"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. 
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.

How long does the average female last in bed?


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.

How long does the average female last in bed?


Regular exercise and a diet rich in antioxidants is also the foundation of permanent weight control and diabetes prevention. Studies at the Duke University Diet and Fitness Center show that weight loss is strongly associated with better sexual function. Other studies show that diabetes is a major risk factor for ED, and that a healthy lifestyle prevents the disease and can restore erection function.


Now, despite there being some unavoidable factors – your age (volume hits peak production around your early to mid-thirties) and the anatomy that your are born with (bigger seminal equipment will naturally yield more) – there are some some ways to help boost volume. But be warned, these may sound very familiar to the ones your just read about supporting stronger erections...
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.
"We used to think that ED in young men was 90 percent psychological, but we now know that most cases are caused by a combination of risk factors. Erectile function depends on hormones, blood supply, nerve function, and psychological health,” said Run Wang, MD, professor of urology at The University of Texas Health Science Center in Houston and director of sexual medicine at MD Anderson Cancer Center.
Remember those cultural messages we discussed earlier, about how men are wild sex aliens from the planet Weenus? Well, men are raised hearing those messages, too, and they can end up screwing with their sexual self-image —for instance, they can lead men to obsess over their own virility, and panic about impressing a new partner, until they've thought their boner into a corner and can't get an erection. Performance anxiety is one of the most common culprits behind lost erections, especially among younger, less experienced men.
Alcohol: A couple of drinks can loosen your inhibitions and help you relax. But alcohol can also impair sexual functioning. Alcohol works on the nervous system by slowing down brain function, breathing, and pulse. Initially, the effect is often psychologically stimulating, since emotions and desires flow more freely. However, while alcohol may boost sexual desire by helping a person to relax, it can decrease performance, especially where erections are concerned. For this reason, it's best for guys to limit their alcohol intake to one to two drinks (or none at all) for optimal sexual function.
Performance anxiety: Perhaps the most common cause of erectile problems among younger guys is performance anxiety. Many cultures place pressure on men to be the "experts" when it comes to sex, which can make men feel like they have to be responsible for sex or know how to please their partner every time. This pressure can be stressful and make it more difficult to get or maintain an erection.
Depression. The profound sadness, emptiness, and hopelessness that characterize depression may also cause ED among younger men. “The biggest effect of depression is on a man’s desire for sexual relations, or libido,” says Drogo Montague, MD, director of the Center for Genitourinary Reconstruction in the Glickman Urological and Kidney Institute at the Cleveland Clinic. “To some extent, depression can affect a man’s ability to maintain an erection. It can be a chicken-and-egg situation. However, reduced libido is a common indicator of depression.”

The penis is the male sex organ, and the shaft of it is the longest part. The glans and head are located at the end of the shaft. The opening at the tip of the head when semen and urine come out is termed the meatus. Inside the shaft are two cylinder-shaped chambers called the corpora cavernosa and they run the length of the penis. They have blood vessels, maze, open pockets, tissue, and others.
It can be difficult and frustrating for men and their partners to cope with erectile dysfunction, especially when the cause is unclear. At this point, it is important to be supportive and understanding of the situation and of one another. Erectile difficulties can cause feelings of inadequacy in both men and their partners. Each may internalize the situation, fearing that s/he is the one to blame. Therefore, open and honest communication with one another is an essential ingredient in strengthening your relationship as you work through this situation together.
My husband is suffering from erectile dysfunction. He has been to many doctors, including a urologist, neurologist, orthopedist, you name it. After many diagnostic tests, it seems that nothing physical can be found. He used to have full erections almost daily. Now nothing. Although he can get hard, he cannot maintain enough for intercourse. What can we do at this point?
Evaluate surgical options. If the other treatments have not proven successful, your doctor may recommend a surgical procedure that will involve an inflatable penile prosthesis being implanted into your penis. Typically a pair of inflatable cylinders are inserted into the penis, which can be pumped up and deflated using a connected device that is inserted into the scrotal sac.
"I like to recommend that couples think outside the box," Dr. Hartzell said. "Intercourse doesn't always have to be the goal; look at sex as pleasure oriented vs. goal oriented." She suggested couples incorporating oral sex and manual stimulation into their bedroom routine. She also advised couples to "have fun" with their sex lives by not adhering to a specific schedule or routine: One woman she works with, for instance, leaves her partner's injection on her pillow as a subtle signal that she's in the mood to have sex.
Pycnogenol is a compound found in the French maritime pine (Pinus pinaster), which grows in southern Canada. Several studies show that in combination with the amino acid L-arginine, it boost synthesis of nitric oxide, which plays a significant role in erection. Other studies show that pycnogenol helps restore wilting erections. In one study, 124 ED sufferers took either a placebo or pycnogenol and L-arginine (four tablets a day, 20 mg pycnogenol, 700 mg L-arginine). After six months, the supplement group showed a modest but significant improvement in erection, without side effects.

How do you fix ed?


Remember what I said before about how it's not you? Okay, sometimes it is you. But it's not that you're not sexy — it's that for men, as well as women, relationship problems (like fighting all the time, or having clashing expectations about where things are going) can severely mess up your sex drive and ability to become aroused. Which makes sense — if you're spending 90 percent of your time together fighting about whether you're going to move in, switching gears to make 10 percent of your time together into a sexy sex party is pretty damned difficult.
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.”
Gray-haired men soaking in Jacuzzis overlooking canyons, thumbing through the morning newspaper in their thick reading glasses, cuddling their wives on gently swaying hammocks while drinking sensible glasses of cabernet...the classic erectile-dysfunction commercials of the past 20 years were pretty clear about who they wanted to reach. Ever since, those iconic images have defined who we as a society assume are in need of penis pills: men of retirement age.
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.

"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."
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.
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.
My husband is suffering from erectile dysfunction. He has been to many doctors, including a urologist, neurologist, orthopedist, you name it. After many diagnostic tests, it seems that nothing physical can be found. He used to have full erections almost daily. Now nothing. Although he can get hard, he cannot maintain enough for intercourse. What can we do at this point?
"This triggers the release of a neurotransmitter called dopamine, and it sends a chemical message from the brain to the penis, causing an increase of blood flow to the penis. The blood vessels leading to the reproductive system then relax and this allows increased circulation in the genital area. When you aren't aroused, the blood vessels in your penis are only partially open. But when your brain sends messages to your penis that you are ready for sex, the vessels open and allow more blood to enter the area. Because of the increased blood flow, blood gets trapped in the penis, which makes the penis expand and causes an erection."
For many young men, performance anxiety plays a large role in erectile dysfunction. Other factors include money and work problems, as well as relationship issues and even issues about sexual orientation. Undiagnosed depression and post-traumatic stress disorder can cause erectile dysfunction--especially if the PTSD is related to a past sexual experience.
Erectile dysfunction can be embarrassing and difficult to talk about for some men. Many men may feel like they need to hide their diagnosis from their partner. "Failure to communicate openly about erectile dysfunction can result in both partners drawing away from the relationship," warns Feloney. Remember that your partner is also affected by your problem; being open and honest is the best way to decrease fear and anxiety. Discuss options for achieving sexual satisfaction together, and be positive — most erectile dysfunction problems can be treated.

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.
So not only are erectile problems common, they're nothing for you or your special friend to be freaked out about. Check out the nine most common reasons that dudes sometimes can't get it up, and get ready to become the soothing voice of reason the next time the guy you're with has a hard time pitching his tent in your happy valley. Everything (and every penis) is gonna be fine!

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