Why Can’t I Get Hard?
Older men aren’t the only ones asking their urologists, “Why can’t I get hard anymore?” Some research suggests that 30 to 50 million American men (younger men included) are struggling with symptoms of erectile dysfunction (ED) — and it’s not always clear why.
The causes of erectile function problems can be any number of things: Alcohol, certain medications, medical conditions, and problems with the nervous system can all affect a man’s ability to maintain an erection. ED can even be a symptom of a mental health condition.
If you’re asking questions like “Why can’t I get a boner?” or “Why do I have a semi-hard penis?” then keep reading to figure out an action plan.
How Blood Flow Affects Erections
Erections are about two things: blood flow in and no blood flow out. Your penis is essentially a balloon filled with blood (well, more like a sponge, but let's use the balloon analogy). Actually, there are two main ones in the penis, and together they’re called the corpora cavernosa (there’s also a third, softer one called the corpus spongiosum).
When you become aroused, these “balloons” fill with blood, and the increased pressure pushing against the surrounding fibrous tissue seals off the exit, trapping that blood inside your penis. Erections fail to happen only when something interrupts this process, and there are a number of things that can do that.
This may include:
Weight
Age
General health
Alcohol consumption
Drug dependency
Medication side effects
Those are just a few of the physical and mental causes that may explain why you’re not getting hard (and which we’ve elaborated on below).
Whether physical or psychological factors cause your ED issues, you may continue to have a normal sex drive. Or, you may experience partial erections that aren’t firm enough for satisfying sexual intercourse.
FYI: Partial erections are health issues, as well as warning signs of erectile dysfunction. While they’re not as severe as a complete lack of firmness, they represent a problem that must be tackled before it worsens.
Why Can’t I Get Fully Hard? 2 Possible Reasons
A variety of triggers can cause any man to experience sexual health issues.
Below, we’ve organised them into two primary categories: physiological reasons, like those associated with heart health, and psychological reasons, like those related to performance anxiety or depression.
1. Physiological Causes
Your erectile health is not independent of the health of the rest of your body, so if something is wrong in another area of the factory, so to speak, it could shut down the production line elsewhere.
For instance, one form of ED, vascular ED, can be caused by inefficient arteries, which are associated with heart disease.
Common physical causes of ED include:
Chronic inflammation associated with diabetes
Metabolic syndrome
Cardiovascular and neurological diseases
Multiple sclerosis (MS)
Parkinson’s disease
Atherosclerosis (clogged blood vessels)
Spinal cord injuries
Peyronie’s disease (penile curvature)
There are even neurological causes of erectile dysfunction to consider, like nerve damage or similar traumas that reduce sensation and function in the penis.
Things like hormonal imbalances (which can be caused by age, weight, or any number of factors) also can contribute to ED and even reduce your sexual desire.
Further, it’s important not to rule out things like lifestyle choices and habits as potential causes of ED, too. The underlying cause of ED could be anything from poor diet and exercise habits to medication side effects.
If you’re experiencing partial erections or are unable to maintain a full erection, it’s possible you’re suffering from one or more of these conditions. Make sure to talk to a healthcare professional if you suspect any of these health conditions may be holding you back in the bedroom.
2. Psychological Causes
Even if your body is to blame for some of your erectile issues, your mental health could also be affecting things. Gained some weight recently? That might affect your heart health — but it might also make you self-conscious in intimate scenarios.
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Meanwhile, performance anxiety, depression, and low self-esteem can adversely affect your ability to get hard by distracting you from arousing thoughts or lowering your interest in sex.
Stress and anxiety might cause a loss of interest in sexual activity generally, so if things in the office or the relationship aren’t great, those problems may be following you all the way to bed.
Some believe that pornography can also cause a form of ED, and while the jury is still out on that one, it may be worth assessing your porn habits. Do you feel like you can only get hard or reach ejaculation when you’re masturbating to porn? Do you think cutting back would help?
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Treatment Options If You’re Not Getting Hard
ED can affect different men to varying degrees. Your medications, underlying health issues, age, and other factors may impact your erectile firmness, so it’s best to ask a professional to assess these possible ED causes.
Your healthcare provider will review your medical history and check you out for things like:
Blood pressure issues, including hypertension
High cholesterol
Low testosterone levels
Side effects or interactions of prescription or over-the-counter medications (such as high blood pressure medications, antidepressants, and antihistamines)
Prostate cancer
They may also inquire about things like relationship problems as well as your smoking, drug, alcohol, and eating habits. All of these are potential ED causes, and you can address them yourself or get help with making lifestyle changes.
Your healthcare provider can help you figure out the right treatment for you. In many cases, they’ll suggest one or more of the following:
Lifestyle-based ED treatments
Medications for ED
Therapy to improve your sex life
Lifestyle-Based ED Treatments
When we discuss treatment options for sexual dysfunction, there’s one straightforward solution to ED: Take better care of yourself.
Before you run to the pharmacy, understand that ED is treatable, with various proven options available. Everything from improving your diet to getting more exercise to switching out medications that cause side effects can help you regain firmness.
Medications for ED
Your healthcare provider may also prescribe erectile dysfunction medications. There are currently four FDA-approved oral prescription ED pills available:
Viagra® (sildenafil)
Levitra® (vardenafil)
Stendra® (avanafil)
These drugs belong to a class of medications called phosphodiesterase type 5 inhibitors (PDE5 inhibitors) that increase blood flow to the penis to help you get and maintain an erection when you want one.
If you’re looking for something more discreet, you may want to consider an erectile dysfunction treatment like Hims Hard Mints, chewable ED meds that contain the same active ingredient in Viagra and Cialis in customised dosages.
Other medications are also available for ED, such as alprostadil, an injectable medication.
Schedule an online consultation with a healthcare provider today to see if you qualify for prescription treatment.
Therapy to Improve Your Sex Life
A word of advice: Don’t assume the cause of your ED is physical. Low self-esteem, performance anxiety, and a slew of other mental health issues can cause ED, and those should be treated with the help of a therapy professional.
There are various psychological treatments and approaches to dealing with the ED problem. You may also benefit from talking to a couples therapist with your partner if you think relationship issues are contributing to ED — or ED is contributing to relationship problems.
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Why Am I Not Getting Hard? A Final Word
“I can’t get rock hard anymore.” It’s a tough thing to admit, to type into a search bar, or to say out loud to a healthcare professional. At least, it may feel that way.
In reality, admitting the problem is a necessary first step to, well, being able to have a full erection again.
If you haven’t been achieving full liftoff recently, remember these key facts:
It’s a whole-body issue. Erections are about more than your penis. Your whole body and your mind also contribute to the health of your erections.
Your mind may be holding you back. Your body can be ready, but if you’re anxious, depressed, or self-conscious, you may be left semi-erect.
This is a fixable problem. Taking ED medication and working towards healthier living can restore your penile power. Talking to a therapy professional can also help if your erection problems are due to psychological causes.
Want to learn more about ED treatments and solutions? Check out these 14 ways to get harder erections, learn more about position-dependent erectile dysfunction, and find out how to know if you have ED.
Dealing with another sexual dysfunction? Learn more about what causes low libido and what to do about premature ejaculation.
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 or medication.