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12 Reasons for Losing an Erection During Sex

Mike Bohl, MD, MPH, ALM

Reviewed by Mike Bohl, MD

Written by Geoffrey C. Whittaker

Published 08/29/2020

Updated 01/31/2024

Just about every guy will fail to perform in the bedroom at some point in life, and losing an erection is nothing you should feel ashamed or embarrassed about.

Feeling concerned, however, is totally normal, too — especially if the problem happens more than once.

You can lose your erection during sex for a lot of reasons, from sexual performance anxiety to alcohol consumption. Sometimes even an underlying health issue may make it hard for you to maintain an erection — yes, even when you’re “in the mood.” 

Getting this problem solved is a multi-step process. Below, we’ve explained how and where to start, including:

  • How and why erectile dysfunction can occur

  • The symptoms of ED you might experience

  • Reasons you may lose your erection during sex

Options for treating weak or inconsistent erections, improving your sexual performance and enjoying more satisfying sex with your partner.

The right reaction to losing an erection is to start asking questions — questions like “why can’t I stay hard?” or “why do I lose my erection during sex?” 

Losing erection integrity can result from a number of factors. These can cause you to either lose your erection during sex or get an erection that isn’t quite firm enough for penetration, including: 

  • Physical health conditions 

  • Medications and recreational drugs

  • Factors related to your lifestyle 

  • Psychological issues like common mental health disorders 

Sometimes, a combination of factors can affect your erections, as well as other aspects of your sexual health and function.

Getting hard may seem easy when you’re younger, but there are actually a number of complex processes that go into every erection — it involves your sex hormones, your nervous system and your cardiovascular system. 

An erection begins with stimulation — either sensory (something you see, hear or touch) or mental (a sexual thought). This triggers your nervous system and increases blood flow to your penile arteries. This continues until you climax or the arousal goes away — unless you’re experiencing erectile issues.

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Some men may imagine that full and permanent flaccidity is what ED is, but ED can vary in severity. So, whether you check the box for “can’t get erection” or for “can’t keep erection,” both are technically symptoms of erectile dysfunction if they happen repeatedly. 

Men with severe erectile dysfunction might not be able to ever get any erections, while men with mild ED may be able to get an erection that just doesn’t last long enough to have satisfying, fulfilling sex every time. 

According to the National Institutes of Health, around 30 million men in the US have some degree of erectile dysfunction. So, while the spectrum of symptoms can be wide, the reach of this particular health condition is considerably wider. 

The truth is that failed erections happen to all of us, and reacting the right way can make dealing with them (and preventing them) a much easier process for you. 

“Why can’t I get hard during sex?” and “why can’t I stay hard during sex?” are two very different questions. Still, whether you can’t keep an erection or aren’t able to get one in the first place, the potential cause list is essentially the same. 

Below we’ve set out 12 key causes of erectile dysfunction and erection loss, where your erection might be getting stuck, stalled or limited. If you suspect any of these to be factors that could apply to you, bring them up to a healthcare provider.

Cardiovascular Issues

Cardiovascular health issues like heart disease, atherosclerosis (clogged arteries) and hypertension (high blood pressure) may affect your blood vessels and stop your penis from getting adequate blood flow for a consistent erection.

Kidney Diseases and Diabetes

Chronic medical conditions like diabetes and chronic kidney disease can affect your cardiovascular system and harm the nerves around your penis, potentially affecting blood flow and nerve function. 

Neurological Disorders

Nervous system disorders like multiple sclerosis (MS) can also affect your ability to get an erection and maintain it while you’re having sex. 

Hormone Imbalances

Sometimes, physical issues that don’t directly affect your blood flow or nerve function can also have an impact on your ability to maintain an erection by affecting your sex drive and everyday level of interest in sexual activity. 

In particular, maintaining adequate testosterone levels is important for keeping your sex drive healthy and consistent. 

Although low testosterone doesn’t cause ED directly, it can reduce your sexual desire and may play a role in some forms of sexual dysfunction. This could affect your level of sexual enjoyment and desire for sex in general, making it more difficult to keep an erection. 

Injuries

Penile injuries that affect the function of your penis may make it more difficult for you to get hard and stay hard in general, and some of them can also cause erections to become painful.

Peyronie’s disease — a condition characterized by ​​fibrous scar tissue in the penis that can cause painful, curved erections — can affect your erections. Similarly, nerve damage from surgery or injuries may increase your risk of losing your erection during sex. 

