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6 Conditions that Could Cause Your Erection to be in Trouble

February 07, 2024 | By: Vinson Wang, MD

Experiencing a difficult-to-maintain erection from time to time does not necessarily indicate clinically significant erectile dysfunction (ED). Occasional ED is, however, an opportunity to rule out underlying conditions that could be hindering your performance – and pursue one of the many treatments available. 

Why Erections Get in a Slump 

Erectile dysfunction is the inability to sustain an erection firm enough for intercourse. It is common, affecting an estimated 30 million men in the U.S. Most commonly, it is caused by the inability to trap blood effectively in the penis. Age is a leading contributor to the condition, but it’s not the only one. A range of health conditions can contribute to erectile dysfunction: 

  • Cardiovascular disease – High blood pressure, atherosclerosis, and vascular disease can reduce inflow of blood to the erectile chambers.
  • Diabetes – High blood sugar levels can, over time, damage your nerves and blood vessels (veins and arteries).
  • Heart disease –  A weak erection is a symptom of heart disease because when plaque builds in the arteries, it reduces blood flow and can impair blood vessel function. 
  • Prostate conditions – Some treatments for prostate cancer, including prostatectomy and radiation therapy, can interfere with the ability to get an erection
  • Peyronie’s disease – This potentially painful condition is caused by a buildup of scar tissue in the penis, making it curve and can result in ED.
  • Low testosterone (Low T) ­– As men age, their sexual hormone levels decline, resulting in diminished sex drives and sometimes erectile dysfunction. But an estimated 20% of adolescent and young adult males have low testosterone levels, as well. 

Further, many medications can cause erectile dysfunction. These drugs include blood pressure pills, antidepressants, antiandrogens, sedatives, and appetite suppressants. 

Treatments That Help Reduce Occasional ED

If you live with any of the above conditions or are taking medications, talk to your doctor about the potential sexual side effects. (Don’t stop taking your medications though without your doctor’s OK.) 

Together, we can find a treatment option that suits you. Among them:

  1. A prescription drug, such as Viagra or Cialis, increases blood flow to the penis.
  2. Ultrasound wave treatment, called Low-intensity Shockwave Therapy, can improve blood flow. This procedure doesn’t just manage the symptoms but addresses the underlying cause of ED.
  3. Non-oral medications can be self-administered through either a penile suppository (intraurethral therapy) or an injection at the shaft of the penis (intracavernosal therapy).
  4. External vacuum devices that can be manually placed over the penis and hand-pumped to draw blood into the shaft.  
  5. A surgically installed implant (inflatable or bendable) can provide a more natural and permanent solution to ED that’s always reliable. 

If Illness Is Not the Cause of Your Weak Erection

In addition to medical conditions, psychological factors can play a strong role in erectile function. Occasional past failures can lead to performance anxiety during future encounters. Adrenaline released by the body during these situations can clamp down on blood flow to the penis. Stress, depression, and anxiety can also compound underlying medical causes to worsen erectile function. Sex therapy can help restore your confidence and improve overall erectile function. Ask your physician about a specialist.

You also should reconsider activities that could interfere with sexual performance, including smoking, drinking alcohol, and recreational drugs. By holding off, your performance might improve.

Remember: Intimacy Requires Communication

The most important step to restoring your sexual performance is talking about it with your partner and physician. A weak erection is a health issue that can be treated. It is absolutely not an indicator of who you are.

To learn more about men’s sexual health conditions and treatments, you can visit our Men’s Sexual Health Clinic. For more information about occasional or persistent ED, watch our video on our ED conditions page. Learn more about sexual issues that affect young men in our blog, here

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