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GIFT IDEAS FOR MEN
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GOLF GIFT IDEAS

 1. Health
 2. Erectile Dysfunction
 3. 9 Signs You May Have Erectile Dysfunction


9 SIGNS YOU MAY HAVE ERECTILE DYSFUNCTION

There can be more to it than just having trouble getting it up.

by Ashley Martens and Emilia BentonUpdated: Nov 16, 2023
Medically reviewed by Jamin Brahmbhatt, MD
Save Article

peakSTOCK//Getty Images

ERECTILE DYSFUNCTION (ED) symptoms can throw a wrench into more than just your
sex life. Your satisfaction may plummet, but it can also take a toll on your
relationship with your partner (not to mention the toll it can take on your
confidence).

It’s a disruption many men will experience at some point in their lives. In
fact, a little over half of men will experience ED symptoms at some point
throughout their lives. It’s not just a concern exclusive to older men, either.
Contrary to popular belief, ED signs and symptoms can happen to any man at any
age. According to a 2017 study in Translational Andrology and Urology, almost 8
percent of men ages 20 to 29, and 11 percent of men ages 30 to 39, experience ED
symptoms.

It’s possible that these signs are actually performance anxiety—where your
anxiety over performing well in bed hinders your ability to get hard. Regardless
of the mechanism, struggling to get hard and stay hard can be embarrassing and
cause issues in your relationship. Luckily, there are plenty of treatment
options to relieve these symptoms.

It can feel difficult and embarrassing to talk to your doctor about your sexual
functions. Again, this issue is incredibly common, and likely something your
doctor deals with all the time. Plus, they’ve likely heard way more embarrassing
stories.

Consider whether you’d rather not discuss it and deal with a limp dick or
confidently address any erectile dysfunction symptoms you may be experiencing
with a professional and get it resolved. Healthcare professionals, especially
urologists, are trained to speak to patients about many kinds of sexual health
and wellness concerns, so for the sake of your sexual performance and pleasure
for both you and your partner, just do it.

Another thing: ED and its symptoms generally do not pop up out of the blue. In
many cases, ED symptoms are the body’s way of telling you there is something
else going on that may need to be addressed, explains S. Adam Ramin, M.D.,
medical director of Urology Cancer Specialists in Los Angeles. Below, everything
you need to know about ED signs and symptoms.


WHAT COUNTS AS ED?

According to Juan Andino, M.D., UCLA Urology Andrology & Infertility Fellow, it
all comes down to one thing: Recurrence.

“Almost all men at some point experience an episode of what people will call
‘performance anxiety.’ That is to say, either due to alcohol, lack of sleep, a
new partner, or stress they could have a less-than-satisfactory intimate
experience. (See many harmless reasons you can't get an erection here.)

But if difficulties with erections become a pattern, regardless of age, it is
worth seeking out an evaluation with a doctor, ideally urologists who are
focused on sexual medicine.


In a 2020 study of almost 400 men under age 40 who were evaluated at The Men’s
Clinic at UCLA, the medical team found that 20 percent of patients had
prediabetes or diabetes, 20 percent had low testosterone, and 11 percent had lab
or physical exam findings suggestive of decreased fertility. In addition to
helping treat the problem of ED, they found medical issues which could be
improved to better a person’s health and prevent future issues with erectile
function and overall health.

These signs point to the risk of ED. Here's what to know.



ED SYMPTOMS TO LOOK OUT FOR


TROUBLE GETTING OR MAINTAINING AN ERECTION

It's obvious, but these are the easiest signs to spot. Lowered libido can be a
sign as well. If you're regularly experiencing any of these, bring it up with
your doctor. You might feel awkward when you start to talk about it, but getting
a solution will feel a lot better than just worrying about it.


YOU HAVEN’T WOKEN UP WITH MORNING WOOD IN A WHILE

Nighttime and early morning erections have nothing to do with feeling aroused:
They happen because your brain releases less noradrenaline—a hormone that keeps
erections from happening nonstop—during sleep.


Having frequent morning wood is a good thing, since it indicates the blood
vessels that allow blood to flow to your penis are healthy, says Dr. Ramin.

If you start noticing that you’re waking up with an erection less often than
usual, that could mean that those blood vessels aren’t working as well as they
should—making it harder for blood to flow into your penis to become erect, Dr.
Ramin says. That means the same issue impeding your morning wood might
eventually rear up in the bedroom, when you’re actually trying to get hard.

Now, there’s no magic number that means you could be in trouble. It’s any amount
that’s different than your normal that raises the red flag.


YOU DON’T THINK ABOUT SEX AS MUCH AS YOU USED TO

Jon Feingersh Photography Inc//Getty Images

If the stuff that usually gets you going just isn’t working anymore, there’s a
good chance that your testosterone levels are lower than normal.