Smoking or Using other Nicotine Products

Smoking is a major risk factor for erectile dysfunction, both because of the damage it can cause to your heart system and the effects of nicotine.

Drinking Alcohol, Especially to Excess

Alcohol and erectile dysfunction can go hand in hand. In an intoxicated condition, you may find it more difficult to maintain an erection if you’ve had a few drinks before going to bed.

Having Overweight or Obesity 

While it’s okay not to be in great shape, having overweight or obesity is associated with a significantly higher risk of developing erectile dysfunction.

Using Steroids 

Although testosterone is linked to a higher sex drive in the short term, research suggests that the use of testosterone and other steroids may increase your risk of developing ED after discontinuation.

Medication Side Effects

Many medications can affect your sex life in different ways, including dulling sexual excitement or reducing your general level of sexual function. Sometimes, these changes can make it more challenging to maintain an erection during sexual intercourse.

Medications that may cause you to lose your erection include:

  • Antidepressant drugs, such as selective serotonin reuptake inhibitors (SSRIs)

  • Medications that affect androgen levels or cause hormone imbalances

  • Anti-anxiety medications 

  • Prescription drugs used to promote sleep

  • Appetite suppressants and/or weight loss medications

  • Antihistamines used to treat colds and allergies

  • Medications for Parkinson’s disease

  • Blood pressure medications

  • Medications for stomach ulcers

  • Other medications

If you’re prescribed a new medication and notice that you’re now losing your erection during sex, it’s best to talk to your healthcare provider. They adjust your dosage or prescribe a different medication with a lower risk of causing erection issues. 

Recreational Drugs

In addition to over-the-counter and prescription medications, many recreational substances and illicit substances can cause erection difficulties and affect your general sexual function, including:

  • Amphetamines

  • Barbiturates

  • Marijuana

  • Cocaine

  • Heroin

If you use illegal drugs and think you may have a substance use disorder, it’s important to talk to your healthcare provider as soon as you can. 

Depression, Stress and Anxiety

Finally, some psychological factors and mental health concerns may affect your ability to remain hard while you’re having sex. 

Anxiety and depression are both associated with a higher risk of developing ED. Feelings of anxiety, fear or guilt about sex can cause you to lose your erection when they become severe.

Sometimes, even stress — about your sexual function specifically or from your career or relationships — can affect your erections and ability to properly connect with your sexual partner. 

Choose your chew

Losing an erection in the middle of sex can be frustrating. But it's not uncommon for men to lose an erection during sex because they’re anxious, stressed, intoxicated or distracted. You don’t necessarily have erectile dysfunction if this happens occasionally, but if it starts to become a pattern, these and other factors may indicate that you should seek erectile dysfunction treatment.

The good news is a variety of treatment options are available to help you more easily maintain your erection during sex, ranging from lifestyle changes to medication.

Make Changes to Your Lifestyle

For the most part, promoting healthy erections is all about living a healthy, balanced and active lifestyle. 

If you’re flaccid due to some obvious physical causes, you should look at your body for solutions. Small, simple changes can have a huge impact on your sexual performance — sometimes without involving medication. 

And science generally agrees. In a meta-analysis from 2011, researchers found that aerobic exercise correlates with a measurable improvement in the symptoms of erectile dysfunction. 

In our guide to naturally protecting your erection, we shared several approaches to try for better erections naturally. They basically boil down to the following medical advice:

  • Keep your body weight in the healthy range

  • Pay attention to your blood pressure, and treat it if it’s elevated

  • Eat a diet that’s built around fruit, vegetables, whole grains and other nutritious foods

  • Keep track of mental health concerns and don’t be afraid to seek treatment

  • Make aerobic exercise part of your daily routine (even if it’s just a little bit)

  • If your sex drive feels weak, get your testosterone levels checked

  • Improve your sleep habits and aim for seven hours or more per night

  • Limit your consumption of porn, as it may affect your erections

While these techniques aren’t guaranteed to improve your erections, they can have a noticeable impact, especially if you only lose your erection occasionally.

We’d also like to point to two common habits changes you may want to make today:

  • Avoid smoking cigarettes or consuming nicotine in other ways. One study published in the Journal of Sexual Medicine in 2008 found that men given nicotine showed low erectile response to erotic material — a factor that may make it harder to feel aroused during sexual activity.

  • Reduce your alcohol intake to no more than two servings per day. In one study from 2007 in men with alcohol dependence, researchers found that the amount of alcohol a person consumes is the most significant predictor of developing sexual dysfunction out of the things they tested for. 

