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How to Know If You Have ED: Signs of ED

Kelly Brown MD, MBA

Reviewed by Kelly Brown MD, MBA

Written by Erica Garza

Published 01/14/2021

Updated 07/16/2024

“Do I have ED?” It’s a pretty common Google search. Erectile dysfunction can be two of the scariest words an adult man can hear. Our culture ties so much of identity, sense of self-worth, and confidence to sexual performance that just one “off” night can send you into a panic.

But how do you know if you have ED? What signs should you be looking for?

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, if it’s happening often.

After all, ED can be a sign of other serious medical conditions or even some mental health issues. The longer you put off seeking medical advice, the longer you put your health at risk.

If you’ve been noticing signs of ED, like being unable to stay hard during sex or your erections aren’t as hard as they used to be, keep reading.

Below, we’ll cover how to know if you have ED, including four critical signs, the symptoms of erectile dysfunction, and what to do if you think you meet the criteria.

Erectile dysfunction is more common than you think, affecting an estimated 52 percent of U.S. men between the ages of 40 and 70. It can happen to younger guys too.

But many men delay seeking treatment until it starts impacting their relationships.

Common signs of ED include:

  • You can’t get fully hard.

  • You lose your erections.

  • You’re less interested in sex than before.

  • Your erections are painful.

Still asking yourself, How do I know if I have ED? We’ll look at each of these symptoms in more detail to help you figure out how to know if you have ED.

1. You Can’t Get Fully Hard

Sometimes, a half-hard hard-on is one of the most glaring ED signs 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 isn’t hard enough to penetrate their sexual partner.

Here’s a quick breakdown of how an erection works (or should work):

  • There are two long chambers called the corpora cavernosa (the spongy part of your penis) that contain blood vessels and tissues, as well as one major artery each.

  • When you become aroused, signals from your brain cause the blood vessels to dilate, allowing blood to flow in. 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, you may have difficulty getting fully hard.

2. You Lose Your Erections

Another sign of ED is losing your erection during sex.

Being able to get to full mast is one thing, but keeping it up during sexual intercourse is another. If you’re not sustaining an erection firm enough to reach orgasm, you may be struggling with ED.

We’re not trying to gaslight you, but believe it or not, there’s a chance your erection problems are all in your head. Physiological and psychological symptoms of ED can manifest similarly or differently — but one sign you’re not dealing with a physical cause is an inability to orgasm before losing an erection.

Work 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 signs of ED.

3. You’re Less Interested in Sexual Activity

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 could be causing your sexual dysfunction. In that case, treatment for low testosterone levels may be necessary.

4. Your Erections Are Painful

Most of us assume sex is always pleasurable, but from complications with a penile implant to Peyronie’s disease (penile curvature), there are a 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.

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.

Personalized Treatment

Enjoy sex like you used to

If you think you’re too young for ED, you might be surprised. While erectile dysfunction does get more common after age 40, it can still happen to guys in their 20s and 30s.

Find out more about what age men stop getting hard for some mind-blowing facts.

ED doesn’t usually appear out of the blue. The condition typically develops over time and worsens the longer you delay treatment.

However, some factors can make it hard to get erections from time to time. These include:

  • Excessive drinking

  • Illicit drug use

  • Stress and anxiety

  • Relationship conflicts

  • Side effects of a new medication

  • Fatigue

  • Physical injuries to the genitals

If any of these apply to you, get in touch with your healthcare provider to see what your options are for treating ED.

If you can’t get fully hard, it might help to go over your medical history with a healthcare professional. They may want to perform a physical exam, order blood tests, or talk to you about risk factors for ED.

These risk factors include:

  • High cholesterol

  • High blood pressure (hypertension)

  • Atherosclerosis (plaque buildup in your arteries)

  • Overweight or obesity

  • Mental health issues

The good news is many of these things can be treated with lifestyle changes or medication.

It can sometimes be hard to tell if you have erectile dysfunction or another sexual health issue.

Some guys might not be dealing with ED specifically but rather a related problem, such as:

  • Low libido (reduced sex drive)

  • Premature ejaculation (PE), ejaculating quickly after sexual activity begins

  • Delayed ejaculation (when it takes a long time to finish)

  • Anorgasmia (inability to orgasm or ejaculate at all)

Like erectile dysfunction, facing these issues occasionally isn’t a cause for concern. But if they happen often (or always), you might want to consider treatment.

Generally speaking, you’ll want to see a healthcare provider in person or consult a medical professional online to figure out if you have ED.

But one assessment you can do at home (or anywhere) is the Sexual Health Inventory for Men. The questionnaire can give you a rough likelihood of whether you have ED based on your answers to 5questions.

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 ED signs you’re seeing — they’ll ultimately be your best guide for solutions.

Here’s the bottom line on how to know if you have ED and what you can do about it:

  • Try oral medications. ED treatments include prescription medications like Viagra® (sildenafil), Cialis® (tadalafil), Levitra® (vardenafil), and Stendra® (avanafil), all of which promote better erectile function. You can also consider chewable ED meds, which come as convenient, discreet hard mints.

  • Rule out other medical conditions. Figure out if ED is a side effect of a bigger health issue, such as heart disease, kidney disease, diabetes, or hormone imbalances.

  • Investigate mental health issues. These might include psychological factors like performance anxiety, sexual trauma, or other problems that could benefit from therapy. If you’re taking medication for a mental health issue antidepressants and think it could be contributing to ED, check with your provider about potentially adjusting your dose or switching meds.

  • Make healthier lifestyle choices. Poor diet, obesity, lack of exercise, stress, and anxiety are all common causes of ED. Try incorporating a healthier diet, more movement, and better sleep into your 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.

Personalized Treatment

Choose your sex chew

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 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 if you’re unsure, seek medical advice. Your healthcare provider can help you navigate how to know if you have ED.

Here’s what to remember about the signs of ED.

  • One night of bad performance shouldn’t be a cause for concern. Too much alcohol or performance anxiety can affect your erectile quality on occasion. But if you’ve noticed multiple ED signs, consult a healthcare provider.

  • Here’s how to know if you have ED. The most common ED signs are not being able to get fully hard, losing your erection during sex, loss of sexual desire, and painful erections.

  • Even young guys get ED. Erectile dysfunction happens to the best of us. Though it’s more common in older men, ED can still impact men in their 20s and 30s for various physiological or psychological reasons.

  • Plenty of erectile dysfunction treatments are available. These ED treatments include prescription medication, therapy, and a general focus on a healthier lifestyle.

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 or do an online consultation with a healthcare provider today.

5 Sources

  1. Dhaliwal AR, et al. (2023). PDE5 Inhibitors. https://www.ncbi.nlm.nih.gov/books/NBK549843/
  2. Leslie ST, et al. (2023). Erectile Dysfunction. https://www.ncbi.nlm.nih.gov/books/NBK562253/
  3. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2017). Erectile dysfunction. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction
  4. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2017). Symptoms & causes of erectile dysfunction. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
  5. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2017). Treatment for erectile dysfunction. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment__text in bold__
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Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kelly Brown MD, MBA
Kelly Brown MD, MBA

Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown was previously Medical Director of a male fertility startup where she lead strategy and design of their digital health platform, an innovative education and telehealth model for delivering expert male fertility care.

She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.

Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.

Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.

Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.

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