The Independent Pharmacy

Find Out Why You're Losing Your Erections During Sex

Scott McDougall
Scott McDougallMPharmDirector & Registered Manager

Reviewed on 26 Feb 2024

Many men experience the loss of an erection at some stage in their lives – most commonly, it is down to temporary issues such as stress, being tired or drinking a little too much alcohol. Losing an erection during sex can also be caused by more serious or long-term medical conditions like high blood pressure or certain medications. If you’ve noticed that you’re finding it difficult to maintain an erection frequently, help is available, and there’s no shame in asking for it.

In most cases, erectile dysfunction (ED) is treatable through a combination of lifestyle changes, relationship work, medications, and therapy. It’s important to understand the common causes of ED and actionable strategies to improve your sexual health and performance. With the right support and care, you can overcome ED and restore intimacy and confidence in the bedroom.

Key Takeaways

  • Losing your erections during sexual activity can happen for many reasons – heart problems, diabetes, anxiety, relationship issues, and more.
  • Making healthy changes to your lifestyle, like exercising, eating right, losing weight if needed, and reducing stress, can improve erections.
  • If stress or depression seem connected to your erection problems, counselling and therapy can really help.
  • Medicines like Sildenafil and Cialis allow more blood to flow to your penis so you can get and stay hard.
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Understanding Erectile Dysfunction

Erectile dysfunction (ED) is defined as the inability to achieve or maintain an erection firm enough for you to have or complete sex. It involves both physiological and psychological components and can range from situational to chronic. Temporary ED or ED that comes and goes is often triggered by:

  • Being tired
  • Stress or worry – whether about your performance or other stresses from daily life
  • Alcohol use

When ED occurs consistently for an extended period, it points to an underlying health condition or emotional issue that requires assessment and treatment. It may also be down to ageing, as many men experience issues with their erections as they get older.

Maintaining erectile function relies on proper blood flow, nerve stimulation, hormone balance, and psychological health. Breakdowns in any of these areas can contribute to sexual performance issues.

Types of Erectile Dysfunction

Erectile dysfunction can be categorised as either temporary (situational) or chronic (ongoing) to help determine appropriate treatment.

Temporary ED

This occurs from time to time and is often caused by stress, fatigue, drinking too much alcohol, or other short-term lifestyle factors. For example, a man may experience difficulty getting erections during periods of high work stress or when overly tired from lack of sleep. But this erectile function returns to normal after the temporary trigger resolves. Situational erectile dysfunction is generally easily reversible.

Chronic ED

This is a persistent inability to get or maintain erections for satisfactory sex. It lasts for months or years rather than coming and going. Chronic ED often indicates an underlying physical health issue such as heart disease, diabetes, neurological disorder or hormone imbalance. It may also reflect a serious psychological problem like depression or anxiety disorder. Chronic cases of ED won’t resolve without focused treatment of whatever is causing it.

Psychological Causes

Stress and Anxiety

Feeling constant stress or worry can make it tough to “get in the mood” for sex. When your body is on high alert, it sends blood to the parts needed for “fight or flight”, not to the penis. Finding ways to calm your mind through exercise, talking with your partner, or practising relaxation techniques can help lower anxiety so your body is ready for intimacy.

Relationship Dynamics

Problems in your relationship can also affect your ability to get an erection. If you and your partner are fighting often, lack emotional intimacy, or have different needs in the bedroom, it can be difficult to feel connected during sex. Seeing a couples counsellor helps improve communication and repair intimacy.

Mental Health

Conditions like depression or PTSD cause chemical changes in the brain that make getting aroused more challenging. The good news is medications and professional counselling are effective treatments for many mental health issues. Improving your overall mental well-being will help get your sex life back on track.

Physical Causes

Heart Health

Getting and keeping an erection depends on blood flow to the penis. Heart health causes for ED can include:

  • Heart disease
  • High blood pressure
  • High cholesterol

These conditions can damage your circulatory system and make it harder to get hard. Taking care of your ticker by exercising, eating healthy, limiting alcohol, and not smoking will benefit your sexual health.


Hormones like testosterone can impact sexual desire and performance. Low testosterone due to ageing, obesity, or other factors is linked to erection challenges. But imbalances in other hormones like thyroid, growth hormone, and prolactin also play a role. See your doctor and get tested to find out if a hormonal condition is the culprit.

Lifestyle Factors

Being overweight, drinking heavily, smoking, doing drugs, and lacking physical activity creates health problems that interfere with good erections. Adjusting your lifestyle can do wonders for your ability to keep an erection during sex. Lifestyle changes you can make include:

  • Achieving a healthy weight
  • Limiting alcohol
  • Quitting smoking
  • Avoiding drugs
  • Exercising regularly

Age-Related Considerations

As men get older, changes in sexual response and activity level are normal and expected. Erections may not be as firm or sustained as in younger years, and more time is often needed between sexual sessions to recover and become aroused again. Men may begin to notice having more difficulty maintaining their erections after they turn 40.

However, age itself does not necessarily mean you will have to live with erectile dysfunction. Many older men maintain fulfilling sex lives well into their senior years. The key is prioritising cardiovascular and hormonal health through diet, exercise, stress management, and regular checkups. Optimal blood flow, flexible blood vessels, and balanced hormones enhance sexual functioning regardless of age.