If any one of these pieces of advice stands out as particularly relevant to your life, focusing on it can often lead to immediate improvement.

Take Part in Psychotherapy

Seeking psychotherapy could be beneficial, as it can be used to treat performance anxiety, stress and other factors that can contribute to erection problems and loss of erection when you want it most. 

If you think that a psychological problem could be contributing to weak, partly flaccid or inconsistent erections, talk to a medical professional. 

Depending on your needs, your therapist may suggest an approach such as cognitive-behavioral therapy (CBT) to overcome negative thoughts and work on your self-esteem to return your erectile function. 

Use Erectile Dysfunction Medication 

Contrary to popular belief and advertising campaigns, ED medications like sildenafil aren’t just used by middle-aged and older men (not that there’s anything wrong with being one of either!). 

Data show that about 40 percent of men experience some level of erectile dysfunction by the age of 40, with an increasing number of younger men using sildenafil and other drugs to deal with ED as it develops.

Medication works. Currently, the FDA has approved four prescription oral medications for erectile dysfunction. All of these medications belong to a class of drugs referred to as PDE5 inhibitors, which make getting and maintaining an erection easier by increasing blood flow to your penis

They include: 

There are also other medications available for ED that aren’t PDE5 inhibitors, such as the injectable medication, alprostadil.

Each erectile dysfunction medication is slightly different — some drugs last for longer, while others produce fewer side effects. You can learn more about the key differences between these ED drugs in our guide to the best medications for erectile dysfunction.

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For men who can’t stay hard and find themselves wondering “why does my erection go away so fast?” sex can be an anxiety-inducing activity. But, chances are,  it’s not where all of the problems lie.

Men’s health is an emergency light problem for most guys — it doesn’t get much attention until a problem puts you in park. Dealing with a lost erection can feel like a serious blow to your confidence, but it doesn’t need to be something you dwell on — or experience again. 

To get back on the road, remember the following:

  • It’s completely normal to occasionally lose your erection during sex. 

  • You should absolutely seek treatment, however, if it’s a constant and consistent issue in the bedroom.

  • It might signal a bigger problem that needs treatment like obesity, addiction or a mental health issue.

  • ED medications can make keeping an erection easier, and give you a confidence boost in bed, and therapy can help too. 

Interested in learning more about factors that can affect your sexual performance? Our detailed guides to the causes of erectile dysfunction and premature ejaculation (PE) talk about two of the most common male sexual issues, as well as the steps that you can take to deal with them.

15 Sources

  1. Definition & Facts for Erectile Dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts
  2. Erection Ejaculation: How It Occurs. (2020, November 27). Retrieved from https://my.clevelandclinic.org/health/articles/10036-erection-ejaculation-how-it-occurs
  3. Symptoms & Causes of Erectile Dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
  4. Could you have low testosterone? (2021, May 13). Retrieved from https://medlineplus.gov/ency/patientinstructions/000722.htm
  5. Drugs that may cause erection problems. (2021, January 10). Retrieved from https://medlineplus.gov/ency/article/004024.htm
  6. Kovac, J.R., et al. (2015, December). Effects of cigarette smoking on erectile dysfunction. Andrologia. 47 (10), 1087-1092. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485976/
  7. Skrypnik, D., Bogdański, P. & Musialik, K. (2014, February). Obesity—significant risk factor for erectile dysfunction in men. Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego. 36 (212), 137-141. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24720114/
  8. Armstrong, J.M., et al. (2018, June). Impact of anabolic androgenic steroids on sexual function. Translational Andrology and Urology. 7 (3), 483-489. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6043738/
  9. Lamina, S., Agbanusi, E.C. & Nwacha, R.C. (2011). Effects of Aerobic Exercise in the Management of Erectile Dysfunction: A Meta Analysis Study on Randomized Controlled Trials. Ethiopian Journal of Health Science. 21 (3), 195-201. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275865/
  10. Arackal, B.S. & Benegal, V. (2007). Prevalence of sexual dysfunction in male subjects with alcohol dependence. Indian Journal of Psychiatry. 49 (2), 109-112. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2917074/
  11. Harte, C.B. & Meston, C.M. (2008, January). Acute Effects of Nicotine on Physiological and Subjective Sexual Arousal in Nonsmoking Men: A Randomized, Double-Blind, Placebo-Controlled Trial. The Journal of Sexual Medicine. 5 (1), 110-121. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2864030/
  12. Dhaliwal, A., Gupta, M. (2022, April 19). PDE5 Inhibitors. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549843/
  13. Lakin, M. & Wood, H. (2018, June). Erectile Dysfunction. Retrieved from https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/erectile-dysfunction/
  14. VIAGRA- sildenafil citrate tablet, film coated. (2017, August). Retrieved from https://www.accessdata.fda.gov/spl/data/40578e70-350a-4940-9630-55d90989c146/40578e70-350a-4940-9630-55d90989c146.xml
  15. CIALIS- tadalafil tablet, film coated. (2017, May). Retrieved from https://www.accessdata.fda.gov/spl/data/05dbd8b6-1b9d-436a-a67c-8a16713f753f/05dbd8b6-1b9d-436a-a67c-8a16713f753f.xml
Editorial Standards

