Why Can’t I Stay Hard During Sex?

Not being able to maintain an erection firm enough to have satisfying sex might not be something you often hear discussed, but it’s a surprisingly common issue.

If you often find yourself googling “why can’t I stay hard during sex,” you may have a form of erectile dysfunction (ED), a sexual issue that affects 30 to 50 million men in the U.S.

Luckily, this is a problem that has solutions. Read on to learn why ED happens, how to know if you have ED, and what you can do to improve your erections for better, more satisfying sex — from erectile dysfunction treatments to healthy habits and lifestyle changes.

A huge range of factors — from your testosterone levels to your stress levels — have the potential to affect your mood, sex drive, and performance in bed. It’s common and normal for men to occasionally have trouble becoming or staying fully erect.

However, researchers have worked out a system for working out how hard an erection should be, as well as how severely you may be affected by ED (if your erection isn’t hard enough for sex). This system is called the Erection Hardness Score (EHS), with possible scores ranging from zero to four:

• 0: The penis does not enlarge.

• 1: The penis becomes larger but not hard.

• 2: The penis is hard but not hard enough for penetrative sex.

• 3: The penis is hard enough for penetration but not completely hard.

• 4: The penis is completely hard and fully rigid.

Although we often associate erectile dysfunction with a complete inability to get an erection, the reality is that ED can vary in severity. 

For example, you may be affected by ED if you can only sometimes get an erection firm enough for penetrative sex. Or, you may have ED if you can initially get an erection with sexual activity but can’t maintain it during sex to reach orgasm and ejaculation. And, of course, you may have ED if you’re unable to get an erection at all for penis penetration.

If you’re in the middle of the above score range, you may find that you can get hard — but not hard enough to have penetrative sex. Yes, that’s still erectile dysfunction.

These issues may be a short-term problem that comes and goes or a long-term issue that occurs whenever you have sex.

Getting and keeping an erection requires several parts of your body — including your nervous system and vascular system — to work together. When you’re sexually aroused, your nervous system relaxes the smooth muscle in vessels that control blood flow to the erectile tissues inside your penis (corpora cavernosa). 

As blood flows to the corpora cavernosa, your penis expands and becomes harder. This blood is then held inside your penis by a fibrous membrane called the tunica albuginea, which helps sustain your erection during sex.

ED occurs when one or several factors either prevent this process from happening, reduce its effects, or disrupt it entirely. Potential reasons for not being able to penetrate due to ED can include:

• Vascular health problems. A condition that affects your vascular system, such as atherosclerosis (plaque buildup in your arteries), heart disease, high cholesterol, and blood vessel disease, can affect your body’s ability to supply enough blood to your penis to get and sustain a firm erection. 

• Health conditions that affect your nervous system. Conditions like type 2 diabetes, multiple sclerosis, Parkinson’s, and even prostate cancer can also make it difficult to develop and maintain an erection. So can injuries that damage the nerves around your spine, pelvis, prostate, bladder, or penis.

• Medications. In some cases, ED may occur as a result of prescription or over-the-counter medications. Medications associated with ED include antidepressants, sedatives, medications that affect your hormone production, ulcer medications, and certain medications used to treat high blood pressure.

• Low testosterone. Having low testosterone levels can cause ED as well as other symptoms like low sexual desire, increased body fat, and fatigue.

• Psychological issues. ED doesn’t just have physical causes. It can also be caused by psychological factors that stop you from feeling relaxed during sex or aroused. This can include anxiety, depression, worries about your sexual performance, or stress.

• Lifestyle choices. Certain habits and aspects of your lifestyle, such as obesity, excessive alcohol consumption, smoking, or lack of exercise, may also increase your risk of developing ED.

• Premature ejaculation. Some research shows there’s a link between ED and another type of sexual dysfunction, premature ejaculation (PE). If you have PE, in which you ejaculate too quickly to have satisfying sex, your attempts to delay ejaculation may make you lose your erection.

When you’re consistently not hard enough to penetrate during sex, you’re likely to feel frustrated — especially when it happens often and affects your sex life with your partner. 

Luckily, there are several things that you can do to improve your erectile function and stay hard during foreplay and sex. Finding the right ED treatment option really depends on which of the many possible causes of erectile dysfunction applies to you.

Keep reading to learn how to have sex with ED that’s satisfying for you and your partner.

