Another way to keep your libido up is to act when you do get aroused. This might mean going home at lunchtime to have sex with your spouse, or leaving a party early with your date if you’re both aroused. Staving off an arousal trains your body to disassociate arousal with erections. You want the opposite. You want to get and keep a strong erection when you feel aroused so that you can have better sex. So this is a great excuse to tend to your sexual needs as they come, if you can.
When these mental hang-ups happen in the moment (aka in bed), they can trigger his brain’s fight-or-flight response, which sends a message to his penis to shut things down. In this way, performance anxiety–induced ED is actually pretty similar to what women experience when our thoughts during sex make it hard to stay turned on and/or orgasm—we just don’t have an appendage that shows the evidence.
There are many factors that can lead to ED. “Psychological causes of erectile dysfunction in young men can include performance anxiety, guilt about sex in general, guilt about having sex with a particular partner, feelings of anger or resentment towards a partner, or simply finding a partner undesirable,” said Carole Lieberman, MD, a psychiatrist on the clinical faculty of the UCLA Neuropsychiatric Institute in Los Angeles.

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Something James, 26, knows for sure about his penis is that it won’t get hard when he’s sleeping with a woman for the first time. No, it has nothing to do with how attracted he is to her. It’s just a classic case of performance anxiety, caused by his personal fears about how awkward and uncomfortable the experience could be—which, of course, turns into a self-fulfilling prophecy.

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Remember those cultural messages we discussed earlier, about how men are wild sex aliens from the planet Weenus? Well, men are raised hearing those messages, too, and they can end up screwing with their sexual self-image —for instance, they can lead men to obsess over their own virility, and panic about impressing a new partner, until they've thought their boner into a corner and can't get an erection. Performance anxiety is one of the most common culprits behind lost erections, especially among younger, less experienced men.
Regular exercise and a diet rich in antioxidants is also the foundation of permanent weight control and diabetes prevention. Studies at the Duke University Diet and Fitness Center show that weight loss is strongly associated with better sexual function. Other studies show that diabetes is a major risk factor for ED, and that a healthy lifestyle prevents the disease and can restore erection function.
Most men may not openly talk about their erection problems, but erectile dysfunction — when a man cannot achieve or maintain an erection well enough or long enough to have satisfying sex — is very common. According to the National Institutes of Health, 5 percent of 40-year-olds and 15 to 25 percent of 65-years old have ED. But while ED is more likely to occur as a man gets older, it doesn’t come automatically with age.

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Regardless of age, if a man is obese and sedentary, with poor dietary habits, he is at greater risk of developing diseases that can lead to erectile dysfunction. These include heart disease, hypertension and type 2 diabetes. Some forms of congenital heart disease may remain hidden and only cause problems in adulthood. Men of any age noticing a marked change in sexual function should contact their physicians to rule out the possibility of a more serious condition.
Now, despite there being some unavoidable factors – your age (volume hits peak production around your early to mid-thirties) and the anatomy that your are born with (bigger seminal equipment will naturally yield more) – there are some some ways to help boost volume. But be warned, these may sound very familiar to the ones your just read about supporting stronger erections...
Try to think of love-making as fun, not a trial. Laugh more, be more playful, and try to create opportunities for being together in situations that would be enjoyable for you both, even if sex does not occur. Most importantly, explore non-penetrative styles of eroticism. These things will help increase your sexual comfort and confidence, and reduce the pressure you currently feel to be an on-demand sex machine. You are merely human.
UW Health urologists with advanced training offer medical and surgical treatment options for men and their partners affected by erectile dysfunction. There are several different ways that erectile dysfunction can be treated. For some men, making a few healthy lifestyle changes may solve the problem. Your urologist will help determine the most effective course of treatment for your condition. 
The strength and frequency of your erection are an important indicator of your overall health. The blood vessels in the penis are smaller than arteries and veins in other parts of your body, so any problems like blockages, blood vessel dilation issues, or hormone imbalances will often show up as erectile dysfunction (or less firm erections) before something more serious like a heart attack or stroke.
If you're still experiencing issues with getting an erection after a few weeks, Dr. Axe says it's time to schedule an appointment with your doctor. "Ask about what health issues can be causing erectile dysfunction, such as cardiovascular problems, hormone imbalances or neurological disorders," he suggests. "It's also important to discuss your medications with your doctor, if you are taking any. Some medications can cause issues with blood flow, so your doctor may choose to change or lower those prescriptions."
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.

