"It definitely was a blow to my masculinity," Francis told Mic. "It didn't help that my wife at the time would say that I must be gay if I couldn't keep it up for her." Compounding the issue, if an erection doesn't happen during a given sexual encounter, the man can obsess over it, inevitably creating pressure and making it difficult for him to become fully aroused during future encounters. 
“Studies looking at men under 40 with ED have found certain psychiatric conditions, like depression and anxiety, at a higher rate than other groups,” Trost says. And as he explains it, anxiety and depression—two things millennials experience at uniquely high rates—can make it more difficult for a man’s brain to respond to arousing stimuli, which can cause a low sex drive or issues getting an erection.
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." 

"When it's persistent and consistent, it's extremely likely to have biological factors" regardless of age, Dr. Irwin Goldstein, director of sexual medicine at Alvarado Hospital in San Diego and the director of San Diego Sexual Medicine, told Mic. But the cause of ED can also be psychological: For instance, if a man can get an erection on his own but not with a partner, then his ED is more likely to be rooted in performance anxiety or a deeper psychological issue. 
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.

At what age does a man get erectile dysfunction?


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. 

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:
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.”
You may already know that lots of hard drugs — like cocaine, heroin, or Oxycontin — can cause sexual problems (though, quite frankly, if you're on cocaine, heroin, or Oxycontin, you have many more pressing concerns to deal with than getting dirrrty). But did you know that sometimes, even pot can inhibit erections? And you thought weed was just a harmless way to enjoy the musical stylings of Pink Floyd. Who knew it could actually mess with one's own pink floyd?
Erectile dysfunction is about more than just the ability to get an erection (although that’s certainly a big part of it). It’s also about how hard your erections normally get, and if you can get an erection that’s hard enough and lasts long enough to have “satisfactory” sex. ED is really about how you (and your partner) feel about your sex life. And a lot of that has to do with how firm your erections get.
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Mention older men’s wilting erections, and people immediately think Viagra. Yes, Viagra, Cialis, and Levitra, can raise flags that have fallen to half staff. But fewer than half of men over 50 have tried them, and of those, fewer than half have renewed their prescriptions. Why? Because the drugs don’t work as well as advertised, and the side effects can be annoying.

How can I fix erectile dysfunction naturally?


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.

Who do I talk to about erectile dysfunction?


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."

What causes a man not to erect?


The first tip for how to keep an erection longer is a simple one. Exercise the penis with kegels. According to sex and relationships expert, Jordan Gray, kegel exercises strengthen your genitals and improve your sex life. Kegel exercise involves “flexing and holding the muscles that stop the flow of urine.” The penis is made up of a ton of muscle. It’s important to keep that muscle tissue strong, healthy, and reactive. Kegels are popular with men and women. If you’re struggling with keeping an erection for a length of time, the reason could be weak muscle tissue.

The production factory of your semen is on an industrial scale, constructed from multiple locations in your genitourinary system. First there are the stars of the show, your spermatozoa, which are naturally synthesised in the seminiferous tubules within your testicles. During the ejaculation process, these then pass through your ejaculatory ducts and blend with fluids from your prostate, seminal vesicles and bulbourethral glands. This melting pot forms your semen as it arrives via urethral meatus (the end of your penis) to the cold light of day – or night.

Exercise on a regular basis. There is evidence that suggests that a sedentary lifestyle can be a factor in erectile dysfunction. Aerobic exercises, such as running and swimming, can help prevent ED. The exercise can help improve blood flow and circulation, naturally help lower high blood pressure and cholesterol, and can even help improve hormonal balance and drive weight loss – all of which are factors that can help you improve ED and maintain an erection.
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.)
"Start by cutting out junk, processed and packaged foods. Instead, focus on eating high fiber foods, like fruit, vegetables, nuts and seeds, and foods that will help to improve blood flow, such as leafy green vegetables. It's also helpful to avoid drinking too much caffeine and alcohol. Next, make sure you are getting regular exercise. This will help you to balance your hormone levels, improve circulation and manage stress."
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."

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.

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.
"Stress and anxiety can adversely affect sexual performance and are common causes of erectile dysfunction,” warns Feloney. “Feelings of stress and anxiety can also lead to depression and a loss of interest in sex." It's important to get these feelings out in the open where you can deal with them. Issues that can lead to erectile dysfunction include fear from previous bad experiences with sex, family or work related stress, poor communication with your partner, and unrealistic goals and expectations.

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