Performance anxiety: Perhaps the most common cause of erectile problems among younger guys is performance anxiety. Many cultures place pressure on men to be the "experts" when it comes to sex, which can make men feel like they have to be responsible for sex or know how to please their partner every time. This pressure can be stressful and make it more difficult to get or maintain an erection.
Some men experience erectile dysfunction as a result of physiological factors, including medications that can interfere with sexual response, chronic illness (e.g., heart disease, high blood pressure, diabetes), physical disability, alcoholism, drug use, or injury that impedes blood flow to the erectile tissue. High cholesterol, which can limit blood flow through the atreries that supply the genital area, can also be associated with erectile dysfunction. For others, psychological concerns, including stress, anxiety, self-esteem, or fatigue are the source. Researchers believe that for many men erectile dysfunction is caused by a combination of physical, psychological, and cultural factors.

How do you know if you are suffering from erectile dysfunction?


Some of the most reliable ED stats have emerged from a large data collection effort called the Massachusetts Male Aging Study. According to that data, rates of ED among men tend to correlate with their age bracket, says Tobias Köhler, M.D., chief of the Division of Male Infertility at Southern Illinois University. “Roughly 40 percent of men in their 40s suffer from ED, 50 percent in their 50s, etc.,” he says.
It’s important not to take a bout of psychological ED personally. Still, when confronting a suddenly soft penis in the moment, “It’s not you” can be hard to believe. For instance, Erin, 22, tried—really tried—to make sex with Drew* happen. The first time his erection died right before they were about to have sex, she improvised and gave him “really long” oral instead. But the lack of a boner was confusing. “That had never happened to me with a sexual partner, so I was like, ‘Okay, he’s just not into me,’” Erin recalls.
Don’t approach sex like a race. If you struggle with losing your erection quickly, you might be used to speeding things up. That’s counterproductive, though. Work on slowing things down and don’t be afraid of what happens in your body. By slowing down, you’re retraining your body to expect something different from sex. Right now, your body probably expects to climax in a very short period of time. If that’s not what you want, you have to train your body to take a little longer.

What's the best alternative to Viagra?


Both James and Michael fit the profile of millennial ED: healthy men with functional penises who experience occasional deflation for psychological reasons rather than mechanical issues (the latter of which typically plagues older men). Researchers and the medical community are aware of this specific problem facing younger men, says Landon Trost, MD, a urologist at the Mayo Clinic.
The reversal of an erection is obviously necessary, but as Dr. Michael Reitano, physician in residence at Roman explains, this can be the impetus for weaker erections. "Usually there is a balance between the chemicals that result in the increased blood flow that results in a firm erection and the chemicals that allow blood to exit the penis and return it to being soft," he says. "That balance is precise and occurs in a sequence that allows an erection to last only as long as needed. However, in someone who experiences a softer erection, the balance of the chemicals that make the penis hard and the chemicals that return it to being soft is off. The scale is tilted."
The American Medical Association (AMA) estimates that more than 30 million men in the US experience ED. And they expect that number to double by 2025, largely due to the fact that erectile dysfunction is affecting more and more guys in their 20’s and 30’s. ED in your 20’s is becoming more common, and that can signal some serious health risks to a growing number of young men.
From a medical perspective, your semen packs a pretty incredible punch. Within the 2 to 5ml of semen (AKA your ejaculate) that you yield every time you ejaculate, there contains around 20 million spermatozoa (your moving sperm), each roughly 50 millionths of a metre long. If you can’t picture this, just think back to your childhood when you stared at the tadpoles in your garden pond. That’s about the gist of it – except much, much smaller. Of course, your spermatozoa are not alone in your semen, having for company complex enzymes and fructose sugars that help your swimmers, well, swim and survive for longer.
The third tip for how to keep an erection longer is to frequently switch positions during sex. You’ll like some positions, but hate others. Keep mixing it up. Return to the ones you like every so often, but spend just as much or even more time in the positions you don’t like. As long as the positions aren’t painful for either you or your partner, doing this will lengthen your erection.
Avoid cholesterol and high blood pressure: high blood pressure and high cholesterol damage the blood vessels and that doesn’t exclude those blood vessels to the penis. This can lead to the issues of ED. Make sure your doctor keeps an eye on your blood pressure and cholesterol levels. One can also get a check of their blood pressure during the visits to their physician as part of a regular checkup.
Despite some very recent legislative changes, opioids—ultra-strong narcotic painkillers—have never been more popular. According to the newest stats from the Centers for Disease Control and Prevention (CDC), enough opioid prescriptions are written each year to stock the medicine cabinets of every single adult in America (with plenty left over for teens, too). “These types of narcotics suppress testosterone levels,” says Dr. Köhler. That means they also mess with your hard-on. So does smoking, drinking a lot of booze, and any other bad habits that hurt your heart and/or vascular function.
Relationship problems often complicate erectile dysfunction. Improving your relationship may be part of the solution. It may be a good idea to get counseling together from a sex therapist, marriage counselor, or a medical specialist. "I almost always see couples together to discuss erectile dysfunction. It often turns out that both partners have issues regarding the sexual relationship and once they are out in the open, couples can work together on a more satisfying sexual experience," says Feloney.
Francis,*, 42, had ED for 11 years before he decided to seek treatment a few years ago. At first, he didn't even realize that he might have ED. "I thought I was either depressed or that I had lost interest in my girlfriend at the time," he said. But when the problem persisted, he realized it was preventing him from having sex with his partner, who often taunted him for struggling to maintain an erection.