Use ED Medication

If you often find yourself saying, “I can get hard but not hard enough,” you may want to consider using FDA-approved ED medication.

Several oral medications are available for ED called PDE5 inhibitors, including well-known options like:

• Sildenafil (Viagra®) 

• Tadalafil (Cialis®)

• Vardenafil (Levitra®) 

• Stendra® (avanafil)

These medications work by increasing blood flow to the erectile tissues inside your penis, making it easier for you to get and stay hard during sex. Most oral ED medications should be taken about 30 to 60 minutes before you have sex for optimal results.

Sometimes, even a low dose of ED medication can increase your confidence in bed and make it easier to maintain a firm enough erection for satisfying, pleasurable sex. 

There are also other medications that can be used for ED, like the injectable alprostadil.

If you’re looking for something more discrete, you may want to consider taking chewable ED mints that contain the same active ingredients in Viagra and Cialis at varying dosages. Schedule an online consultation with a licensed healthcare provider to determine if prescription medication is appropriate. 

Treat Psychological Causes of ED

Sometimes, the best way to overcome erectile dysfunction and improve your sexual health is by improving your mental health. 

Common psychological causes of ED include stress, anxiety, depression, relationship problems, and feelings of guilt or low self-esteem. These issues can also affect your sex drive, which may make you feel less interested in having sex.

Research suggests that sexual performance anxiety — a common cause of psychogenic ED — may improve with cognitive-behavioral therapy (CBT) and relaxation techniques such as mindfulness meditation. 

For issues such as depression and anxiety, it’s best to reach out to a licensed mental health provider for assistance. 

Limit Your Porn Consumption

The link between porn and erectile dysfunction isn’t crystal clear. However, some research has found that avoiding online porn may make you more receptive to real-life sexual stimulation and reduce the risk of experiencing sexual performance issues like ED.

If you watch porn habitually during masturbation, try cutting it out of your life for a few weeks to see if your erections and sexual function improve.

You can learn more about the relationship between porn and sexual performance issues in our guide to porn-induced erectile dysfunction. 

Consider Switching Medications

While erection problems are often considered risk factors for medical conditions like heart disease and kidney disease, penile function can also be the result of medication side effects.

If you’re currently prescribed medication that can affect your erections and sexual performance, consider talking to a healthcare provider about making changes to your medication use. You may be able to switch to a different type of medication that’s less likely to affect your sexual health and erectile function. Alternatively, your healthcare provider may suggest making certain changes to the way you use your medication to reduce its impact on your erections.

Just be sure not to stop taking any type of medication or adjust your dosage without first getting medical advice from your healthcare provider. 

Live a Healthy Lifestyle

Erectile dysfunction is closely linked to broader health issues like obesity, lack of exercise, and habits like cigarette smoking. For example, research suggests that a BMI over 30 is associated with a three-times greater risk of developing sexual dysfunction compared to a BMI in the healthy weight range.

As we’ve covered in our guide to protecting your erections naturally, making simple changes to your lifestyle, such as exercising regularly, eating a healthy diet, limiting your consumption of alcohol, and getting enough sleep, can also have a real positive impact on your sexual health. 

Bigger changes, such as quitting smoking, maintaining healthy blood pressure, and getting medical support to lose weight, may have an even greater effect on your erections and sexual performance. 

If the reason you’re not able to penetrate is that you can’t stay hard during sex, don’t delay getting the help you need.

Erectile dysfunction is a common issue that affects men of all ages and backgrounds in the U.S., even younger men. Only a healthcare provider can help you determine what’s making it hard for you to get, well, hard. Remember:

• There are many potential reasons why you can’t stay hard during sex. There are physical and psychological causes of ED. They include cardiovascular issues, certain medications, low testosterone, depression, and even relationship issues.

• Treatment options are available. You can improve your erectile function and sexual performance using ED medications, such as sildenafil (Viagra) and others. 

• Lifestyle choices may improve ED and your ability to stay hard. Simple changes to your lifestyle, such as being more active and maintaining a healthy weight, can also reduce your risk of dealing with long-term ED.

Learn more about how to improve your sex life if you have ED by reviewing these 14 tips to maintain an erection naturally, explore 8 foods that support healthy erections, and learn about sexual health products like penis rings and medication that can help improve your performance in bed.