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.

Mike Bohl, MD

Dr. Mike Bohl is a licensed physician, a Medical Advisor at Hims & Hers, and the Director of Scientific & Medical Content at a stealth biotech startup, where he is involved in pharmaceutical drug development. Prior to joining Hims & Hers, Dr. Bohl spent several years working in digital health, focusing on patient education. He has also worked in medical journalism for The Dr. Oz Show (receiving recognition for contributions from the National Academy of Television Arts and Sciences when the show won Outstanding Informative Talk Show at the 2016–2017 Daytime Emmy® Awards) and at Sharecare. He is a Medical Expert Board Member at Eat This, Not That! and a Board Member at International Veterinary Outreach.

Dr. Bohl obtained his Bachelor of Arts and Doctor of Medicine from Brown University, his Master of Public Health from Columbia University, and his Master of Liberal Arts in Extension Studies—Journalism from Harvard University. He is currently pursuing a Master of Business Administration and Master of Science in Healthcare Leadership at Cornell University. Dr. Bohl trained in internal medicine with a focus on community health at NYU Langone Health.

Dr. Bohl is Certified in Public Health by the National Board of Public Health Examiners, Medical Writer Certified by the American Medical Writers Association, a certified Editor in the Life Sciences by the Board of Editors in the Life Sciences, a Certified Personal Trainer and Certified Nutrition Coach by the National Academy of Sports Medicine, and a Board Certified Medical Affairs Specialist by the Accreditation Council for Medical Affairs. He has graduate certificates in Digital Storytelling and Marketing Management & Digital Strategy from Harvard Extension School and certificates in Business Law and Corporate Governance from Cornell Law School.

In addition to his written work, Dr. Bohl has experience creating medical segments for radio and producing patient education videos. He has also spent time conducting orthopedic and biomaterial research at Case Western Reserve University and University Hospitals of Cleveland and practicing clinically as a general practitioner on international medical aid projects with Medical Ministry International.

Dr. Bohl lives in Manhattan and enjoys biking, resistance training, sailing, scuba diving, skiing, tennis, and traveling. You can find Dr. Bohl on LinkedIn for more information.

Publications

  • Younesi, M., Knapik, D. M., Cumsky, J., Donmez, B. O., He, P., Islam, A., Learn, G., McClellan, P., Bohl, M., Gillespie, R. J., & Akkus, O. (2017). Effects of PDGF-BB delivery from heparinized collagen sutures on the healing of lacerated chicken flexor tendon in vivo. Acta biomaterialia, 63, 200–209. https://www.sciencedirect.com/science/article/abs/pii/S1742706117305652?via%3Dihub

  • Gebhart, J. J., Weinberg, D. S., Bohl, M. S., & Liu, R. W. (2016). Relationship between pelvic incidence and osteoarthritis of the hip. Bone & joint research, 5(2), 66–72. https://boneandjoint.org.uk/Article/10.1302/2046-3758.52.2000552

  • Gebhart, J. J., Bohl, M. S., Weinberg, D. S., Cooperman, D. R., & Liu, R. W. (2015). Pelvic Incidence and Acetabular Version in Slipped Capital Femoral Epiphysis. Journal of pediatric orthopedics, 35(6), 565–570. https://journals.lww.com/pedorthopaedics/abstract/2015/09000/pelvic_incidence_and_acetabular_version_in_slipped.5.aspx

  • Islam, A., Bohl, M. S., Tsai, A. G., Younesi, M., Gillespie, R., & Akkus, O. (2015). Biomechanical evaluation of a novel suturing scheme for grafting load-bearing collagen scaffolds for rotator cuff repair. Clinical biomechanics (Bristol, Avon), 30(7), 669–675. https://www.clinbiomech.com/article/S0268-0033(15)00143-6/fulltext

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