Condoms: It may sound like an excuse to get out of wearing a condom, but many guys have problems maintaining an erection when putting one on. The interruption of sex play is often distracting, as is the stress of putting on a condom. Other times, deeper concerns, like guilt or performance anxiety, manage to seep into a guy's consciousness when there's a pause in sexual activity.
Even if your relationship isn't the source of it, depression can keep you from getting an erection. "Erectile dysfunction can affect someone with depression even when he is in a stable and loving relationship," says Dr. Reitano. "Unfortunately, the drugs used to treat depression can cause erectile dysfunction, as well. The good news is that erectile dysfunction medications work whether the difficulty is from the depression itself or from the medications."
"Surprisingly, up until the 1980's, most sex experts held the Freudian view that weak erections were caused by deep-seated, unconscious neuroses or psychological problems," she explains. "This view has now widely been rejected by professionals in the field of sexuality and it's now understood that erection problems that stem from deep psychological problems are the exception, not the rule. A majority of weak erections are caused by a combination of sexual misinformation, relationship problems, depression and other life stresses."
Use penile injection therapy. An alternative method that you may be advised on by a doctor is penile injection therapy. For this you will be trained by the doctor how to inject your penis with medicine that relaxes the blood vessels and promotes the blood flow that causes an erection. This treatment has been shown to be effective at treating a range of issues both physical and psychological.
Stiffy Solution: The good news is, almost all of these conditions can be successfully treated if you catch them early on. And since erectile problems may be the first side effect your dude has experienced, seeking medical treatment for his erectile problems may be the thing to get him into a doctor's office. So if your dude is a well-rested, non-drinking, non-smoking, paragon of relaxation who suddenly can't get wood, urge him to talk to his doctor — his misbehaving penis may actually be communicating something way more important than "Not tonight, honey."
Did you know that a cock ring can help you maintain an erection? This O-shaped toy fits around your penis and helps keep blood in the shaft, where you want it. A cock ring also helps prevent venous leakage, a form of erectile dysfunction where blood flows to your penis, but has trouble staying there. (Giddy, a new cock-ring-like gadget designed to treat ED, may also help guys with venous leakage maintain stronger erections.)

Remember that he is in his 40's, and that's a huge factor too. Around the age of 30, testosterone, androgen, and other hormone levels gradually begin to drop at about a rate of 1 percent. and as a direct result, by the time a man reaches 40, hormone drops cause loss of muscle mass and increased body fat. As a man reaches 45 these gradual hormone drops cause brain capacity and function to slowly regress. This, mixed with risks of genetic diseases like diabetes and high blood pressure, all take a toll on the body, especially the sex organs. Those who are physically active are at a huge advantage, as working out inhibits hormone levels, the neuromuscular system, and protein synthesis to maintain.
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.
But recently, slick, millennial-chic ads started popping up on social media from new men’s brands like Roman and Hims. Even though the (young) founders of these companies say they aren’t trying to market ED meds to your Tinder dates or male partners, clearly they are looping 20- and 30something guys into the deflated-D narrative for the first time ever.

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. 


Try this: just reduce how much porn you consume in a week. If you want to take it a step further, watch it with your partner. Use it to inspire your sex life, not replace it. Keep in mind that fatigue plays a big role in your ability to keep an erection. Watching too much porn and subsequently masturbating to it could tire you out for actual sex with a partner later on. Balance is key.

Alcohol is a depressant, not an aphrodisiac or a libido enhancer. Excessive consumption can interfere with the ability to achieve an erection at any age, and even occasional drinking can make erectile dysfunction worse in older men. Feloney advises using alcohol in moderation: "In small amounts, alcohol can relieve anxiety and may help with erectile dysfunction, but if you drink too much, it can cause erectile dysfunction or make the problem worse."
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.
Assuming an absence of any significant spinal damage or hormonal disorders, the potential barriers are in fact different at stage one and two. At stage one, anything that causes impairment in your psychological ability to become stimulated will hamper an activation of your nervous system. At stage two, anything that contributes to a narrowing of blood vessels will hamper the engorgement of your erection.
In an article on Men’s Health about things that wreck your erection, some examples of threats to an erection are sugar, lack of sleep, sleeping near a newborn baby, and lack of vitamin D. The common theme in the article is that reduced testosterone impacts your erection. Not all scientists agree with that. But there are definitely links between testosterone and erectile problems.
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).
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.

Remember what I said before about how it's not you? Okay, sometimes it is you. But it's not that you're not sexy — it's that for men, as well as women, relationship problems (like fighting all the time, or having clashing expectations about where things are going) can severely mess up your sex drive and ability to become aroused. Which makes sense — if you're spending 90 percent of your time together fighting about whether you're going to move in, switching gears to make 10 percent of your time together into a sexy sex party is pretty damned difficult.
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. 
Irrespective of how stage one was achieved, the next part is all about your plumbing. Courtesy of your nervous system stimulus, a powerful blood vessel dilator, nitric oxide, is released into the trabecular arteries and smooth muscle in your penis. This causes the arteries and the main bulkhead of your penis, the corpora cavernosa, to become engorged with blood. Helpfully, to keep this blood in place and maintain your erection, the ischiocavernosus and bulbospongiosus muscles of your penis constrict, effectively blocking the veins of your penis from draining blood out.
There are different reasons which cause erections and even some factors that make a person lose their erection. It can be troubling for some as it occurs during sexual activity with a partner. Self-consciousness, fatigue, distractions and more can cause the temporary loss of erection. If such things happen, don’t sweat it too much as it is a common and natural occurrence.

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Getting hard is also an overwhelmingly mental task. "Yes, men are saddled with the scheduled 'morning boner' and may experience an occasional random erection but by and large an erection needs to be achieved through mental stimulation," says Backe. "If you aren't turned on, your body isn't going to send more blood to the penis — bottom line. So, ultimately, you need a clean and clear mind for healthy and clear erections. Keeping the mind healthy will allow proper mental stimulation to occur at the right time."
The National Institutes of Health estimates that erectile dysfunction strikes as many as 30 million men in the United States. Its prevalence does increase with age — 4 percent of men in their 50s are affected by ED, 17 percent in their 60s, and 47 percent of those over 75. But research has also found that 5 percent of those affected were between 20 and 39.

“Although having sex at 70 is not the same as having sex at 20, erectile dysfunction is not a normal part of aging,” according to Michael Feloney, MD, urologic surgeon and expert on sexual dysfunction issues at the Nebraska Medical Center in Omaha. “You should still be able to have a satisfying sex life as you age." If you are experiencing erectile dysfunction, these 10 dos and don'ts may help.


For many older men, issues like diabetes, hypertension and heart attacks are often contributing factors to erectile dysfunction. But Goldstein said that in younger men, ED is far more likely to stem from physical trauma. This could be the result of a sports injury, such as a misplaced karate kick, a surfboard hitting the wrong area or long-distance bike riding. It could also be a result of a sexual injury. (This is most common during heterosexual intercourse, especially in the woman-on-top position, the sex position dubbed "most dangerous" by a 2015 study.)

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