Maintaining An Erection

One-off problems – there are several reasons why you might have difficulty keeping an erection during sex. Most, if not all, men find that they will fail to keep their erections at some point during their lives. 

Most of the time, this is absolutely nothing to worry about. Losing an erection is usually due to common, everyday factors like: 

• Stress
• Tiredness
• Anxiety (‘first night nerves’)
• Drinking too much alcohol
• The side effect of a drug you’re taking

Certain people will experience this more often than others, and it is fairly common for some. 

Sign of underlying health problems – if you regularly lose your erection during sex, it could be a sign of an underlying health condition. This could be a physical or an emotional health condition, and may require treatment by way of medication or lifestyle changes. 

The main physical reasons you might lose your erection during sex are: 

• High cholesterol or high blood pressure
• Blood flow issues (a narrowing of the blood vessels in your penis)
• A physical issue with the shape of your penis, like Peyronie's disease
• Side effects of a prescription medication 
• Premature ejaculation 
• Hormone problems

It can also be caused by psychological reasons: 

• Stress
• Performance anxiety 
• Lack of desire/arousal 
• Emotional/mood problems 

Erectile dysfunction (ED) is the condition of repeatedly losing erections and it's very common, and isn’t a lifelong diagnosis. Most of the time, it is easily treated by medicines or with counselling. If you are concerned about losing your erections during sex, talk to your doctor for advice. They will be able to rule out any underlying physical cause needing treatment. 

Some solutions for maintaining erections work better than others depend on the causes of your situation. As with any health condition, it helps is your treatment is

For physical causes – the main ED treatments include: 

• Medications called PDE-5 inhibitors – Viagra or Viagra Connect (Sildenafil), Cialis (Tadalafil), Levitra (Vardenafil), or Spedra (Avanafil)
• Medications to help lower your blood pressure
• Statins to help lower your cholesterol levels
• Hormone Replacement Therapy (HRT) if the cause is low testosterone
• Changing your current medication (if your erection situation is a side effect)

For psychological causes – ED treatments can include: 

• CBT (cognitive behavioural therapy)
• Couples counselling (if you have a regular partner) 
• Practising techniques to reduce stress and anxiety (like meditation, mindfulness, or yoga)

Can support treatment, no matter the cause – at the same time as either form of treatment, it can be helpful to make certain lifestyle changes, such as: 

• Losing weight (if you’re overweight)
• Eating a balanced, healthy diet
• Quitting cigarettes (if you smoke) 
• Taking regular exercise
• Getting enough sleep every night
• Cutting back on your alcohol intake (try to stick to less than 14 units per week)
• Taking a break from activities like cycling (if you cycle more than 3 hours per week)

You should know yourself if you typically struggle with any of these, but even if you don’t, this is a good guide to follow so that you have the best possible chances of treating your ED. 

In many cases, yes – Viagra (or sildenafil) is proven to be an effective medical treatment for certain cases of ED. Although, this again depends upon the cause of your erectile problems. PDE-5 inhibitors (like Viagra) are usually the first port of call for treating ED, if there are no other physical or psychological reasons that need addressing first. 

However, medication like Viagra won’t be suitable for everyone – you can’t use Viagra if you: 

• Are allergic to its ingredients
• Have or have had a serious heart or liver problem
• Have had a recent stroke or heart attack
• Have low blood pressure

How to know if they're right for you – the easiest way to tell whether or not Viagra is suitable for you is to have a online doctor's assessment, or to ask your GP. If they decide that it could help you, and that it’s safe for you to take, you can get you medication. You can go through this process online using services like Superdrug Online Doctor.

No, not necessarily – it’s possible for you to lose erections even when you are fully aroused and want to continue having sex with your partner. 

It is possible that your relationship is involved – for example, if you aren’t attracted to your partner, then this could make it harder for you to stay erect during sex. Also, if you're having relationship or emotional problems that have been causing you or your partner high stress, this could also be the cause. 

Talk to your partner about your concerns – communication is important for a healthy sexual relationship. In some cases, couples find that couples counselling or stress management techniques can help to solve the issue of erection loss.

If you can stay hard when you masturbate but you can’t stay hard during sex, this could be due to a number of different reasons. 

Masturbation and sex are different – one of the main reasons is that masturbating is rarely the cause of anxiety or social pressure, whereas sex can be. Simply put: you’re much more likely to get nervous about having sex with a partner than you are by yourself. Talk to your partner about how you’re feeling, take things slowly, and try to stay relaxed during sex with another person. 

This situation is more common if you're younger – losing your erection during sex, but being able to stay hard during masturbation, is an issue more commonly linked to younger men. This is because the physical causes of losing erections are likely as you get older, so for younger men it's more likely to be psychological causes. If you can't stay erect whether you're masturbating or having sex then it's more likely to have a physical cause.

Do I need to change the way I masturbate – not necessarily, but you can try and see if it works for you. If you always (or very regularly) masturbate to porn, it could make it harder for you to reach orgasm in other situations. You could try masturbating without porn, or cut down on masturbating generally and see if it helps you maintain your erection during sex. You may still find one of the treatments listed above is a better solution.