Advanced Solutions and Treatments

Lifestyle Changes

Simple changes can massively improve erection quality in men. Changes you should think about making include:

  • Exercising often – Try to walk, swim, or bike for 30 minutes most days. Being active keeps blood vessels healthy.
  • Eating fruits, veggies, lean protein, whole grains – More good stuff, less junk food, salt and sugar.
  • Losing weight if needed – Extra body fat can make erections more difficult to achieve.
  • Limiting alcohol – No more than 1-2 drinks a day. Too much booze causes trouble getting hard.
  • Don’t smoke, do drugs – Smoking shrinks blood vessels. Drugs throw hormones out of whack.
  • Finding ways to relax – Yoga, deep breathing, less work stress.

Medical Treatments

Oral medications like sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra) improve blood flow to the penis and are effective ED treatments for most men. These medications are normally taken between 30 minutes up to 2 hours before sex. Possible side effects include headache, flushing, upset stomach, vision changes, and prolonged erection requiring medical attention. You should always discuss the pros, cons, drug interactions, and optimal timing with your doctor.

Other medical options include penile injections to stimulate blood flow, urethral suppositories inserted before sex, vacuum erection devices to draw blood into the penis, and penile implants for severe cases. Each treatment has advantages and disadvantages, so review them with your doctor to find the right fit.

Therapy and Counselling

Seeing a sex therapist or counsellor, either alone or with your partner, can provide helpful strategies for reducing performance anxiety, overcoming intimacy issues, and improving relationship dynamics that may be interfering with sexual functioning. Therapy is considered first-line treatment for ED stemming from psychological causes like depression, PTSD and anxiety.

Preventive Strategies

Since ED is often related to vascular problems, maintaining heart health helps massively in preventing ED. Regular exercise, a Mediterranean-style diet, stress management, and avoiding smoking preserve blood vessel integrity and flexibility – the key to great erections throughout life.

Professional Consultation Guidance

Talking to Your Doctor

Visiting a doctor, pharmacist, or men’s health specialist for a consultation is recommended to properly assess the cause of ED and explore solutions tailored to your health history and lifestyle. Expect to answer questions on medical history, current medications, lifestyle factors, and recent relationship challenges. Be prepared to undergo lab tests to check hormone levels, blood sugar, cholesterol, and more based on risk factors. Effective, personalised treatments often combine medication, therapy, and lifestyle changes.

Support From Your Partner

If you’re in a relationship, consider having your partner attend consultations to understand ED causes and treatments. Schedule couples counselling if relationship problems may be a contributing factor. Partners can provide vital emotional support through open communication, patience, and affection while exploring solutions together. Remember, intimacy is about more than sex – focus on maintaining sensuality, closeness and pleasure through other means as well during the healing process.

Conclusion: How The Independent Pharmacy Can Help You

Anyone who finds themselves struggling to maintain an erection during sex can take comfort in knowing solutions are out there. As we’ve talked about, psychological issues like stress, depression or relationship problems can trigger ED. Or the cause may be physical – poor cardiovascular health, hormonal imbalances, medication side effects or ageing.

The first step to consider should be lifestyle adjustments like diet, exercise, lowering alcohol intake and quitting smoking – all of these can help treat ED linked to health conditions. Therapy addresses mental health factors, while couples counselling improves relationship dynamics. There are also excellent medications that enhance blood flow for firmer erections.

To pinpoint the factors unique to your situation and create a customised treatment plan, consider contacting us here at The Independent Pharmacy. Our experts can provide ongoing support, recommendations and quality medications and supplements to help you keep your erection during sex. Contact us today to take the first step.


What are the most common causes of erectile dysfunction?

The most frequent causes are circulatory problems, psychological issues like anxiety or depression, certain medications, and hormonal imbalances. Lifestyle factors like obesity, smoking, and excessive alcohol use also play a role for many men.

How do I know if I need medications for ED?

Your doctor can help determine if prescription medications may be beneficial. Oral drugs like Viagra and Cialis can assist men whose ED is related to blood flow restriction. But medications treat symptoms only, so lifestyle changes and counselling are still important.

Is erectile dysfunction all in my head?

Not necessarily. While psychological factors like stress and depression can cause ED, it often stems from physical health conditions like heart disease, obesity, diabetes, or hormone imbalance. A doctor’s evaluation is needed to identify the underlying cause.

What lifestyle changes should I make?

Losing excess weight, exercising regularly, eating a healthy diet, limiting alcohol, quitting smoking, and reducing stress are all lifestyle changes that can improve ED. Work-life balance and good sleep habits also help manage anxiety contributing to sexual issues.

What are the best treatments for erectile dysfunction?

Treatment is based on the cause and severity of ED. Oral medications like Sildenafil, Tadalafil and Cialis work for many men. Other options include injections, devices, supplements, counselling, and, in some cases, surgery. Your doctor will advise the most suitable therapies to restore sexual function.


NHS (2023) ‘Erectile dysfunction (impotence)’ -

British Heart Foundation ‘Let’s talk about... erectile dysfunction’ -

M. Ziegelmann (2022) ‘What is erectile dysfunction? A Mayo Clinic expert explains’ -

Johns Hopkins Medicine ‘Erectile Dysfunction’ -

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