Why You Can’t Get an Erection: Causes and Treatments

Why You Can’t Get an Erection: Causes and Treatments

NOT BEING ABLE to get hard when you’re ready to get it on can be distressing. But it definitely happens from time to time, and it doesn’t necessarily mean something is wrong.

Many factors could be at play, from stress, eating habits, or lifestyle changes. It could be a side effect of a medical condition, or you’re so worried you won’t be able to perform in bed that it creates a cycle where you struggle to get an erection, says Juan Cedeno, M.D., a urologist at Baptist Health South Florida.

Many men are “afraid to talk about it,” he says. “We have to normalize erectile dysfunction.”

Struggling to get an erection is something that will likely happen to most men at some point in their lives, adds Daniel Brison, M.D., a urologist and medical advisory board member at 1MD Nutrition.

Talking to your doctor may be uncomfortable, but physicians can help, and having trouble getting it up doesn’t always mean you need to take ED drugs, Dr. Brison says. Often, making a few lifestyle tweaks can help. Here are some common reasons that you can’t get an erection.

Reasons You Can’t Get an Erection

YOU MIGHT NOT be able to get totally hard due to what else is happening in your life—whether it’s something you just did (drink, masturbate), something you’re thinking (things that are stressing you out), or a medication that you’re taking. Take a look through these reasons and see if any sound like what you’re experiencing right now. Knowing what’s causing it can help you get to the right solution.

You’re Not Getting Enough Sleep

“IT’S VERY HARD—if you lead a chronically sleep-deprived life—to experience sexuality to the fullest pleasurable extent,” says Nathan Starke, M.D., a urologist and director of the Men’s Health Clinic at Houston Methodist.

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Most adults are at least a little bit sleep-deprived. More than a third don’t get the recommended minimum of seven hours a night, according to the Centers for Disease Control and Prevention.

As part of your natural circadian rhythm, testosterone levels rise while you sleep and spike first thing in the morning when you wake up, Dr. Starke says. Testosterone spikes again around midday. If you don’t get the proper amount of sleep, your natural sleep cycle gets disrupted, which could lead to fewer spikes and lower average testosterone.

A symptom of lower testosterone could be erectile dysfunction, he adds.

Also, if you’re tired all the time, you probably won’t have much of a libido, which Dr. Cedeno says will also make it tough to get an erection.

Your Diet Is Out of Whack

OVERALL HEALTH IS key to erectile functioning. Focusing on eating a healthy, balanced diet can help, Dr. Starke said. “My preference is low-carb, low-saturated fat, high protein, high complex carbs, lots of fruits and vegetables,” while avoiding ultra-processed foods as much as you can.

Research published in JAMA Network Open in 2020 suggested that men who followed the Mediterranean Diet or the Alternative Healthy Eating Index 2010 diet, which emphasize vegetables, fruits, nuts, legumes, and fish (and avoiding red and processed meats) had a lower risk of developing ED.

You’re Too Sedentary

NOT GETTING ENOUGH physical activity could also diminish your overall health, which could make it tough to get an erection, Dr. Brison says. A sedentary lifestyle can raise your risk for high blood pressure, high cholesterol, and diabetes, which are also risk factors for ED.

“They all contribute to a decrease in the blood flow necessary to obtain a proper erection,” he explains.

So, find an activity you enjoy, whether it’s walking, hiking, or weightlifting, and try to do it at least a few times a week. It’s good for every part of your body, including your penis.

You’re Dealing With Obesity

OBESITY CAN INCREASE inflammation and stress on your body. It can cause nerve and blood pressure problems, Dr. Starke says. All of these things can interfere with your ability to get an erection. Your neurological system tells the blood vessels in your pelvis to relax certain muscles. This allows blood into the penis, leading to an erection.

Obesity can also affect hormone production, which may lead to lower testosterone and contribute to ED.

Focusing on eating a healthy diet and getting plenty of exercise will help you maintain a healthy weight. This will likely enhance your libido and ability to get an erection.

You Drank Too Much

IF YOU HAD one too many drinks and realize you just can’t get hard, thank whiskey dick, which is as real as it is a drag.

Alcohol depresses your central nervous system, says Jamin Brahmbhatt, M.D., a urologist at Orlando Health. It decreases blood flow to your penis, preventing you from getting hard.

So while that drink might relax you enough to get into bed—and it’s true, some guys might perform better with a tiny bit of booze in their system—it might prevent you from getting the job done if you go overboard, he says.