Stiffy Solution: Obviously, no one should ever go off a prescribed med without consulting with a doctor. But there are erection-friendly alternatives to nearly every daisy-wilting medicine listed above. And your dude shouldn't let embarrassment keep him from talking to his GP about this — doctors are well aware that erectile difficulties are a possible side effect for all of these medicines; they just don't know which patients will experience what side effects, so they're waiting for you, the patient, to bring it up.
There is no evidence that mild or even moderate alcohol consumption is bad for erectile function, says Ira Sharlip, MD, a urology professor at the University of California San Francisco School of Medicine. But chronic heavy drinking can cause liver damage, nerve damage, and other conditions -- such as interfering with the normal balance of male sex hormone levels -- that can lead to ED.
If he's over 40 and not the most healthy, then years of "bad habits" could have provoked the incident; lack of exercise, shitty eating, alcohol abuse, drugs, tobacco, all damage our blood vessels. The same exact blood vessels that take the long juan from 6 to 12. Plus, you guys were taking a hot bath together, which also thins blood. So, right off the bat, there are six different variables you have no control over. If his exterior his A-ok, then lets dig deeper...
Erectile dysfunction is no laughing matter. And although it is not an easy thing to talk about, there are trained professionals who can give you good advice about what may be the cause of your current predicament. Many men like to talk about sex, but like women, they may find it harder to talk about sex when it is not going well. You won’t be judged or talked about at BPAS. We are here to help you with some of the more private things in life.
Evaluate surgical options. If the other treatments have not proven successful, your doctor may recommend a surgical procedure that will involve an inflatable penile prosthesis being implanted into your penis. Typically a pair of inflatable cylinders are inserted into the penis, which can be pumped up and deflated using a connected device that is inserted into the scrotal sac.

Another clue it’s psychological: He starts going soft around the same time your commitment level has shifted. In fact, sudden ED happens so often among newlyweds—there’s the pressure of becoming a married man plus, hi, the expectation of amazing wedding-night sex, says Dr. Trost—it even has a name: honeymoon syndrome. And a study published in the journal Translational Andrology and Urology found that once a guy’s sexual confidence takes a hit, he can get anxious about it happening again, and all that pressure creates a vicious cycle of erection fixation.


Medications. There are several different ED medicines that can help produce an erection, such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). These medications work the same way: they relax smooth muscle and allow increased blood flow into the penis. Testosterone replacement and medications injected directly into your penis to help with erection are also common.


Francis,*, 42, had ED for 11 years before he decided to seek treatment a few years ago. At first, he didn't even realize that he might have ED. "I thought I was either depressed or that I had lost interest in my girlfriend at the time," he said. But when the problem persisted, he realized it was preventing him from having sex with his partner, who often taunted him for struggling to maintain an erection.
So not only are erectile problems common, they're nothing for you or your special friend to be freaked out about. Check out the nine most common reasons that dudes sometimes can't get it up, and get ready to become the soothing voice of reason the next time the guy you're with has a hard time pitching his tent in your happy valley. Everything (and every penis) is gonna be fine!
In the long term, the best thing you can do for ED problems is “stay playful and keep the focus off getting your partner erect,” says Goldberg. Experiment with new erotic scenarios and situations, like having sex in a different room, wearing lingerie, or role-playing your fave fantasy. Oh, and don’t limit yourselves to just intercourse either (which applies to all couples, whether or not you’re dealing with ED). “The broader your definition of sex,” Goldberg says, “the more sex you can be having.”
Relationship problems often complicate erectile dysfunction. Improving your relationship may be part of the solution. It may be a good idea to get counseling together from a sex therapist, marriage counselor, or a medical specialist. "I almost always see couples together to discuss erectile dysfunction. It often turns out that both partners have issues regarding the sexual relationship and once they are out in the open, couples can work together on a more satisfying sexual experience," says Feloney.
Then, to rewind and reset the mood once you’re between the sheets, Goldberg suggests setting aside time for strictly fooling around. Try “sensate focus,” a sex-therapist favorite in which you and your partner majorly slow down your foreplay, focusing heavily on the sensations that feel best to both of you. “This helps make being physically intimate more of a relaxing, sensual, and erotic experience,” Goldberg says. And it helps his body disassociate sex from the stressful experience of losing his hard-on, which can help put a stop to his erection fixation and prime him for full-on intercourse again.
Like going bald, ED becomes more common as men age. According to the National Institutes of Health, about 5% of all 40-year-old men have ED and that number rises with age. Between 15% and 25% of 65-year-old men have ED. This is one of the reasons you see so many ED drug commercials during televised sporting events, Fox News programs, and other shows that typically attract men over 50 (just kidding, Fox).

