Erectile dysfunction: What causes it and when to talk to a professional

Getting or keeping an erection isn’t always easy. It can happen at different points in life, and fatigue, stress, alcohol or personal worries can all temporarily affect how your body responds during sex.

If it keeps happening or starts to worry you, though, it’s worth paying attention. Erectile dysfunction has a range of possible causes, some of which may be connected to your overall health.

The good news? There are solutions. And you don’t have to navigate the questions on your own.

What is erectile dysfunction?

Erectile dysfunction means having ongoing trouble getting or keeping an erection firm enough for satisfying sexual activity.

It can happen at different ages and for many reasons. Contrary to what you may have heard, it isn’t simply an unavoidable part of aging.

An occasional difficulty usually isn’t cause for concern. If sex doesn’t go as expected after a stressful week, very little rest or a few too many drinks, it may just be your body responding to the circumstances.

For a closer look at the different stages of sexual response, read our article on sexual response.

What can cause erectile dysfunction?

There’s no single explanation for erectile dysfunction. Your physical health, emotional well-being and daily habits can all play a part, and several factors may be involved at once.

Stress and fatigue

When life is demanding, you’re short on sleep or your mind is full, both desire and sexual response can be affected. It can be hard to get physically aroused when you’re mentally somewhere else.

Performance anxiety

Worrying about getting or keeping an erection can make it harder to do just that. After one disappointing experience, you may feel nervous about the next time you have sex. That added pressure can make the difficulty more likely to happen again.

Read more in our article on performance anxiety and sex.

Underlying health conditions

Diabetes, heart and blood vessel disease, high blood pressure and some neurological conditions can be linked to erectile dysfunction.

That’s why ongoing trouble with erections shouldn’t be dismissed as a matter of age. Sometimes, it’s a reason to take a closer look at your health.

Some medications

Some medications can affect sexual function. If you notice a change after starting a new medication, talk to your pharmacist or doctor. Never stop taking a medication on your own.

Hormones

Hormonal changes can also affect sexual function. A drop in certain hormones, including testosterone, may play a role.

Lifestyle habits

Smoking, drinking heavily, and not getting enough physical activity can contribute to erection difficulties. Erections depend on blood flow, so habits that are good for your heart and circulation can also support sexual function.

An occasional difficulty doesn’t mean something is wrong

Your body won’t necessarily respond the same way every time you have sex.

A lot depends on what’s happening at the time. Being tired, stressed, distracted or emotionally unsettled, as well as drinking alcohol, can all affect your ability to get an erection.

What matters more is asking yourself: Is this happening often, has it been going on for a while, or is it worrying me?

If it’s affecting your confidence, sex life, relationship or peace of mind, it’s worth talking about.

Having trouble with an erection doesn’t mean you don’t feel desire or that your sex life is “broken.” There’s more to sex than erections and penetration. Finding other ways to be intimate can help ease the pressure, too.

What can help?

What helps will depend on what’s causing the difficulty. Sometimes, changes to everyday habits can make a difference: getting more exercise, drinking less alcohol, quitting smoking, getting enough sleep and taking care of your heart health.

If stress or anxiety is involved, learning to manage it may help as well. An open conversation with your partner can also take some of the pressure off and make intimacy feel more comfortable.

A healthcare professional can help you explore the options that fit your situation, whether that means medical treatment, psychosexual therapy or changes to your daily habits.

When is it time to talk to a healthcare professional?

Consider making an appointment if erection difficulties:

• Happen often or don’t go away
• Worry you or affect how you feel
• Interfere with your confidence, sex life or relationship
• Start suddenly, especially if you have other symptoms or health risk factors

Erectile dysfunction can sometimes be connected to circulation problems or other health issues that need to be checked.

You don’t have to wait until it becomes a major problem to bring it up. Your doctor, pharmacist or a sexual health professional can help you understand what might be happening and what to do next.

Start by talking about it

Erectile dysfunction may feel awkward to bring up, but it’s common. It says nothing about your worth, how much desire you feel or your ability to enjoy a satisfying sex life.

If it keeps happening, a conversation with a healthcare professional can help you understand why and find an approach that suits your needs.

Your sexual health deserves attention, and asking questions is a good place to start.