Feels like something is restricting its full potential to occur. Also it feels kinda “tight”. Like as if blod is trying to break out some clogged veins but can’t. Before PAS my erections were harder and bigger yet felt “soft”. If that makes any sense.
Probably bloodflow related. We don’t know the exact mechanism.

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No I’d say the whole package is pretty loose hanging, but just complete disconnect. Almost like rubber.

I get nocturnal erections but never morning ones

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Same here…

Same. I wish we had some insight into this. Presumably if our vascularity or tissue was fucked, we wouldn’t be able to get any erections. I’m aware that the hormonal paths are different between sexual erections and nocturnal ones, but surely there can’t be anything wrong with the tissue if it can sustain an erection.

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I have this as well dude. I get morning erections definitely not as strong to the point of pain or last until I get up and take a slash, but they’re there and stronger than anything I can muster up later in the day (lots of manual stimulation very weak).

Can I ask if anyone with erection issues doesn’t have sensitivity issues? I think I’m one of the outliers in that my penile sensitivity all seems to be normal my dick just won’t react to anything.

wtf, I have the same. So weird.

Interesting to see many experience the same issue.

That points out that brain dick connection is lost and mostly related with dopamine or dopamine serotonin balance.

I am like you i always have nocturnals some times hard sometimes soft but i had them. One day i woke up with solid boner and as soon as i gather consciousness i lost it. Which points out brain problem caused by neurosteroidal or dopamine imbalance…

It’s true. When the mind wake up the erection morning going down.

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What do you need to take to fix that? Dopa mucuna, etc?

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I don’t think it’s as simple as dopamine/serotonin balance or Wellbutrin would fix us all. Plus I’ve taken ssris and seen no change

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Did you guys notice any improvements in your libido / erections over time?

Could it be possible that there are 3 types of PFS

  • Just hormonal imbalance
  • Something wrong with receptors or something else
  • Combination of both

Some people have near-complete / complete recoveries within a year. I’m assuming these type of people fall under the first bucket.

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I don’t even know if I’d call a hormonal imbalance, PFS. The cases that look like hypogonadism and resolve from those standard protocols are certainly something else. Most the folks who don’t get better have perfectly fine hormonal levels, so my guess is something receptor level or neurotransmitters, potentially mediated by epigenetics. I think that there can also be secondary detriments from being deprived of these normal processes too.

Ultimately though, we have no clue and may never. Acceptance has been the route of taken at this point. I’d like to get better no doubt, but need to reorient my life to the possibility I won’t. I do acknowledge I say that from a place of relative privilege though because most of my sides have been sexual apart from gyno that I am getting removed in a couple weeks. Some people are much worse off and my heart pains for them.

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Not necessarily, I think dopamine imbalance is the end point, it probably started with altered neurosteroid production which modulates GABA glutamate system that disturbs serotonin system and in the end you get broad range of imbalance.

Also I used methylphenidate, it solved lots of brain fog issues, depression and low libido but no help on ed.
My best solution for ed was d2 agonist cabergoline.
It worked way more better than 20 mg cialis, most of Erection and low ejaculation problems solved plus I got immediate restoration on brain dick connection, May be even dopamine receptor expressions were altered who knows…

When you take mph or Wellbutrin it enhances whole brain dopamine transmission almost same level for D1 like and D2 like receptors plus it increases noradrenaline which is not good for erections possibly blocks pro erectile effect of dopamine blockade. So when you take mph or bupropion your libido goes high but not erectile function.

Also mingling dopamine receptors are not good if you saturate them unnecessarily and if this causes a up regulation, normal orgasms will become dull and pleasureless or you will lost your will for sex and might feel anhedonic.

Any way I think root cause is different but out come possibly same for pfs , pssri or accutane victims.

May be we all have some undiscovered genetic susceptibility for this imbalance and finasteride triggers it.

I am really hopeful that I have a compound that restores brain dick connection.

Some member posted this worth checking

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I’m glad to hear that is working out for you! Unfortunately my doctor won’t prescribe me methylphenidate, so that’s not an option for me.

Good to hear, so your libido was fixed witht his?

Absolutely yes but I wrote in several posts if you take it first hours it kills erections unable to get it up or maintain it even with cialis after several hours it wears off Libido effect remains for a day then you get good erections and decent libido. I discovered this effect very late I thought mph was good for libido and bad for Ed. It seems time depended if anyone uses it and complains about erectile function try my way take it in the morning and have sex in afternoon or night.