So not only are erectile problems common, they're nothing for you or your special friend to be freaked out about. Check out the nine most common reasons that dudes sometimes can't get it up, and get ready to become the soothing voice of reason the next time the guy you're with has a hard time pitching his tent in your happy valley. Everything (and every penis) is gonna be fine! 

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Some men experience erectile dysfunction as a result of physiological factors, including medications that can interfere with sexual response, chronic illness (e.g., heart disease, high blood pressure, diabetes), physical disability, alcoholism, drug use, or injury that impedes blood flow to the erectile tissue. High cholesterol, which can limit blood flow through the atreries that supply the genital area, can also be associated with erectile dysfunction. For others, psychological concerns, including stress, anxiety, self-esteem, or fatigue are the source. Researchers believe that for many men erectile dysfunction is caused by a combination of physical, psychological, and cultural factors.
Erectile dysfunction, also known as ED or impotence, is the inability to attain or maintain an erection of the penis adequate for the sexual satisfaction of both partners. It can be devastating to the self-esteem of a man and of his partner. As many as 30 million American men are afflicted on a continuing basis, and transient episodes affect nearly all adult males. But nearly all men who seek treatment find some measure of relief.
“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.
There can be both an indirect and direct way to achieve this. The reflex erection is the direct way, achieved by touching your penis to trigger the nerves in the lower part of your spinal cord and your peripheral nervous system. The psychogenic erection is the indirect way, via non-mechanical sexual stimulation (visual, for example) and sexual arousal. This activates the limbic system in your brain, sending electrical signals down to your erectile nerve centres via the lower regions of your spinal cord. The latter is why you can get both nocturnal or "morning glory" erections, rather non-erotically referred to as nocturnal penile tumescence. How romantic.
"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.

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.


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."

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.
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.
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.)
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.

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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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“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.
Stiffy Solution: Luckily, alcohol-induced impotence (also known by the infinitely less classy alias "whiskey d*ck") is a totally temporary condition, one that should clear up as soon as your dude can once again walk a straight line and recite the alphabet backwards. If your dude has consistent erectile problems from consistently drinking too much, however, he should consider cutting down on the sauce, and possibly talking with a doctor.

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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.
Relationship problems often complicate erectile dysfunction. Improving your relationship may be part of the solution. It may be a good idea to get counseling together from a sex therapist, marriage counselor, or a medical specialist. "I almost always see couples together to discuss erectile dysfunction. It often turns out that both partners have issues regarding the sexual relationship and once they are out in the open, couples can work together on a more satisfying sexual experience," says Feloney.
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.
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:
Defined as "the inability to get or keep an erection firm enough for sexual intercourse," ED affects nearly 30 million men in the United States (though a 2007 study put the figure at 18 million), according to data from the National Institutes of Health. Doctors have anecdotally reported an increasing number of young male patients; in a recent Vanity Fair piece on hookup culture, writer Nancy Jo Sales spoke with women who noted that many of their Tinder hookups struggle with the condition.
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:

Alcohol: A couple of drinks can loosen your inhibitions and help you relax. But alcohol can also impair sexual functioning. Alcohol works on the nervous system by slowing down brain function, breathing, and pulse. Initially, the effect is often psychologically stimulating, since emotions and desires flow more freely. However, while alcohol may boost sexual desire by helping a person to relax, it can decrease performance, especially where erections are concerned. For this reason, it's best for guys to limit their alcohol intake to one to two drinks (or none at all) for optimal sexual function.
Regardless of the reason, men spend a lot more time on their butts than they ever have before, shows data from the CDC. And all that sitting hurts your heart and your waistline, which saps your vigor below your belt, Dr. Köhler explains. You need a good 30 to 45 minutes of vigorous exercise at least 5 days a week to counteract all your chair time, experts say.

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My husband is suffering from erectile dysfunction. He has been to many doctors, including a urologist, neurologist, orthopedist, you name it. After many diagnostic tests, it seems that nothing physical can be found. He used to have full erections almost daily. Now nothing. Although he can get hard, he cannot maintain enough for intercourse. What can we do at this point?
It may be that after trialling all the above, including the little blue pills, you are still having challenges. There are always other options. The only issue is that they tend to move further away from science, proven efficacy and fact and more towards anecdotal evidence and illegitimate science, all while preying on a natural desperation to find a solution. I would say, if you are at this stage, go and see your doctor to discuss a referral to see a urology specialist. It may spare you dabbling, unsuccessfully, with the various less-proven methods, including:
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.
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]

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The blood vessels in your penis are smaller than the larger veins and arteries in other parts of your body. What that means is the first sign of hypertension, heart disease, high cholesterol, and clogged arteries may not be a stroke or a heart attack. It will often be erectile dysfunction. Regular physical activity reduces your risks for cardiovascular disease (which is awesome), but it also lowers your risk for ED. If there’s a better reason to sweat through a spin class, I can’t think of one.
“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.
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...
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.
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.

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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. 

"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."

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"Some physical problems that can lead to weak erections are the inability of your brain to send signals to your penis, which can be caused by neurological conditions like MS, Parkinson's disease and Alzheimer's," adds Axe. "Studies suggest that stress, anxiety and depression can produce major chemical changes in your brain, leading to the inability of smooth muscles to relax and allow for an erection. On top of this, researchers have also indicated that the failure to achieve an erection can aggravate a man's anxiety levels, leading to a vicious cycle."

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Instead, bench any P-in-V action for a beat and lower the stakes by telling him you want to fool around—not as a precursor to penetrative sex but just for the fun of it, suggests Natalie Finegood Goldberg, a sex therapist in Los Angeles who specializes in erectile dysfunction therapy. If this is a hookup situation, make it clear to him that you don’t expect or need him to have an erect penis for the two of you to have a good time, Goldberg says. You can always have oral sex, make out, or do some manual stimulation—because the worst thing you can do is freeze him out.

"Some physical problems that can lead to weak erections are the inability of your brain to send signals to your penis, which can be caused by neurological conditions like MS, Parkinson's disease and Alzheimer's," adds Axe. "Studies suggest that stress, anxiety and depression can produce major chemical changes in your brain, leading to the inability of smooth muscles to relax and allow for an erection. On top of this, researchers have also indicated that the failure to achieve an erection can aggravate a man's anxiety levels, leading to a vicious cycle."

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