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Not Getting Hard Enough to Penetrate? What to Know

Mike Bohl, MD, MPH, ALM

Reviewed by Mike Bohl, MD

Written by Geoffrey C. Whittaker

Published 07/22/2021

Updated 03/27/2024

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

If you often find that you can get hard but not hard enough, leading you down the rabbit hole of googling “why can’t I get hard during sex,” you may have a form of sexual dysfunction. As it turns out, many men find that over time, they can’t get hard enough for penetrative sex.

Luckily, this is a problem that has solutions. Read on to learn how and why erectile dysfunction (ED) happens, as well as how it may affect your ability to maintain a firm erection during foreplay and penetrative sex. You can also learn what you can do to improve your erections and in turn stay firm for better, more satisfying sex — from erectile dysfunction medications to healthy habits and lifestyle changes.

A huge range of factors — from your age, to the quality of your relationship with your partner,  to the amount of stress you experience day to day — 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 formulated a system for working out how hard an erection might 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 erectile dysfunction when you can only sometimes get an erection firm enough for penetrative sex, or when you can initially get an erection with sexual activity but can’t maintain it during sex to reach orgasm and ejaculation — and, of course, when you’re unable to get an erection at all.

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 sexual intercourse with your partner.

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 muscles that control blood flow to the corpora cavernosa, which is a pair of sponge-like areas of erectile tissue inside your penis. 

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 prevents this process from happening, reduces its effects or disrupts it entirely. Potential factors causing ED can include:

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

  • Conditions that affect your nervous system can also make it difficult to develop and maintain an erection. These include type 2 diabetes, multiple sclerosis and injuries that damage the nerves around your spine, pelvis, prostate, bladder or penis.

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

  • ED may also be caused by psychological factors that stop you from feeling relaxed during sex, affect arousal or reduce your sex drive. This can include anxiety, depression, worries about your sexual performance or stress.

  • Certain habits and aspects of your lifestyle, such as having overweight or obesity, consuming too much alcohol, smoking cigarettes or not getting enough physical activity, may also increase your risk of developing ED.

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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 one 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 ED medication.

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

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 to ED, like the injectable, alprostadil.

We offer several oral medications for ED online, such as chewable ED mints, following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate. 

Choose your chew

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 help to improve real-life sexual expectations 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 of 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 nutritious diet, limiting your consumption of alcohol and getting enough sleep, also can have a real positive impact on your sexual health. 

Bigger changes, such as quitting smoking or maintaining healthy blood pressure, may have an even greater effect on your erections and sexual performance. 

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If you find yourself saying “I only get hard for one person,” or not being able to perform at all, talking to someone is the first step you need to take. 

Erectile dysfunction is a common issue that affects an estimated 30 million men of all ages and backgrounds in the U.S., but there are a large number of potential causes. Only a healthcare professional can help you determine what’s making it hard for you to get, well, hard.

Most likely, a healthcare provider will start the conversation by telling you the following:

  • If you have mild ED, you may find it that you are not getting hard enough to penetrate during sex with your partner.

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

  • 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.

Our full guide to erectile dysfunction goes into more detail about the most common causes of ED, symptoms and the science-based steps that you can take to maintain good sexual health and function throughout your life. 

7 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. ED Diagnosis - Erection Hardness Score. (n.d.). Retrieved from https://www.smsna.org/patients/conditions/hsdd?view=article&id=354:ed-diagnosis-erection-hardness-score&catid=71
  3. Erection Ejaculation: How It Occurs. (2020, November 27). Retrieved from https://my.clevelandclinic.org/health/articles/10036-erection-ejaculation-how-it-occurs
  4. Symptoms & Causes of Erectile Dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
  5. Pyke, R.E. (2020, April). Sexual Performance Anxiety. Sexual Medicine Reviews. 8 (2), 183-190. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31447414/
  6. Park, B.Y., et al. (2016, September). Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Behavioral Sciences. 6 (3), 17. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039517/
  7. Skrypnik, D., Bogdański, P. & Musialik, K. (2014, February). Obesity--significant risk factor for erectile dysfunction in men. Polski Merkuriusz Lekarski. 36 (212), 137-41. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24720114/
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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