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).

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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.
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.
If your erections are really strong, fantastic. Regular erections—including daily morning erections—are an important measure of a man’s health. If you get strong, frequent erections, that’s great! There’s no need to be concerned about being “too hard” as your body only has so much blood to offer. However, an erection that lasts too long (generally more than two hours) can be dangerous as priapism (erections lasting longer than 2 hours) can cause tissue damage. If you’ve had an erection lasting longer than four hours contact a doctor or emergency care immediately.
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?


While physical anatomy and chemical reaction are both important for getting and keeping an erection, the brain is one of the most vital parts of this puzzle. "An erection is controlled by multiple areas of your brain, including the hypothalamus, limbic system and cerebral cortex," notes Axe. "Stimulatory messages are sent to your spinal erection centers and this facilitates an erection. When there's an issue with your brain's ability to send these important messages, it can increase the smooth muscle tone in your penis and prevent the relaxation that is necessary to get an erection."

Some men have had success by using natural supplements to improve their erections. "There are also natural remedies that can be used to improve erectile dysfunction," says Dr. Axe. "This includes herbs such as ginseng, horny goat weed, maca root and ginkgo biloba. You can also try supplementing with L-arginine, DHEA and niacin. If you choose to try natural products to maintain a strong erection, it's still a good idea to discuss this with your doctor, especially if you are also taking medications."


The "Am I Normal?" study examined more than 15,000 men in the UK. The average erect penis was 5.16 inches (13.1cm), while the average flaccid penis was 3.61 inches (9.2cm). But maybe take this with a pinch of salt – the "study limitations" section of the research paper states “relatively few erect measurements were made in a clinical setting and the greatest variability between studies were seen in the flaccid stretched length”. Yes, how hard is too hard to yank for a study?

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?

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.

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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.”

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The good news? That same study found that men were significantly less likely to have erectile dysfunction if they worked out regularly, maintained a healthy weight, avoided tobacco, and kept their alcohol intake to a minimum (two drinks a day, if you drink booze at all, should be your limit). So don't accept erectile dysfunction as an inevitable downside of aging. Talk to your doctor if you're having problems getting or sustaining erections.
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.
It can be difficult and frustrating for men and their partners to cope with erectile dysfunction, especially when the cause is unclear. At this point, it is important to be supportive and understanding of the situation and of one another. Erectile difficulties can cause feelings of inadequacy in both men and their partners. Each may internalize the situation, fearing that s/he is the one to blame. Therefore, open and honest communication with one another is an essential ingredient in strengthening your relationship as you work through this situation together.
While physical anatomy and chemical reaction are both important for getting and keeping an erection, the brain is one of the most vital parts of this puzzle. "An erection is controlled by multiple areas of your brain, including the hypothalamus, limbic system and cerebral cortex," notes Axe. "Stimulatory messages are sent to your spinal erection centers and this facilitates an erection. When there's an issue with your brain's ability to send these important messages, it can increase the smooth muscle tone in your penis and prevent the relaxation that is necessary to get an erection."
Erectile dysfunction in older men. Because erections primarily involve the blood vessels, it is not surprising that the most common causes in older men are conditions that block blood flow to the penis, such as atherosclerosis or diabetes. Another vascular cause may be a faulty vein, which lets blood drain too quickly from the penis. Other physical disorders, as well as hormonal imbalances and certain operations, may also result in erectile dysfunction.

You may be unsurprised to learn that little has changed over the years when it comes to erections. In fact, this is probably only matched the pursuit of erectile greatness (judging by the growing column inches on the subject). But there too is a new kid on the sexual performance block: the volume of your semen – likely born out of the explosion of easily accessible online pornography and its warped portrayal of “what’s normal” in sex. Divided into two parts (one: your erection; two: your semen), here’s what you need to know about these two bedfellows...
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).
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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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.

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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