Testosterone is the main hormone responsible for your sex drive, explains New
York-based urologist and sex expert David Shusterman, M.D. If it plummets, your
desire to get going in bed may, too. And if you’re not really in the mood,
getting hard will be next to impossible.

RELATED STORY

 * 21 Tips for Getting Hard and Staying Hard

“It can be more helpful to reframe this and highlight that decreased libido and
erectile dysfunction are the known sexual symptoms of testosterone deficiency or
low testosterone,” explains Dr. Andino.

“A man experiencing ED may also have a decrease in libido due to an
uncomfortable experience in the bedroom, but if the low libido is associated
with ED and other symptoms are present like decreased energy, decreased
motivation, difficulty gaining muscle and putting on weight, then it is
important to seek out an expert evaluation to rule out a testosterone
deficiency,” he says. Check out the sneaky signs of low testosterone here.

Unfortunately, some “men’s” or “wellness” clinics use testosterone labs in
isolation to convince men they have a problem and sell them testosterone gels or
injections, says Dr. Andino. Those therapies have issues of their own, such as
potential loss of fertility. In order to avoid this, Dr. Andino recommends
getting a testosterone test with a licensed doctor who has experience in sexual
medicine. Find out more about getting a good testosterone test here.


YOUR CHOLESTEROL OR BLOOD PRESSURE IS HIGH

The results from your annual physical’s lab work might hint that your erection
is in danger. Two of the most common tells? High cholesterol and high blood
pressure.

High total cholesterol is anything 240 milligrams per deciliter (mg/dL) or
higher, and blood pressure should be 120/80 millimeters of mercury (mm Hg) or
below. (One high BP reading probably isn’t a big deal. But more than two to
three elevated readings over time likely means you have high blood pressure.)

Both high cholesterol and high blood pressure can damage your blood vessels,
causing them to lose their elasticity. This makes it harder for the vessels to
expand so more blood can flow into your penis, says Dr. Ramin. That in turn can
make getting hard more difficult. “If the vessels can’t dilate, there won’t be
enough blood flow to cause an erection,” he says.

Don't assume this doesn't relate to you: More and more millennials are clocking
in with high blood pressure. Here's why and what to do about it. Even if you're
not in that age group, it's worth taking a look at the common causes of high
blood pressure and what you can do about them.



YOUR GUMS ARE SWOLLEN, TENDER, OR BLEED EASILY

Gums that are swollen, painful, or bleed when you brush or floss are likely
signs of gum disease. That doesn’t cause ED directly, but it can set off a chain
of events that could create problems for your package, Dr. Shusterman explains.

That’s because gum disease can lead to inflammation throughout your body, which
can damage your blood vessels. And if your blood vessels aren’t functioning
properly, it’ll be tougher for blood to flow into your penis and make you hard.


YOU DON’T GET AS HARD AS YOU USED TO—OR YOU HAVE TROUBLE STAYING THAT WAY

You’re still getting hard enough for sex. But your penis still might be
signaling an issue if you notice any kind of change to your erection—in fact,
this can be the early stage of ED.

“It’s usually a slow, progressive problem,” Dr. Ramin says. “Initially, a
patient might notice that his erections are not as firm, or that he isn’t able
to maintain his erections for as long as before.”

RELATED STORY

 * What's Wrecking Your Boner?

There’s no cutoff level for how soft or short an erection has to be to signify a
problem, though. It’s just about changes from your own personal norm, says Dr.
Ramin. It’s probably not a big deal if it only happens once. But if you notice
it happening frequently and you can’t think of a mental reason why you’d be
having trouble getting hard (like you’ve been extra exhausted or stressed), that
might be pointing to a bigger issue.


OTHER THINGS THAT COULD BE CAUSING ED


YOU STARTED A NEW PRESCRIPTION MEDICATION

Antidepressants and high blood pressure meds are particular culprits, says Dr.
Ramin. Antidepressants like SSRIs (like Prozac or Paxil) and SNRIs (like Effexor
and Cymbalta) can make it harder for hormones and chemical signals that make you
feel aroused, like norepinephrine, to reach the brain, explains Dr. Ramin. And
that lowered libido can make it harder to get an erection. Typically, you’d
start to notice these symptoms within a couple weeks of starting the meds. Talk
to your prescriber; often, there's another medication with similar effects that
you can use that doesn't create this side effect for you.

When it comes to lowering blood pressure with meds, that's essential for your
overall health, but can be troublesome for your sex life. Lower BP means less
blood flow to the arteries in your penis, which could mean trouble getting hard,
Dr. Ramin says.


YOU’RE SUFFERING IN THE SLEEP DEPARTMENT

No matter what’s stealing your shuteye, lack of sleep can lead to problems in
the boner department. That may be especially true if you have sleep apnea, a
sleep disorder where your breathing pauses frequently throughout the night.

