ERECTIONS ∙ 3 minutes read

5 reasons you might not be able to get an erection

By Kirsty Mason | Medically reviewed by Dr Jaskirt Matharu

Having problems getting an erection? We take a look at the possible causes of erectile dysfunction in men.

Erectile dysfunction (ED) is a common condition that affects men across the world. Despite this, the topic is still taboo and education on the causes of ED is limited. 

Every man’s experience is unique, but there are several common conditions that can lead to ED. We take a look at 5 of the most likely reasons why you might not be able to get an erection, and what can be done about it.

1. You’re overindulging in alcohol, tobacco, or drug use

Are you living a lifestyle packed with booze and narcotics? Among the many reasons why cutting back on alcohol and drug use is critical to your health, an overindulgent lifestyle may be driving your ED.

Let’s take a look at how an unhealthy lifestyle is linked to ED:

  • Alcohol: Alcohol abuse is associated with sexual dysfunction and is known to affect erections, both short-term and long-term. Over an extended period of time, alcohol abuse can lead to nerve damage. This can potentially result in continuous ED. Booze also raises your risk of diseases and damage to the liver - health conditions that are linked to ED.
  • Smoking: There’s a wealth of scientific evidence for the link between smoking and ED. The harmful gasses in cigarette smoke damage blood vessels and may ultimately lead to the deterioration of the delicate inner lining of your arteries, meaning you’re faced with a cocktail of problems when it comes to getting an erection. This is because the healthy supply of blood flow to the penis is critical for supporting strong erectile function and anything that disrupts the blood flow is likely to result in ED.
  • Drugs: You may have heard of ‘pilly willy’ but recreational drugs don’t just cause short-term damage to your erections. Cocaine results in the narrowing of blood vessels, which, as noted earlier, means bad news for erections. Even more worryingly, chronic abuse of cocaine could lead to permanent vascular damage. And yes, that does mean chronic ED. Although every drug is harmful in its own way, you’ll find that drugs such as MDMA, poppers, anabolic steroids, ketamine, and methamphetamine have similarly detrimental effects on your erections.

If alcohol, tobacco, or drugs are causing your ED, the best course of action is to cut out the damaging habits. Although this is no easy feat, the good news is that there’s a huge amount of support available, including your GP, sexual health clinic, and charities.

2. You’ve got a medical condition

There’s enormous variety in possible physical causes of ED. Conditions that make you particularly vulnerable to ED include:

  • high blood pressure
  • obesity
  • diabetes
  • heart conditions
  • peripheral vascular disease
  • Parkinson’s disease
  • multiple sclerosis
  • Peyronie’s disease

To gain insight into possible physical causes of ED, you can take an at-home Erectile Dysfunction Blood Test. This test measures the common physical causes of ED including testosterone and cholesterol. If you’re worried about health conditions such as Parkinson’s disease or diabetes, you should visit your local GP for a diagnosis.

3. You’ve got side effects from your medication

The list of prescription drug types that can interfere with your erectile function is a lengthy one. It includes:  

  • pain-killers (especially opiates)
  • tranquilisers (especially benzodiazepines)
  • antidepressants
  • antihistamines
  • medications for high blood pressure
  • antipsychotics
  • diuretics
  • hormone regulators
  • chemotherapy agents

Even if you think your medication is causing your ED, you should speak to your doctor first before discontinuing the medication.

4. You’ve had an injury or medical treatment

A physical injury may harm some of the functions needed to achieve and maintain an erection. For example, a fractured pelvis could disrupt the relevant internal anatomy needed for a healthy erection. 

Aside from this, certain surgical procedures, particularly those that are focused on the pelvic area, could unintentionally increase the risk of erectile dysfunction. Particularly risky surgery includes prostate surgery, where the prostate is removed (prostatectomy). ED could even be a result of prostatic radiation therapy.

5. It’s psychological

Your feelings shouldn’t be underplayed. Stress, anxiety, and depression have a biochemical basis - they’re known mediators of sex drive. A sense of shame or failure in the bedroom (performance anxiety) can create psychological barriers to getting an erection. Some men suffer from body image anxiety which complicates their ability to achieve an erection.

Overcoming psychological ED could be as simple as taking medication, such as sildenafil or Viagra Connect in order to boost your confidence. You may also want to try incorporating relaxation techniques into your everyday life, such as yoga or meditation. For relationship issues or mental health conditions such as anxiety or depression, you should consider therapy or seek support from a charity.

The bottom line

Erectile dysfunction isn’t a diagnosis by itself. It’s a sign of problems elsewhere, possibly in your lifestyle, medical history, or mental well-being. Whatever the cause, it’s worth investigating if erectile dysfunction begins to interfere with your life.

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