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.

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It’s important not to take a bout of psychological ED personally. Still, when confronting a suddenly soft penis in the moment, “It’s not you” can be hard to believe. For instance, Erin, 22, tried—really tried—to make sex with Drew* happen. The first time his erection died right before they were about to have sex, she improvised and gave him “really long” oral instead. But the lack of a boner was confusing. “That had never happened to me with a sexual partner, so I was like, ‘Okay, he’s just not into me,’” Erin recalls.

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These specific chemicals are found in erectile dysfunction medications such as Viagra and Cialis."The chemicals that cause the outflow are called phosphodiesterases," says Reitano. "To give you a stronger erection, erectile dysfunction medications (PDE-5 inhibitors) block or inhibit the phosphodiesterases, which enables the blood vessels in the penis to stay open and receive more blood, creating a firmer and longer lasting erection. This is why the drugs are called phosphodiesterase inhibitors (PDE-5 inhibitors for short)."
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.
As a relatively young man, Mher was in the minority of patients with erectile dysfunction, who are predominantly over the age of 50. But he's far from the only young man who's struggled with the condition. According to a 2013 study in the Journal of Sexual Medicine, an estimated one in four patients with new, onset ED are under the age of 40 — yet because we rarely hear about these men, they're left feeling embarrassed and alone.
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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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.”
Some men experience erectile dysfunction as a result of physiological factors, including medications that can interfere with sexual response, chronic illness (e.g., heart disease, high blood pressure, diabetes), physical disability, alcoholism, drug use, or injury that impedes blood flow to the erectile tissue. High cholesterol, which can limit blood flow through the atreries that supply the genital area, can also be associated with erectile dysfunction. For others, psychological concerns, including stress, anxiety, self-esteem, or fatigue are the source. Researchers believe that for many men erectile dysfunction is caused by a combination of physical, psychological, and cultural factors.

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Occasional ED is common in all men, including young and healthy men. But if you have a persistent or recurrent problem with initiating or maintaining an erection and it's causing you or your partner distress, talk to your doctor. “Lack of nighttime erections is another cause for concern, said Wang. These occurrences serve to nourish the penis with oxygen and keeping the blood supply healthy, he explained. "Young men should get four or five of these a night. If you are not getting these and you are having frequent problems with ED, you need to check in with your doctor,” he recommended.


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."
Try this: just reduce how much porn you consume in a week. If you want to take it a step further, watch it with your partner. Use it to inspire your sex life, not replace it. Keep in mind that fatigue plays a big role in your ability to keep an erection. Watching too much porn and subsequently masturbating to it could tire you out for actual sex with a partner later on. Balance is key.
Defined as "the inability to get or keep an erection firm enough for sexual intercourse," ED affects nearly 30 million men in the United States (though a 2007 study put the figure at 18 million), according to data from the National Institutes of Health. Doctors have anecdotally reported an increasing number of young male patients; in a recent Vanity Fair piece on hookup culture, writer Nancy Jo Sales spoke with women who noted that many of their Tinder hookups struggle with the condition.
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.
Research has shown that the same eating patterns that can cause heart attacks due to restricted blood flow in the coronary arteries can also impede blood flow to and within the penis. The blood flow is needed for the penis to become erect. Diets that include very few fruits and vegetables along with lots of fatty, fried, and processed foods can contribute to decreased blood circulation throughout the body.
These specific chemicals are found in erectile dysfunction medications such as Viagra and Cialis."The chemicals that cause the outflow are called phosphodiesterases," says Reitano. "To give you a stronger erection, erectile dysfunction medications (PDE-5 inhibitors) block or inhibit the phosphodiesterases, which enables the blood vessels in the penis to stay open and receive more blood, creating a firmer and longer lasting erection. This is why the drugs are called phosphodiesterase inhibitors (PDE-5 inhibitors for short)."
The strength and frequency of your erection are an important indicator of your overall health. The blood vessels in the penis are smaller than arteries and veins in other parts of your body, so any problems like blockages, blood vessel dilation issues, or hormone imbalances will often show up as erectile dysfunction (or less firm erections) before something more serious like a heart attack or stroke. 

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.
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.
Get a blood test to evaluate your testosterone levels. Testosterone naturally peaks in adolescence and young adulthood and drops off as you age. If a blood test reveals that you have low testosterone levels, there's a good chance this could be the culprit behind your erectile dysfunction. Your doctor will likely recommend natural lifestyle changes first, such as losing weight or increasing muscle mass. If your testosterone levels are lower than average for your age, they may prescribe taking supplemental testosterone.[12]

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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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]

If you think you have erectile dysfunction, or ED, you’re bound to have questions for your doctor about what’s happening and how to fix it. Lots of men have been there. Don’t be afraid to talk to your doctor and ask him any and all questions you might have that can start you on the road to getting a solution. Here are the first six questions you should definitely ask:

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"Surprisingly, up until the 1980's, most sex experts held the Freudian view that weak erections were caused by deep-seated, unconscious neuroses or psychological problems," she explains. "This view has now widely been rejected by professionals in the field of sexuality and it's now understood that erection problems that stem from deep psychological problems are the exception, not the rule. A majority of weak erections are caused by a combination of sexual misinformation, relationship problems, depression and other life stresses."
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.
The National Institutes of Health estimates that erectile dysfunction strikes as many as 30 million men in the United States. Its prevalence does increase with age — 4 percent of men in their 50s are affected by ED, 17 percent in their 60s, and 47 percent of those over 75. But research has also found that 5 percent of those affected were between 20 and 39.
It’s important not to take a bout of psychological ED personally. Still, when confronting a suddenly soft penis in the moment, “It’s not you” can be hard to believe. For instance, Erin, 22, tried—really tried—to make sex with Drew* happen. The first time his erection died right before they were about to have sex, she improvised and gave him “really long” oral instead. But the lack of a boner was confusing. “That had never happened to me with a sexual partner, so I was like, ‘Okay, he’s just not into me,’” Erin recalls.

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