Reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Erectile dysfunction can be two of the scariest words an adult man can hear. Our culture ties so much of our identity, sense of self-worth and confidence to sexual performance and virility that even the smallest “off” night can have us panicked about plumbing problems.
Having an off night doesn’t necessarily mean you have erectile dysfunction (ED), and nobody should beat themselves up over the occasional failure to achieve a full erection. But it’s not a problem you should ignore, either, particularly if it happens more than once.
There’s a difference between a single instance and an ongoing problem — which is to say, a difference between a bad night and having the diagnosable condition of erectile dysfunction. However, there’s not always a difference between ED and health problems, medical conditions or even some mental health conflicts you haven’t addressed yet.
If you had a heavy-drinking night that ended poorly and are researching on your phone while hungover, do yourself a favor and treat the hangover first.
But if this isn’t the first time, and you’re starting to see a pattern of these soft and softened events — and particularly, if it’s affecting your life or relationships — you may have erectile issues.
Below, we’ll cover four important signs of ED and what to do if you think you meet the criteria.
Since ED is a urologic disease, one of the best resources is the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). According to them, the most obvious symptom of erectile dysfunction is, well…erectile dysfunction — not being able to get and keep it up.
The National Institutes of Health (NIH) defines erectile dysfunction pretty clearly: “A condition in which you are unable to get or keep an erection firm enough for satisfactory sexual intercourse.”
This is pretty straightforward, but the questions of how and why are a little trickier. The truth is, many factors can cause erectile dysfunction, from poor diet and obesity to stress and anxiety. ED can be caused by illicit or prescribed drugs and their side effects, emotions, antidepressants, lifestyle choices and hormone imbalance.
Since it has so many common causes, ED is a fairly common disease, affecting an estimated 52 percent of U.S. men between the ages of 40 and 70 — and 30 to 50 million men nationwide.
Symptoms (and erection firmness) can vary from person to person. So instead of deciding based on your last boner, use the following four criteria as a sign you should talk to someone about ED:
You can’t get fully hard.
You lose your erections.
You’re less interested in sex than before.
Your erections are painful.
Let’s look at each of these in more detail.
Sometimes, a half-hard hard-on is one of the most glaring symptoms you’ll notice. A major problem many men have is that, although they may be getting hard-ish, they either can’t get a full erection or their erection is not hard enough to penetrate for sex.
A quick breakdown of what’s going on inside your member: There are two long chambers called the corpora cavernosa that contain lots of cardiovascular mechanics, including blood vessels and tissues, as well as one major artery each.
When you become aroused, your brain dilates the blood vessels, allowing blood to flow in. The blood becomes trapped in the corpora cavernosa, keeping you erect.
We’d like to think it’s either “on” or “off” with these functions, but if blood flow is insufficient or it isn’t sealed in, it can make erectile dysfunction a half-problem.
Talk with a healthcare professional about your medical history. They might want to discuss your drug and alcohol use, order blood tests or talk to you about risk factors for ED, like high cholesterol, high blood pressure and other things that can be treated with lifestyle changes.
Another way you might notice problems is if you keep losing your erection during sex.
Being able to get to full mast is a good sign, but keeping it up during intercourse is equally (if not more) important, right? Well, if sustaining an erection is also an indicator of erectile health, then not fully sustaining it until you orgasm is a sign your health isn’t great — and that you’re potentially struggling with ED.
Believe it or not, there’s a chance this cause of ED is all in your head. Physiological and psychological symptoms can manifest similarly or differently, but one sign your symptoms may be psychological or emotional is an inability to orgasm before losing an erection.
Office stress or an easily distracted, wandering mind may lead to you losing hardness, which can happen sometimes. But a pattern of losing it can point to performance anxiety, stress or a fear of sexual failure — all symptoms of ED.
Guys, we need to talk about the elephant in the room: low sex drive.
Maybe you’re having less sex as a result of ED, or perhaps you’re not too concerned about ED because you’re not as interested in sex.
Previous issues with erectile dysfunction, a fear of failure and low self-esteem can all cause you to become avoidant of (or lose interest in) sexual activity — but so can hormonal changes.
Many men with erectile dysfunction lose interest and motivation to pursue sexual activity to some extent, which can cause further harm to their confidence — and their relationships.
If this sounds familiar, health conditions like low testosterone may be causing your sexual dysfunction. In this case, treatment for low testosterone levels may be necessary.
Most of us assume sex is always pleasurable, but from complications with a penile implant to Peyronie’s disease, there are any number of reasons it can be painful. And pain could be a cause of erectile dysfunction.
A painful erection (especially as a result of something like priapism) can reduce sexual desire, affect sexual functioning and make you avoid sex like that one room where you always seem to get a static shock.
Painful erections and problems with ejaculation can sometimes suggest major urology problems, so it’s a good idea to talk to a healthcare professional about these when they flare up. They could be signs of anything from prostate cancer to vascular issues.
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If your sex life and sexual health are suffering, ED may be to blame. Your next step should be to speak to a healthcare professional about the symptoms you’re seeing — they’ll ultimately be your best guide for solutions.
For a sneak preview of their advice, we’ve assembled some guidelines and takeaways. To treat ED, you can:
Determine whether ED is a side effect of a bigger health issue, such as heart disease, kidney disease or diabetes.
Make significant lifestyle changes to incorporate a healthier diet, more exercise or better sleep into your daily routine.
But that’s all part of the second phase of your journey. For now, the most important thing you can do is ask for help.
Let’s put a few fears to rest real quick, starting with the panic over your first (or second) failure to launch.
One-off ED issues can happen, particularly when medication or alcohol is involved. So if the problem is very occasional or usually correlated to substances, you might not have ED.
But there’s still reason to be vigilant. Impotence is a condition best dealt with proactively, so keep the following in mind as you make choices and take action:
If you’ve experienced multiple incidents, it’s a sign ED is a pattern, not a bad night’s performance.
Even if you’re healthy, performance anxiety can cause ED, and there are various psychological treatments and approaches for dealing with the problem.
Thankfully, there are plenty of erectile dysfunction treatments, including medication, therapy and a general focus on a healthier lifestyle.
You might even want to consider a pack of our chewable ED meds hard mints for convenient, as-needed doses.
If you’re still unsure whether you have ED or want to know what treatment options are available, see our comprehensive guide to erectile dysfunction.