Though few things are worse for your erection than a cigarette habit, coffee can actually help you out below the belt. A study by the University of Texas Health Science Center at Houston found that men who consumed the caffeine equivalent of 2-3 cups of coffee per day were less likely to suffer from erectile dysfunction than those who preferred to wake up with caffeine-free beverages.

Can I Get Viagra over the counter at Walmart?


If this scenario sounds familiar, you're in good company. "In an ideal world, strong erections would come simply and naturally," says Caleb Backe, health and wellness expert at Maple Holistics. "However, due to a myriad of reasons, erectile dysfunction can set it at any given time or for a prolonged period of time for a large part of the male population. It is estimated that as many as 30 million men in the United States alone suffer from ED."
Relationship problems often complicate erectile dysfunction. Improving your relationship may be part of the solution. It may be a good idea to get counseling together from a sex therapist, marriage counselor, or a medical specialist. "I almost always see couples together to discuss erectile dysfunction. It often turns out that both partners have issues regarding the sexual relationship and once they are out in the open, couples can work together on a more satisfying sexual experience," says Feloney.
You may already know that lots of hard drugs — like cocaine, heroin, or Oxycontin — can cause sexual problems (though, quite frankly, if you're on cocaine, heroin, or Oxycontin, you have many more pressing concerns to deal with than getting dirrrty). But did you know that sometimes, even pot can inhibit erections? And you thought weed was just a harmless way to enjoy the musical stylings of Pink Floyd. Who knew it could actually mess with one's own pink floyd?
It may be that after trialling all the above, including the little blue pills, you are still having challenges. There are always other options. The only issue is that they tend to move further away from science, proven efficacy and fact and more towards anecdotal evidence and illegitimate science, all while preying on a natural desperation to find a solution. I would say, if you are at this stage, go and see your doctor to discuss a referral to see a urology specialist. It may spare you dabbling, unsuccessfully, with the various less-proven methods, including:
If the problem is physical, there are numerous treatments available, such as penile injections or penile revascularization surgery, which increases blood flow to the cavernosal artery of the penis. There are also medications like Viagra, Cialis and Levitra, but Lehmiller cautioned men with erectile difficulties not to self-medicate without seeing a doctor beforehand due to the potential negative side effects associated with such medications (such as chest pain or shortness of breath).
“Studies looking at men under 40 with ED have found certain psychiatric conditions, like depression and anxiety, at a higher rate than other groups,” Trost says. And as he explains it, anxiety and depression—two things millennials experience at uniquely high rates—can make it more difficult for a man’s brain to respond to arousing stimuli, which can cause a low sex drive or issues getting an erection.

"On the physical side of things, we most prominently have physical fitness as the No. 1 factor in erection achievement and sustainability," he continues "If a body isn't healthy, it's going to labor to send blood flowing properly and to function in many respects. Much like a car in need of a tune-up, a body which is out of shape or overweight is going to labor to perform functions — like causing an erection."


"I like to recommend that couples think outside the box," Dr. Hartzell said. "Intercourse doesn't always have to be the goal; look at sex as pleasure oriented vs. goal oriented." She suggested couples incorporating oral sex and manual stimulation into their bedroom routine. She also advised couples to "have fun" with their sex lives by not adhering to a specific schedule or routine: One woman she works with, for instance, leaves her partner's injection on her pillow as a subtle signal that she's in the mood to have sex.
A dating death sentence: How men perceive their ED issues also changes with age. With older men, "they've had a life of good erections to look back on," Rose Hartzell, Ph.D., EdS, an AASECT-certified sex therapist with San Diego Sexual Medicine, told Mic. But with some younger men who haven't had much opportunity to be sexually active, "they might feel cheated" out of having a good sex life.

What age does a man stop getting hard?

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