Nearly 70 percent of guys who have sleep apnea also have ED, according to the
International Society for Sexual Medicine.

RELATED STORY

 * How Sleep Impacts Performance

Sleep deprivation causes testosterone levels to plummet and can make you feel
more stressed or anxious, Dr. Shusterman explains. And all of those things can
kill your libido and make it harder to get an erection.




YOU HAVE KIDNEY DISEASE

Guys with kidney disease may also develop problems maintaining erections. That's
because medical conditions like these also impact hormone levels, blood
circulation, and energy, according to the National Kidney Foundation. Or some
guys lose interest in sex because because of the emotional and physical changes
these conditions may cause.

However, men may regain their interest with time as they treat the initial
kidney problems. But that's not to say that all men with kidney problems will go
on to experience ED. Taking prescribed medication, communicating with your
doctor, and speaking with a psychologist can help guys maintain a healthy sex
life.


HOW IS ED DIAGNOSED?

Dr. Andino always asks his patients who may be experiencing erectile dysfunction
symptoms three questions:

 * Has your erection been weaker? Is this causing difficulties with intimacy or
   sexual activities?
 * Have you been able to keep an erection long enough for satisfying sex?
 * Have you taken a pill to help with erections like Viagra or Cialis?

These are just a few prompts to think about that may help you in figuring out
whether or not it is worth scheduling an appointment with your doctor to further
discuss some potential treatment options. And remember that an occasional
episode where an erection is not as hard as before or went away sooner than
expected is usually not concerning, says Dr. Andino.

There's no reason to feel embarrassed about needing medical intervention—ED is
incredibly common. “For example, 50 percent of men who are 50 or older have ED.
However, we also know that in some cases changes in erectile function can
precede heart issues by 5 to 10 years. As the research from UCLA shows, even in
young men, there can be medical issues that are identifiable and often
reversible without requiring life-long medications.”

The bottom line is if erectile problems are recurrent, it is worth having an
evaluation with a doctor, says Dr. Andino. “If risk factors are identified,
these visits can be life-changing ultimately ensuring patients are optimizing
their sexual function while promoting their overall health.”


HOW IS ED TREATED?

Treatment for erectile dysfunction varies based on the individual. Some
medications, such as certain anti-depressants and diuretics, may cause ED
symptoms. According to Harvard Health, it is estimated that 25 percent of ED
cases are caused by medications. In that case, your doctor may opt to switch up
your prescriptions.

You may be prescribed an oral medication that will help you get and maintain an
erection, such as sildenafil (Viagra), vardenafil (Levita), or tadalafil
(Cialis). These drugs promote relaxation of muscles and increase blood flow to
the area. These drugs do cause some medication interactions—be sure to share
your medication list with your doctor so they can properly prescribe the best
one for you. They can cause some side effects, such as headaches, digestive
issues, vision problems, dizziness, low blood pressure, and prolonged erection
(priapism).

Beyond medical therapy your doctor may suggest vacuum erection devices, penile
injections, or a penile implant.


CAN ED BE PREVENTED?

You can prevent ED by prioritizing living an overall healthy lifestyle. Here are
a few things you can do to prevent ED, according to the National Institutes of
Health:

 * Quit smoking
 * Avoid drinking too much alcohol
 * Eat a well-balanced diet, filled with whole-grains, lean meats, and plenty of
   fruits and vegetables
 * Maintain a healthy weight to prevent diabetes and high blood pressure
 * Stay physically active
 * Avoid illegal drugs


Ashley Martens
Journalist

Ashley Martens is a wellness writer based in Chicago. With a lifelong passion
for all things health and wellness, Ashley enjoys writing about topics to help
people live happier and healthier lives. With a foundation in fitness, food, and
nutrition, Ashley covers it all including sexual health and travel topics.
Ashley is also a NASM-certified personal trainer and group fitness instructor.

Read full bio
Emilia Benton
Contributing Writer

Emilia Benton is a Houston-based freelance writer and editor. In addition to
Runner's World, she has contributed health, fitness and wellness content to
Women's Health, SELF, Prevention, Healthline, and the Houston Chronicle, among
other publications. She is also an 11-time marathoner, a USATF Level 1-certified
running coach, and an avid traveler.

Medically reviewed byJamin Brahmbhatt, MD

Jamin Brahmbhatt, MD, FACS, is a board-certified urologist and sexual wellness
expert. He is Assistant Professor of Urology at UCF College of Medicine.
Currently serves as Vice-Chief of Staff at Orlando Health South Lake Hospital
and is past president of the Florida Urological Society.Dr. Brahmbhatt is a TEDx
speaker, on-air health expert, Top 40 under 40, and recipient of numerous
patient-choice awards. 

Read full bio







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