You Recently Masturbated

IF YOU JUST got off solo, you might have to wait before you can hop into bed with a partner, says Dr. Brahmbhatt. The delay might have something to do with a spike in the hormone prolactin after you orgasm, according to a study published in the International Journal of Impotence Research. This hormone has been linked to difficulties maintaining an erection or even ejaculating.

“It’s like running a marathon; your body will need to relax and rejuvenate before you run again,” explains Dr. Brahmbhatt. The average man has a 30-minute refractory period.

But that’s “average.” The actual time varies among people, according to the International Society for Sexual Medicine, and it’s often shorter for younger men. Some guys may need as little as 10 minutes; others need an hour or two to recharge.

You’re Stressed and Exhausted

THE MENTAL ASPECT of sexuality is crucial, says Dr. Starke. When you’re stressed or anxious, it can put you in fight or flight mode, and an erection may be the last thing on your mind. These states can also increase inflammation, which may harm your libido, too.

frustrated man and sleeping woman

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Feeling stressed can spike your cortisol levels. That can be a problem, since the stress hormone can block the effects of testosterone, a study published in Hormones and Behavior found. That can kill your libido and cause problems with your erection.

If you’ve struggled to perform in the past, that may be on your mind, too, increasing your anxiety, which contributes to the cycle of ED, Dr. Cedeno says. Stress and anxiety might also increase the likelihood of premature ejaculation.

“Stress exhausts you mentally and physically,” says Dr. Brahmbhatt. “When you’re stressed out, your body is trying to mobilize all of your energy to your main functional organs, so something like your penis is going to be the last thing on this list.”

Pay attention to self-care strategies that help you sleep better and exercise more—these can often help with anxiety as well as exhaustion. If anxiety is keeping you from doing things or it’s taking over your thoughts and mental energy, talk to a mental health professional. If you have no idea where to start, call the mental health helpline at 988, and someone can point you to resources.

You Have a New Partner

YOU FINALLY CLICK with someone, but as soon as you try to have sex, your member wilts—along with your confidence. Michael Eisenberg, M.D., a urologist at Stanford Medicine, says that being unable to get an erection with a new partner is incredibly common. “Relaxation can help, and increased foreplay can sometimes help.”

If you’re worried that your penis size doesn’t stack up to other men, or if you’ve had awkward sexual experiences in the past, your brain might not be able to let go of that when it comes time to perform. Your body might physically experience this as a high-stress situation and pump your system with adrenaline, killing your ability to get it up, says Dr. Brahmbhatt.

You’re Taking Certain Medications

THERE ARE MANY medications that can interfere with your ability to get hard, according to the University of Maryland Medical Center.

That includes certain high blood pressure medications, like beta-blockers and diuretics, says Steven Lamm, M.D., medical director of NYU Langone’s Preston Robert Tisch Center for Men’s Health. While they’re great for your heart, their interference with your sympathetic nervous system and blood vessel walls can decrease the blood flow to your penis.

Taking certain antidepressants can keep you from an erection, too, says Dr. Brison. Serotonin reuptake inhibitors like Prozac and Lexapro can decrease your testosterone levels or even lead to delayed ejaculation.

If you’re taking these medications and experiencing ED, let your doctor know what’s going on. You shouldn’t have to live with side effects that cramp your life. In many cases, a doctor can work with you to find a different drug or dose to minimize these side effects, says Dr. Brahmbhatt.

You and Your Partner Are Trying to Conceive

WHEN YOU’RE TRYING to conceive, it can put a lot of pressure on you to perform. “The stress of having sex around the ovulatory cycle can take away the spontaneity and make sex more of a chore,” says Dr. Eisenberg.

When to See a Doctor About Not Getting Hard

MANY THINGS CAN contribute to ED, Dr. Brison says. If it happens occasionally, it’s likely nothing to worry about. But if you persistently struggle to get an erection and it’s stressing you out, see a doctor.

Lots of factors could be to blame, and he says finding the exact cause is crucial.

“Seeking early evaluation is always a better option,” Dr. Brison says. “Identifying the cause and treating early is always the better choice, and early intervention is often easier and carries better results.”

That can ensure you get the treatment you need, whether it’s an ED drug, help with a diet or exercise plan, or a referral to a mental health professional.

Talking about ED can be embarrassing, but Dr. Starke says it’s the only way to get the help you need. “We do this all the time. We’re going to make an uncomfortable topic easier to talk about.”

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