“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.
Use penile injection therapy. An alternative method that you may be advised on by a doctor is penile injection therapy. For this you will be trained by the doctor how to inject your penis with medicine that relaxes the blood vessels and promotes the blood flow that causes an erection. This treatment has been shown to be effective at treating a range of issues both physical and psychological.
"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. 

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Something James, 26, knows for sure about his penis is that it won’t get hard when he’s sleeping with a woman for the first time. No, it has nothing to do with how attracted he is to her. It’s just a classic case of performance anxiety, caused by his personal fears about how awkward and uncomfortable the experience could be—which, of course, turns into a self-fulfilling prophecy.

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"If any of these physiological factors don't work properly, a man can experience weak erections," says Axe. "Problems maintaining an erection can be due to a number of issues, from hormone imbalances, to neurological issues, cardiovascular conditions, stress and issues with your mental health. There is not one clear way to explain erectile dysfunction — it depends on the man and his specific health condition."
...the root of the ground cover, Panax ginseng, which is the Asian species, and Panax quinquefolius, the American plant (grown mostly in Wisconsin). Ginseng is an "adaptogen," a medicinal herb that helps build and maintain body vitality, allowing users to better adapt to the stresses they face in life. Ginseng is available where herbal medicines are sold.
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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.)
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.

As recently as two decades ago, doctors tended to blame erectile dysfunction on psychological problems or, with older men, on the normal aging process. Today, the pendulum of medical opinion has swung away from both notions. While arousal takes longer as a man ages, chronic erectile dysfunction warrants medical attention. Moreover, the difficulty is often not psychological in origin. Today, urologists believe that physical factors underlie the majority of cases of persistent erectile dysfunction in men over age 50.
"Smoking is a short- and long-term cause of erectile dysfunction," warns Feloney. "In the short-term nicotine constricts the blood vessels that you need to get an erection, and in the long-term nicotine contributes to hardening of the arteries that can cause erectile dysfunction." Some approaches for quitting include making a clean break, avoiding the triggers of smoking, trying a nicotine patch or gum, and joining a smoke cessation program.
In an article on Men’s Health about things that wreck your erection, some examples of threats to an erection are sugar, lack of sleep, sleeping near a newborn baby, and lack of vitamin D. The common theme in the article is that reduced testosterone impacts your erection. Not all scientists agree with that. But there are definitely links between testosterone and erectile problems.
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.  
Improve your nutrition. Certain foods, such as those that are fatty, fried, sugary, and processed, can result in decreased blood flow throughout your body and can contribute to a vascular form of erectile dysfunction. Increase your intake of fruits, vegetables, whole grains, and heart-healthy fats to improve your blood circulation and increase the amount of time you’re able to maintain an erection.
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.

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.
If you notice that it is becoming a common occurrence, then a dialogue needs to happen because then it is less about him going limp and more about his personal health. Recommend he see a doctor and let him know you are there for him. Our bodies are clever and are always giving us signs, both positive and negative. This could be a tipping point in his life.
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.

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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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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