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Why can’t I get and keep an erection?

NHS Choices

At some stage in their life, most men have an occasional episode of being unable to get and keep an erection. It’s usually nothing to worry about and is often a result of:

  • stress
  • tiredness
  • anxiety
  • drinking too much alcohol

However, if you frequently have erection problems, you could have erectile dysfunction (ED), also known as impotence.

What is erectile dysfunction (ED)?

ED is a regular inability to get and keep an erection. It may only happen in some situations; for example, you may be able to get an erection when masturbating, but can’t keep an erection when you’re with your partner. It’s important to remember that erectile dysfunction is a symptom and not a disease, therefore it’s important to identify what may be causing it.

Who gets erectile dysfunction?

ED can affect men at any age, but is more common as men get older. It’s estimated that half of all men aged between 40 and 70 have some degree of ED.

What causes erectile dysfunction?

ED can have physical and psychological causes. Sometimes it’s a combination of both.

Examples of physical causes include:

  • narrowing of the blood vessels in the penis – this is commonly linked with cardiovascular disease, high blood pressure or diabetes
  • hormonal conditions – such as thyroid problems
  • certain kinds of medicines or drugs

Examples of psychological causes include:

  • depression
  • anxiety
  • fear of failing at sex
  • relationship problems or mental health problems

It’s thought that most cases of ED have physical causes. However, many men with ED can feel stressed or anxious about their condition, which can make it worse.

ED can also be a side effect of some medication.

Read more information about the causes of ED, including medicines that can cause it as a side effect and factors that increase your risk of ED.

How is erectile dysfunction treated?

Treatment for ED depends on what’s causing it.

If ED is caused by a medical condition, such as those mentioned above, treating this condition may resolve the problem.

Symptoms of ED can often be improved by making lifestyle changes, such as:

  • losing weight (if you’re overweight)
  • giving up smoking
  • drinking less alcohol
  • not taking illegal drugs
  • exercising regularly
  • reducing stress

When to get medical advice

If you think you have symptoms of ED, it’s important to see your GP or go to a genitourinary medicine (GUM) clinic, so they can assess whether you need any treatment. If you find talking about it embarrassing, remember that doctors are used to dealing with problems like this.

It’s important to identify the cause of your symptoms, because erectile dysfunction can be an early sign of another condition, such as cardiovascular disease.

PUBLISHED: Page last reviewed: 11/11/2014.
COPYRIGHT © 2015 NHS Choices

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