There are different reasons which cause erections and even some factors that make a person lose their erection. It can be troubling for some as it occurs during sexual activity with a partner. Self-consciousness, fatigue, distractions and more can cause the temporary loss of erection. If such things happen, don’t sweat it too much as it is a common and natural occurrence.
The answers to these questions, as well as physiological tests like an ultrasound or neurological assessment, can help determine the root cause of ED. Depending on the cause, different treatment options are available. Treatments range from medication, to hormone replacement therapy, to vascular surgery, to sex therapy and/or couples counseling. It sounds like you have ruled out many physical factors, in which case it may be useful to consider psychological factors. Often, couples counseling and/or sex therapy (as a couple or individual) can identify factors related to ED, help with communication, and improve sex for both partners. For a sex therapist, check out the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) web site and click on the "Locate a Professional" link.
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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A “cycle”, as you put it, can certainly become established after a man experiences a number of erectile failures and begins to lose confidence. Once the idea of attempting intercourse produces anxiety rather than excitement, it becomes less and less likely he will successfully produce a reliable erection. Pharmaceutical agents can bypass this cycle, but it can also be extremely important to learn to be less fixated on erectile ability and instead focus on pleasure. Learning it is possible to give and receive enormous pleasure without an erection can be a vital aspect of a return to sexual health. This knowledge can lead to a reduction of the pressure you mentioned, as well as to a lifetime of sexual confidence and enjoyment.

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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.
Sit down with your partner and talk honestly about your sex together. Is it good? Do you both like it? This is important, because feeling discontent can cause you to lose an erection frequently. So open up. Maybe one or both of you isn’t enjoying the sex anymore. You can definitely improve the quality of sex that you have, but it’s start with honesty. Frequency, intensity, and a number of other things from scents to bad breath can dramatically impact sex.
"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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The most common diagnostic test for erectile dysfunction is called penile ultrasound. This test uses sound waves to look for abnormal penile blood supply. Another test that may be done is nocturnal penile tumescence testing, in which a type of computer is attached to the penis to see if nighttime erections are occurring. If a young man is having nighttime erections but can’t get an erection during sex, a psychological cause becomes more likely.
Additionally, financial struggles, issues at work, and issues at home with children or external family can impact the quality of sex you’re having. Remember that sex is a two person game. Both people need to be invested in it for it to be good. And good sex leads to longer, stronger, more powerful erections. It’s in both of your best interest to have better sex.

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.
Fortunately, the harm free radicals cause can be prevented with antioxidant nutrients, notably vitamins A, C, and E, and the minerals, selenium and zinc. Antioxidant supplements can help, but nutritionists and public health officials agree that the best way to get antioxidants is from foods rich in them: fruits, vegetables, beans, and whole grains. That's why health officials urge at least five servings of fruits and vegetables every day. Many studies show that as fruit and vegetable consumption increases, risk of heart disease and every major cancer decreases. There have been no big studies of dietary antioxidants and sexual satisfaction, but the link is biologically irrefutable. As antioxidant intake increases, so does blood healthy flow around the body, including into the penis. If you smoke, quit. And eat at least five daily servings of fruits and vegetables—fruit with breakfast, a salad and/or vegetable at lunch and dinner, and snack on fruit.

The most common diagnostic test for erectile dysfunction is called penile ultrasound. This test uses sound waves to look for abnormal penile blood supply. Another test that may be done is nocturnal penile tumescence testing, in which a type of computer is attached to the penis to see if nighttime erections are occurring. If a young man is having nighttime erections but can’t get an erection during sex, a psychological cause becomes more likely.
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.

Watch whatever you eat: poor diet is also the reason for weak erections. As per the research, specific eating patterns cause heart attacks due to the restricted blood flow in coronary arteries which impede blood flow to the penis. Blood flow is also required for the penis to make it erect. Some of the diets also include vegetables and fruits that have fried, fatty and even processed foods that contributed to decreasing the blood circulation throughout the whole body. Anything which is terrible for man’s heart is also wrong for his penis and gaining an erection. One can learn how to keep an erection


Another clue it’s psychological: He starts going soft around the same time your commitment level has shifted. In fact, sudden ED happens so often among newlyweds—there’s the pressure of becoming a married man plus, hi, the expectation of amazing wedding-night sex, says Dr. Trost—it even has a name: honeymoon syndrome. And a study published in the journal Translational Andrology and Urology found that once a guy’s sexual confidence takes a hit, he can get anxious about it happening again, and all that pressure creates a vicious cycle of erection fixation.
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.
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.
"This can take some time, but it can help to stop a cycle of too much anxiety, followed by an erectile issue. It also can help you realize where you draw the most physical pleasure. People tend to focus only on the genitals when it comes to sex. However, they can experience pleasure all over their bodies. If they learn how to utilize this, it can be a resource for future arousal, fun and pleasure."

“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.
Cigarette smoking is a risk factor for ED, according to the 2014 Report of the U.S. Surgeon General. Excess weight can also contribute to erectile dysfunction. A 2004 Italian study found that one-third of their 110 obese study subjects were able to eliminate their erectile dysfunction problems by losing fifteen percent of their weight through diet and exercise.
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. 

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.
For many older men, issues like diabetes, hypertension and heart attacks are often contributing factors to erectile dysfunction. But Goldstein said that in younger men, ED is far more likely to stem from physical trauma. This could be the result of a sports injury, such as a misplaced karate kick, a surfboard hitting the wrong area or long-distance bike riding. It could also be a result of a sexual injury. (This is most common during heterosexual intercourse, especially in the woman-on-top position, the sex position dubbed "most dangerous" by a 2015 study.)

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