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]

Is erectile dysfunction permanent?


Smoking and a diet high in animal fat (sausage at breakfast, pizza for lunch, burgers for dinner) are hell on the cardiovascular system. They fill the bloodstream with oxygen ions (“free radicals”) that injure the artery walls and spur formation of fatty, cholesterol-rich deposits, “plaques.” Over time, plaques grow and narrow the arteries, restricting blood flow. When plaques affect the arteries in the heart, the result is heart disease, in the genitals, erection impairment. Studies show that compared with the general population, smokers suffer much more erectile dysfunction (ED). Other studies show that as cholesterol levels increase, so does risk of ED.
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.

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.
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."

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.

How long does it take for cialis to peak?


As it turns out, there are actually tons of things that can keep guys from getting an erection that have nothing to do with you (also, all that stuff you learned in middle school about how all guys are hump-crazed sex lunatics might have been slightly off). Between 20 and 30 million American men experience recurring erection difficulties, and almost all men have, at one time or another, had their top ramen refuse to boil. And while erectile issues are often seen as an older man's problem, in reality, one quarter of men seeking medical treatment for erectile difficulties are under 40.
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.
The first tip for how to keep an erection longer is a simple one. Exercise the penis with kegels. According to sex and relationships expert, Jordan Gray, kegel exercises strengthen your genitals and improve your sex life. Kegel exercise involves “flexing and holding the muscles that stop the flow of urine.” The penis is made up of a ton of muscle. It’s important to keep that muscle tissue strong, healthy, and reactive. Kegels are popular with men and women. If you’re struggling with keeping an erection for a length of time, the reason could be weak muscle tissue.
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.
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.”

What vitamins help sexually?


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.

How can I treat erectile dysfunction at home?


A very stressful or intense situation, or performance anxiety, could definitely make a man lose his erection. The pressure to perform could be psychologically too intense to keep a strong one. Another, lesser talked about erection killer is difficulty penetrating a partner during sex. It’s related to performance anxiety and stress, but also fatigue. If sex becomes tiring, fatigue will bring a quick end to an otherwise great night.

Does nitric oxide help sexually?


Occasional ED is common in all men, including young and healthy men. But if you have a persistent or recurrent problem with initiating or maintaining an erection and it's causing you or your partner distress, talk to your doctor. “Lack of nighttime erections is another cause for concern, said Wang. These occurrences serve to nourish the penis with oxygen and keeping the blood supply healthy, he explained. "Young men should get four or five of these a night. If you are not getting these and you are having frequent problems with ED, you need to check in with your doctor,” he recommended.
“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.
"One of the reasons erectile dysfunction increases with age is that the diseases that lead to it also increase with age," notes Dr. Feloney. Evaluating the causes of erectile dysfunction starts with your doctor taking a good health history and giving you a physical exam. Common medical issues that can lead to erectile dysfunction include diabetes, high blood pressure, hardening of the arteries, low testosterone, and neurological disease. Talk to your doctor about better managing these health conditions.
These specific chemicals are found in erectile dysfunction medications such as Viagra and Cialis."The chemicals that cause the outflow are called phosphodiesterases," says Reitano. "To give you a stronger erection, erectile dysfunction medications (PDE-5 inhibitors) block or inhibit the phosphodiesterases, which enables the blood vessels in the penis to stay open and receive more blood, creating a firmer and longer lasting erection. This is why the drugs are called phosphodiesterase inhibitors (PDE-5 inhibitors for short)." 

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.
Depression. The profound sadness, emptiness, and hopelessness that characterize depression may also cause ED among younger men. “The biggest effect of depression is on a man’s desire for sexual relations, or libido,” says Drogo Montague, MD, director of the Center for Genitourinary Reconstruction in the Glickman Urological and Kidney Institute at the Cleveland Clinic. “To some extent, depression can affect a man’s ability to maintain an erection. It can be a chicken-and-egg situation. However, reduced libido is a common indicator of depression.”
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.

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."

What causes a man not to erect?


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).
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 of us are raised to believe that men are ravenous sex-beasts, eternally horny and only pretending to be a part of polite society so that they can find some new crevice to jam their Jeremy Irons into. So the first time we cross paths (and genitals) with a guy who can't get an erection, many of us immediately panic and assume that the problem must be us. We must be profoundly unsexy. After all, what could else possibly stop these hormone-addled maniacs from getting 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.
Gray-haired men soaking in Jacuzzis overlooking canyons, thumbing through the morning newspaper in their thick reading glasses, cuddling their wives on gently swaying hammocks while drinking sensible glasses of cabernet...the classic erectile-dysfunction commercials of the past 20 years were pretty clear about who they wanted to reach. Ever since, those iconic images have defined who we as a society assume are in need of penis pills: men of retirement age.

Achieving an erection is a complex process involving the brain, hormones, nerves, muscles and blood circulation. If something interferes with this process, the result may be erectile dysfunction. In some cases, erectile dysfunction is the first sign of other serious underlying health conditions, such as cardiovascular problems, that need treatment because erectile dysfunction can share the same risk factors for heart attacks and strokes.
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. 

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."
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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