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."


Medications for erectile dysfunction don't work for everyone and may cause side effects that make a particular drug hard to take. "Work with your doctor to find the right treatment. There are still options for people who fail at medical treatment," advises Feloney. Alternatives to erectile dysfunction drugs include vacuum pump devices, medications injected into the penis, testosterone replacement if needed, and a surgical penile implant.
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.
"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."
"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."
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.
"This triggers the release of a neurotransmitter called dopamine, and it sends a chemical message from the brain to the penis, causing an increase of blood flow to the penis. The blood vessels leading to the reproductive system then relax and this allows increased circulation in the genital area. When you aren't aroused, the blood vessels in your penis are only partially open. But when your brain sends messages to your penis that you are ready for sex, the vessels open and allow more blood to enter the area. Because of the increased blood flow, blood gets trapped in the penis, which makes the penis expand and causes an erection."
Regular exercise for about 20 to 30 minutes a day may act as a libido enhancer and certainly will improve your overall health. "Exercising improves blood flow to all areas of your body and that includes the pelvic region where the blood vessels needed for sexual functioning are located," says Feloney. Some other ways that regular exercise can improve your sexual performance include building up your stamina, lowering your blood pressure, relieving stress, and helping you look and feel better.

Not to give your already stressed-out dude one more thing to worry about, but stress is the cause of 20 percent of all erectile problems, from one-off boner blunders to a lingering inability to get and maintain an erection. Of course, sex difficulties are just the tip of the stress-induced health problem iceberg — sustained stress can also lead to insomnia, stomach troubles, chest pains, anxiety, and more severe health issues in the long term.
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.
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.
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.
The vascular processes that produce an erection are controlled by the nervous system and certain prescription medications may have the side effect of interfering with necessary nerve signals. Among the possible culprits are a variety of stimulants, sedatives, diuretics, antihistamines, and drugs to treat high blood pressure, cancer, or depression. But never stop a medication unless your doctor tells you to. In addition, alcohol, tobacco, and illegal drugs, such as marijuana, may contribute to the dysfunction.
"This triggers the release of a neurotransmitter called dopamine, and it sends a chemical message from the brain to the penis, causing an increase of blood flow to the penis. The blood vessels leading to the reproductive system then relax and this allows increased circulation in the genital area. When you aren't aroused, the blood vessels in your penis are only partially open. But when your brain sends messages to your penis that you are ready for sex, the vessels open and allow more blood to enter the area. Because of the increased blood flow, blood gets trapped in the penis, which makes the penis expand and causes an erection."
Ask about transurethral pharmacotherapy. Your doctor may suggest you try this treatment, which involves placing a suppository into the urethra. The suppository contains alprostadil, which is then absorbed into the blood stream, relaxing blood vessels and improving blood flow into the penis. This treatment is thought to be less effective than the vacuum devices, or injection therapy.[16]

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