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Hello,

I read your article on male sexual health and I have a question. I used to work out like three times a week, most of it were pumping weights and cardio. I stopped doing this for the past two years. Also I am working on starting a company by myself and doing my PhD. For some reason I am not getting the kind of erection that I used to, is it because of my personal or professional problems?

Thanks,

MV

Thanks for writing us, MV. Fluctuations in the strength of erections are common concerns for men. Often, we aren’t taught how our bodies work during sexual arousal, which raises questions when we notice our sexual responses changing. Let’s talk a little bit about the anatomy of the penis and the physiology of an erection – and what lifestyle changes can mean for one’s wood.

At Attention

An erection is produced when blood is trapped in the spongy tissue of the penis (or clitoris, women get erections, too!). As erections are controlled by your involuntary nervous system, (like digestion), you can’t will them to happen, like snapping your fingers. In fact, erections are a much more complex process than we might think.

During an erection, the spongy tissue of the penis, become engorged in response to physical (touch) and/or psychological (thoughts) stimulation. When this stimulation occurs, the brain sends a message to the pelvic area, causing the arteries into the penis to dilate, increasing blood flow. Simultaneously, a muscle at the base of the penis tightens, constricting veins that, decreases blood flow leaving the penis.

As stimulation increases, this may mean that the amount of blood — therefore the erection itself — increases. When the stimulation is decreased or after orgasm, the veins dilate allowing the blood to exit the penis. So in order for an erection to occur, there must be 1) sexual stimulation, 2) a nervous system response, and 3) increased (and constricted) blood flow into the penis.

Hard To Say

There are many different issues that can affect the strength of an erection, all related to the three aspects above.

First, age impacts erections. As we age, the length of time and stimulation it may take to achieve an erection may increase. Additionally, the firmness of the erection itself may decrease. However, this may also be accompanied by increased control over ejaculation. This is a natural and wonderful part of aging, but because many men may feel as though their masculinity is connected to their ability to have a quick, hard erection, it may not feel so wonderful.

Second, because the nervous system plays such an important role (both in the sensation of being “turned on” and the subsequent nerve response) emotional distractions, such as anxiety or stress, can make it difficult to focus on the experience. If, as you mention, a man is experiencing pressure at work or school, it can be difficult to be in the mood. When we add to this the pressure men may place upon themselves to be sexual — messages that many men internalize about how they should always be ready for sex — men may get caught in an anxiety loop, worrying about achieving and maintaining an erection, which may decrease the erection strength, which may increase the worry, etc.

Third, medical issues can impact the ability to achieve an erection. Vascular conditions, alcohol, smoking, diabetes, and medication can all impact the body’s ability to respond to sexual stimuli and maintain blood flow. The changes in exercise you mention might impact the firmness of an erection, but it might not be simply physical. Exercise may encourage blood flow generally, but it may also help connect you to your body and increase self-esteem, which can guard against some of the psychological factors affecting erections.

Wood Working

Whatever might be causing the changes in your erections, the first thing to do is to give yourself (and your body) a break. Erections aren’t magical, and they vary for many reasons. Also, a satisfying, pleasurable sexual experience isn’t about how hard erections are, but the variety of ways that individuals may pleasure themselves and each other during sex.

That said, if anxiety and stress are impacting erections, you might need to pay attention to this stress. This could mean finding a mental health professional or sex therapist who you can talk with about the particular issues you mention. If you suspect there may also be a medical component to the erection, talk to a medical professional about your concern. They can work with you to identify any medical causes that could be impacting erections.

Often, drugs like Viagra are seen as a “cure” for erectile issues. But these drugs merely impact one piece of the erection process, they aren’t a panacea. We are critical of the ways that medicine may be prescribed for an issue that can be largely psychological or part of a natural decline due to aging. Medication may be one option for addressing erectile concerns, but it cannot substitute for communication with your sexual partner or awareness of our own feelings and distractions about the sexual experience.

Join us next week as we answer a reader’s question on celibacy!