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.
If the problem is physiological, that is, if a man cannot maintain an erection due to illness, it is best to go to the doctor or specialist and treat the problem accordingly. Sometimes treating this problem with medication is enough to solve the problem; other times, however, a doctor might recommend the use of Viagra in order to achieve full erection.
The answers to these questions, as well as physiological tests like an ultrasound or neurological assessment, can help determine the root cause of ED. Depending on the cause, different treatment options are available. Treatments range from medication, to hormone replacement therapy, to vascular surgery, to sex therapy and/or couples counseling. It sounds like you have ruled out many physical factors, in which case it may be useful to consider psychological factors. Often, couples counseling and/or sex therapy (as a couple or individual) can identify factors related to ED, help with communication, and improve sex for both partners. For a sex therapist, check out the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) web site and click on the "Locate a Professional" link.
The penis is the male sex organ, and the shaft of it is the longest part. The glans and head are located at the end of the shaft. The opening at the tip of the head when semen and urine come out is termed the meatus. Inside the shaft are two cylinder-shaped chambers called the corpora cavernosa and they run the length of the penis. They have blood vessels, maze, open pockets, tissue, and others. 

How can I treat ED at home?


Smoking damages blood vessels, inhibiting blood flow throughout the body ... and I mean throughout the body. While studies have found that men with erectile problems only make up 20 percent of the general population, 40 percent of men with erectile problems are smokers. And a 2011 study of a group of male smokers with erectile problems found that 75 percent of them saw those erectile problems disappear after they quit.


Exercise on a regular basis. There is evidence that suggests that a sedentary lifestyle can be a factor in erectile dysfunction. Aerobic exercises, such as running and swimming, can help prevent ED. The exercise can help improve blood flow and circulation, naturally help lower high blood pressure and cholesterol, and can even help improve hormonal balance and drive weight loss – all of which are factors that can help you improve ED and maintain 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.
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.

What causes erectile dysfunction in males?


Having erection trouble from time to time isn't necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.
This simple five-question quiz asks you to rank your erections in various situations (during the past 6 months) on a scale from 1-5. It’s not a perfect tool, but it’s simple, short, and gets you thinking about the difference between just getting an erection and being hard enough for penetration and a healthy sex life (because those are two different things). 

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.
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.

When something isn't working the way it should be, understanding the science behind what is supposed to be happening is key to pinpointing the problem. As Dr. Josh Axe, D.N.M., C.N.S., D.C., founder of DrAxe.com explains, getting an erection is a full body and mind process. "Erections actually begin in the brain and they're promoted by thoughts related to sex and sexual desires," he says.
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.
If you notice that it is becoming a common occurrence, then a dialogue needs to happen because then it is less about him going limp and more about his personal health. Recommend he see a doctor and let him know you are there for him. Our bodies are clever and are always giving us signs, both positive and negative. This could be a tipping point in his life.
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.

How long can the average man stay erect?


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.”
Be intimate in new ways. If your sex is focused just on penetration and climax, you may feel under more pressure to quickly get and maintain an erection, which can make this harder to do. Try to find new and more varied ways to be intimate with your partner that are not just about sprinting to the finish line. Take time with each other, such as taking a bath or shower together or massaging each other.[9]
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.
Now, it may be that all you need to do is tackle some of the issues outlined in these key tools. However, yes, that advice may also come in the form of a small magic blue pill. Sildenafil (Viagra) is a phosphodiesterase type 5 inhibitor, designed to promote blood flow to your penis and achieve a sustainable erection. It can sometimes be a short-term option to help you "get back on the horse" or a longer-term method (if there is an irreversible dysfunction) to help you enjoy a healthy intimate relationship.
Just as certain meds can make it difficult for men to have an orgasm, some can keep the flagpole from even getting raised in the first place. Anti-depressant medications like Prozac and Zoloft, anti-anxiety pills like Valium, high blood pressure medicine like Diuril, and even over-the-counter cold medicines like Sudafed and anti-heartburn pills like Zantac can inhibit erections.
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.
Don't forget mental health, either! "If you are experiencing stress at work, in your relationships or at home, open up communication about these issues," notes Axe. "Try natural stress busters like spending time outdoors, taking some vacation time for yourself or seeing a therapist. You also need to make sure that you are getting enough rest every night — seven to nine hours of sleep per night."

As a relatively young man, Mher was in the minority of patients with erectile dysfunction, who are predominantly over the age of 50. But he's far from the only young man who's struggled with the condition. According to a 2013 study in the Journal of Sexual Medicine, an estimated one in four patients with new, onset ED are under the age of 40 — yet because we rarely hear about these men, they're left feeling embarrassed and alone.
“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 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."
If you’re a guy over 40, there’s a fifty-fifty chance that you have a problem getting or keeping an erection. Now, I don’t mean the sort of erection you saw in American Pie! I mean an erection that’s firm enough and long-lasting enough for sexual satisfaction. Every guy has times when he just can’t manage an erection. Still, if you’re having trouble achieving a satisfying erection more than 50% of the time, you’ve got erectile dysfunction (ED).

Which Erectile Dysfunction Drug Is Best?


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).
"This can take some time, but it can help to stop a cycle of too much anxiety, followed by an erectile issue. It also can help you realize where you draw the most physical pleasure. People tend to focus only on the genitals when it comes to sex. However, they can experience pleasure all over their bodies. If they learn how to utilize this, it can be a resource for future arousal, fun and pleasure."

"Primarily because people tend to get anxious around introducing these things. Also, introducing these things too early can perpetuate a myth that it's low desire that is leading to the erectile issue. Low sexual desire is often not the cause of the problem. There can be other factors, such as depression, anxiety, poor self-image or esteem, etc. Without proper processing, adding sexual aids can add to a sense of shame if they don't work."
And be aware that the vast majority of physical or psychological causes of erectile dysfunction are temporary. They may go away as quickly as they occurred. But if anything is bothering you or your partner, you should seek out confidential, professional advice. There is no point in worrying and not doing anything about it. It may just make the situation worse.
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). 

What causes a man not to be erect?


Don’t panic. That will only make it worse. Erectile dysfunction is common. In younger age groups it is more likely to be a psychogenic issue around performance anxiety (don’t seek to be like a porn star is a top tip). In men between the ages of 40 and 70, it is estimated that 50 per cent will have some degree of erectile dysfunction. In this age group, there may be a more of a physical issue around blood flow. In either case, consult your doctor and they will be able to give you some more advice. An erectile litmus test is, if you are getting nighttime or early morning erections, it is likely a psychological not a physical vascular issue.


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.

How can I fix erectile dysfunction naturally?

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