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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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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"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.