The American Medical Association (AMA) estimates that more than 30 million men in the US experience ED. And they expect that number to double by 2025, largely due to the fact that erectile dysfunction is affecting more and more guys in their 20’s and 30’s. ED in your 20’s is becoming more common, and that can signal some serious health risks to a growing number of young men.
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.
Depression, anxiety, stress, insecurity, conflicted emotions, missing the last quarter of the basketball game, all can have an effect. If your man is a healthy dude, then his brain could be cockblocking your giving of "brains." As a man, it is a very defeating feeling and not something you just talk out with your penis. He has got to remain cool. If it happens, the faster he pushes it out of his brain the faster his subconscious will kick in his arousal. Try something like this: grab a glass of water, take a pee break and then just hang in bed together. Share laughs, talk about other things and let your companionship do the work. The less he is engaging his inner dialogue and the more he is engaging you, the faster his inner workings will settle and his libido will be back in action. That is, of course, if he really does want it to happen.
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."
Irrespective of how stage one was achieved, the next part is all about your plumbing. Courtesy of your nervous system stimulus, a powerful blood vessel dilator, nitric oxide, is released into the trabecular arteries and smooth muscle in your penis. This causes the arteries and the main bulkhead of your penis, the corpora cavernosa, to become engorged with blood. Helpfully, to keep this blood in place and maintain your erection, the ischiocavernosus and bulbospongiosus muscles of your penis constrict, effectively blocking the veins of your penis from draining blood out.
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.

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Erectile dysfunction can be embarrassing and difficult to talk about for some men. Many men may feel like they need to hide their diagnosis from their partner. "Failure to communicate openly about erectile dysfunction can result in both partners drawing away from the relationship," warns Feloney. Remember that your partner is also affected by your problem; being open and honest is the best way to decrease fear and anxiety. Discuss options for achieving sexual satisfaction together, and be positive — most erectile dysfunction problems can be treated.
"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.
Erectile dysfunction is no laughing matter. And although it is not an easy thing to talk about, there are trained professionals who can give you good advice about what may be the cause of your current predicament. Many men like to talk about sex, but like women, they may find it harder to talk about sex when it is not going well. You won’t be judged or talked about at BPAS. We are here to help you with some of the more private things in life.
For more information, check out the related Q&As. And while you're determining the cause of your partner's ED, you can still be intimate with activities other than intercourse that you both enjoy. As an exercise, you can try focusing on non-genital sensations, such as kissing and cuddling. You can also pleasure by caressing, touching, and stroking one another, having oral sex, or incorporating sex toys into your sex play. What non-intercourse intimacies do you enjoy? What about your partner? Have you discussed all the things you like that don't require an erection? Enjoying each other's company might give you both the emotional support and physical intimacy you need to help maintain a spark and eventually get the fire going again. Good luck,
"Diseases and illnesses can hamper one's ability to achieve an erection," he explains. "Cancer, diabetes and heart disease is the cause in many cases. Low testosterone count caused by genetics, inactivity or unusual level of estrogen in the body can limit penile function as well." High blood pressure and high cholesterol can also be detrimental to erections.
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.

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If ED happens to a boyfriend or husband, ask (outside the bedroom) if he’s ever seen a doctor about it. Only 15 percent of men have, according to our survey—but a doc visit might be the simplest solution. For instance, if your guy’s ED seems like a psychological issue, his doctor may refer him to a therapist who can help him work through whatever’s getting him down. Or he may be given a temporary prescription for sildenafil, the active ingredient in Viagra, which is safe and effective when used correctly.

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Try to think of love-making as fun, not a trial. Laugh more, be more playful, and try to create opportunities for being together in situations that would be enjoyable for you both, even if sex does not occur. Most importantly, explore non-penetrative styles of eroticism. These things will help increase your sexual comfort and confidence, and reduce the pressure you currently feel to be an on-demand sex machine. You are merely human.
Most men know their penis is not likely to hit a grand slam every time it steps to the plate. According to a study published in the American Journal of Medicine, 85 percent of men between the ages of 20 and 39 say they “always” or “almost always” can get and maintain an erection, which means 15 percent of men in the prime of their life have a hard time getting hard at least occasionally. The same study found that of men between the ages of 40-59, only 20 percent said they could get a healthy enough erection for sex most of the time. In other words, solid wood is far from a foregone conclusion.
Though few things are worse for your erection than a cigarette habit, coffee can actually help you out below the belt. A study by the University of Texas Health Science Center at Houston found that men who consumed the caffeine equivalent of 2-3 cups of coffee per day were less likely to suffer from erectile dysfunction than those who preferred to wake up with caffeine-free beverages.

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But recently, slick, millennial-chic ads started popping up on social media from new men’s brands like Roman and Hims. Even though the (young) founders of these companies say they aren’t trying to market ED meds to your Tinder dates or male partners, clearly they are looping 20- and 30something guys into the deflated-D narrative for the first time ever.
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.

There is no evidence that mild or even moderate alcohol consumption is bad for erectile function, says Ira Sharlip, MD, a urology professor at the University of California San Francisco School of Medicine. But chronic heavy drinking can cause liver damage, nerve damage, and other conditions -- such as interfering with the normal balance of male sex hormone levels -- that can lead to ED.

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Where it comes from: When talking about erectile dysfunction, it's important to note that while there are many potential causes, they can essentially be divided into two discrete categories: physical and psychological. It's also important to note that there's a huge difference between chronic ED and the occasional (and very normal) inability to maintain an erection during sex.  
Performance jitters. For some young men, the desire to perform well in bed can be so overwhelming that, in turn, it causes them to not perform at all. “When a younger man experiences ED, it often is associated with significant performance anxiety, which in turn increases the problem, sometimes turning a temporary situation (i.e., too much to drink that night) into a permanent problem,” says Jerome Hoeksema, MD, assistant professor of urology at the Rush University Medical Center in Chicago. “The more they worry about it, the worse it gets. Young men need to recognize this cycle and try to reduce the ‘stress’ surrounding sex.”

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.
For starters, while past studies have estimated that ED affects somewhere between 1 and 10 percent of men under 40, our survey revealed that 80 percent of guys who responded have had an issue getting it up at least once. Here, we get to the bottom of what’s killing their boners and help you handle the moment if and (more likely) when it happens to you.
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.
"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."
Most men know their penis is not likely to hit a grand slam every time it steps to the plate. According to a study published in the American Journal of Medicine, 85 percent of men between the ages of 20 and 39 say they “always” or “almost always” can get and maintain an erection, which means 15 percent of men in the prime of their life have a hard time getting hard at least occasionally. The same study found that of men between the ages of 40-59, only 20 percent said they could get a healthy enough erection for sex most of the time. In other words, solid wood is far from a foregone conclusion.
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?

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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.) 

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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.

A 2013 study published in The Journal of Sexual Medicine evaluated 439 men for erectile dysfunction and compared ED causes and frequency in men 40 or younger to men over 40. They found that 26 percent of the younger men had ED. Although these men were healthier and had higher levels of testosterone than the older men, they were more likely to be smokers or to have used illicit drugs. In almost half of the younger men with ED, the ED was considered severe.

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"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.
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."

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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?

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