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DR. AYSHA BUTT

MEDICAL DIRECTOR

Dr. Aysha Butt is the Medical Director of FROM MARS, and is a GP Partner at Woodcote NHS Medical Practice.

GMC NUMBER: 6164178

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Sex

How to get an erection

Erections. It should be simple, shouldn’t it? Sometimes, it just isn’t. And sometimes it just won’t happen at all.

If you struggle with erections and it’s having an impact on your sex life, remember there are things you can do to improve your chances of getting and keeping an erection.

Here we’ll explain how you can get erections more reliably. We’ll also answer some other questions about erections you may have been curious about but never asked.

How do erections work?

Let’s start at the beginning – the mechanics of erections.

You get an erection when your penis fills with blood. During an erection, the vessels carrying blood into your penis widen, increasing its flow. At the same time, the vessels carrying blood out of your penis constrict, decreasing the flow out. This change in blood flow causes the vessels and cavities in your penis to fill with blood, making it swell and become hard.

What triggers this is a surprisingly complex process. Here, we’ll give it to you quick and simple.

Erections begin with your nervous system (your brain and nerves) sending signals to the blood vessels around your penis. It can be triggered directly by your nerves, with no involvement from your brain. This kind of stimulation is purely physical. A region of your brain, called the cerebral cortex, can also trigger an erection without any touching. Think sight, smell, taste, sound, imagination. Basically, whatever does it for you.

Your hormones, especially testosterone, also play a role in erections, with testosterone involved in nearly every step of the erection process.

In summary, you get aroused by something, and then your brain sends signals to your blood vessels to increase the flow of blood to your penis and to reduce the amount of blood that leaves it. You get hard. And it’s your good friend testosterone that helps all of this happen.

What is the male refractory period?

The male refractory period is the amount of time it takes for you to get an erection and be able to orgasm again after you’ve just ejaculated. How quickly can you go again? Your refractory period is usually shorter when you’re younger and can be as fast as 15 minutes in 18-year-olds and up to 20 hours in 70-year-olds.

What age does a man stop getting hard?

There’s no simple answer to this. The age you stop getting hard can depend on your condition, your lifestyle, and your genetics. Testosterone tends to start falling in men in their 30s and 40s, and erectile dysfunction becomes more and more common as men move into their 50s, 60s, and beyond. Having trouble with erections isn’t guaranteed, though it does become more likely with age.

How to get an erection more reliably?

As we mentioned above, erections start with some sort of stimulation, whether physical or mental. You need to focus on whatever works for you.

Patience is needed too. You can’t force it. Try and stay calm and relaxed, as anxiety is kryptonite for erections.

If you regularly struggle to get or keep erections, then you may have an underlying issue that’s affecting you. You’ll improve your chances of getting an erection if you address this issue.

What can stop you from getting an erection?

When you can’t get or keep an erection that’s hard enough for sex, it’s called erectile dysfunction (ED). It used to be called impotence, but ED is less of a loaded term.

We’ll give it to you straight. ED can make you feel powerless and emasculated. Sexual partners don’t always react to it in the most level-headed and understanding of ways either.

But if you’ve ever had ED, it might help to know it’s pretty common. Studies show that the majority of men experience ED at some point in their lives. Experts used to think ED was something that only happened to older men, but researchers are finding ED can be common among younger men too, and that it may be becoming more frequent.

In terms of what causes ED, getting an erection is a complex process, meaning many things can interfere with it. Let's take a look at some of the main causes:

Physical causes of erectile dysfunction

As erections begin in your nervous system, conditions that affect your brain and nerves can interfere with erections. These conditions can include damage to your spine, strokes that cause brain damage, and diseases like multiple sclerosis and Parkinson’s disease.

Anything that interferes with the flow of blood through your body can stop the process too, like having heart disease, high blood pressure, high cholesterol, or diabetes.

Changes in hormone levels, particularly testosterone dips, can also interrupt the process. Fluctuating testosterone might be because of conditions like an underactive thyroid gland or testosterone declining as you age.

Psychological causes of erectile dysfunction

In addition to the physical side of erections, getting inside your own head can also affect your sex life. Your desire for sex begins in your brain, and anything that disrupts your thinking and unsettles your mindset can impact your erections. Examples include:

· Performance anxiety (doubts about your sexual ability)

· Worries about premature ejaculation

· Issues with your body image

· Addiction to pornography

· Problems in your relationship

· Stress in other areas of your life

· Mental health issues like depression and anxiety disorder

Lifestyle causes of erectile dysfunction

Your lifestyle can also cause ED or make it worse. All of the following can also cause the problem:

· Being overweight

· Lack of exercise

· Poor or not enough sleep

· Smoking cigarettes

· Drinking alcohol

· Recreational drugs like marijuana and cocaine

· Medications that cause ED, including some antidepressants, antihistamines, and beta-blockers

These aren’t all the causes of ED, but just an overview of some of the possible culprits. Read more about the causes of ED.

What can you do about erectile dysfunction?

There are a few things you can do to tackle ED. Here’s where you should start.

See your doctor

First, you need to get to the bottom of what’s causing your ED. Your doctor is the best person to help.

If you can’t get an erection at all, even when masturbating, your ED is probably the result of a physical or lifestyle problem. Your doctor can assess your health, including requesting tests for serious health conditions like heart disease and diabetes.

If you can get an erection by yourself or in your sleep, your ED is probably a psychological issue, rather than a physical or a lifestyle one. You should still see your doctor, as they can refer you to a mental health professional who may be able to help.

You should have your health checked too, to make sure your ED isn’t an early warning sign of a serious physical health condition. It’s best to be on the safe side.

Lead a healthier life

Improving your lifestyle can make it easier for you to get and keep erections. If you exercise, keep your weight down, get enough sleep each night, and avoid alcohol, cigarettes, and recreational drugs, you can improve your chances of getting lasting erections.

Changing your diet to include certain foods can also help with erections by improving blood flow and boosting your testosterone levels.

Try ED meds

One of the most effective treatments for ED is a medication like Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil). They improve the flow of blood to your penis, making it easier for you to get an erection.

These medications can help you overcome physical problems that can stop you getting an erection, and they may be able to help with psychological causes of ED too.

How to get a harder erection?

The same things that give you erectile dysfunction can also make your erections weaker. So, the same solutions to ED will also help give you firmer erections. You should start by finding out if you have any medical or psychological conditions that could be affecting your erections. You can also make lifestyle changes that help improve erections, like getting enough sleep, exercising, keeping your weight down, eating certain foods, and avoiding things like alcohol and cigarettes.

How to get an erection when nervous?

Nerves can stop you from getting hard. We could tell you that you need to relax, but you knew that already, and someone telling you to relax is often the opposite of useful. If nerves are a regular problem for you, you may have performance anxiety, which can mean you’re not confident about your sexual ability and worry you won’t satisfy your partner. If you have performance anxiety, it may help to talk to a mental health professional. Speak to your doctor about a referral.

Remember, erections are complex and very personal. There might be any number of reasons why you’re struggling, but with the right changes to your lifestyle and some extra help from the right ED meds, you’ll get there.