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If you find yourself with a man who is experiencing these problems, naturally, you might concern yourself with how to provoke and maintain their erection. This is often not not so much because you fear for your own personal enjoyment, but because you care about the pleasure and self-esteem of your partner. Follow these tips if you want to know more about how to handle a man who is impotent:
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.

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“With the success of Viagra-type drugs, there has been a tendency to start all patients with ED on one of these drugs and not look much further for a medical cause. But we now know that ED may be an early warning for heart and blood vessel disease, so it is important to look for common risk factors. These include high blood pressure, diabetes, medications, smoking, drinking, and drugs,” said Dr. Wang.
The good news? That same study found that men were significantly less likely to have erectile dysfunction if they worked out regularly, maintained a healthy weight, avoided tobacco, and kept their alcohol intake to a minimum (two drinks a day, if you drink booze at all, should be your limit). So don't accept erectile dysfunction as an inevitable downside of aging. Talk to your doctor if you're having problems getting or sustaining erections.
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."

Obesity. Obesity itself is not a risk factor for ED — but there is a connection. “The bigger concern is that obesity can lead to type 2 diabetes or vascular diseases, which are risk factors for ED,” says Montague. Morbid obesity, a term used to classify individuals who are significantly overweight, can cause hormonal changes that are triggered by excess body fat. In addition, obesity can put physical limitations on sexual intercourse.
For many young men, performance anxiety plays a large role in erectile dysfunction. Other factors include money and work problems, as well as relationship issues and even issues about sexual orientation. Undiagnosed depression and post-traumatic stress disorder can cause erectile dysfunction--especially if the PTSD is related to a past sexual experience.
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.
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.” 

Pycnogenol is a compound found in the French maritime pine (Pinus pinaster), which grows in southern Canada. Several studies show that in combination with the amino acid L-arginine, it boost synthesis of nitric oxide, which plays a significant role in erection. Other studies show that pycnogenol helps restore wilting erections. In one study, 124 ED sufferers took either a placebo or pycnogenol and L-arginine (four tablets a day, 20 mg pycnogenol, 700 mg L-arginine). After six months, the supplement group showed a modest but significant improvement in erection, without side effects.
Mention older men’s wilting erections, and people immediately think Viagra. Yes, Viagra, Cialis, and Levitra, can raise flags that have fallen to half staff. But fewer than half of men over 50 have tried them, and of those, fewer than half have renewed their prescriptions. Why? Because the drugs don’t work as well as advertised, and the side effects can be annoying.

Injury to the nerves and arteries near the penis can lead to erectile dysfunction. According to the National Institutes of Diabetes and Digestive and Kidney Diseases, surgeries for prostate and bladder cancer can injure penile nerves and arteries, although it doesn't always happen. Spinal cord injuries can affect the ability to achieve and maintain an erection, as can injuries to the penis, prostate, bladder and pelvis.
The strength and frequency of your erection are an important indicator of your overall health. The blood vessels in the penis are smaller than arteries and veins in other parts of your body, so any problems like blockages, blood vessel dilation issues, or hormone imbalances will often show up as erectile dysfunction (or less firm erections) before something more serious like a heart attack or stroke.
UW Health urologists with advanced training offer medical and surgical treatment options for men and their partners affected by erectile dysfunction. There are several different ways that erectile dysfunction can be treated. For some men, making a few healthy lifestyle changes may solve the problem. Your urologist will help determine the most effective course of treatment for your condition. 

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