Most men will have trouble at some point in their life with either getting or keeping an erection, particularly as they get older.

This can be caused by anxiety, tiredness, stress, alcohol or drugs. It’s usually temporary and nothing to worry about.

However, if it keeps happening it may be that your physical health or emotional health are the cause.

There are many physical causes of erection difficulties:

  • obesity
  • diabetes
  • heart disease
  • hypertension (high blood pressure)
  • high cholesterol
  • low testosterone
  • enlarged prostate
  • sleep disorders
  • multiple sclerosis
  • Parkinson’s disease

Other causes of erection difficulties that aren’t related to age or illness are:

  • drinking too much alcohol
  • smoking or recreational drugs
  • certain medications
  • anxiety or depression
  • lack of exercise
  • stress or sexual fear
  • performance anxiety.

When to get help

If you're worried about your erection, see a healthcare professional. They will be able to discuss the problem, check any medication you may be taking and do a physical examination.

The treatment will depend on what's causing it, as well as what you and your partner think will work best.

Treatments can include:

  • Medications
    • Drugs like sildenafil (Viagra), vardenafil and tadalafil work by increasing blood flow in your penis. You take them before you have sex to help get an erection.
    • You might be prescribed testosterone if the level of this hormone is low, but it won't help if circulation or nerve problems are causing your erection problems.
  • Lifestyle changes: Your healthcare professional might suggest that you lose weight or start an exercise routine to improve your symptoms. They might also recommend that you stop smoking, cut down on alcohol, or stop using recreational drugs such as cannabis.
  • Counselling: If stress, depression, or relationship problems are causing your erection difficulties, talking to a counsellor could help.
  • Vacuum device: also called a penis pump. This is a kind of tube that fits over the penis. It comes with a pump that removes air from the tube and draws blood into the penis to create an erection. You then place an elastic ring around the base of the penis to maintain the erection. The tube can then be removed. After sex, the ring is removed to end the erection.

Erection difficulties can be caused by many things and can come about gradually or suddenly. It can be very upsetting and result in a lot of stress and worry. It can feel embarrassing to discuss this with others but seek help if you need it.