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Independent expert answers
on psychiatry and psychology

I cannot get an erection (hard penis) any more

Abstract: I can not get an erection any longer. When a man cannot get an erect penis long enough.

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I cannot get an erection (hard penis) any more

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Question(s): 
Written by: Dr Martin Winkler
First version: 29 Mar 2010.
Latest revision: 26 May 2015.

I am 57 years and cannot any more get an hard penis. Drugs do not help with erectile dysfunction. What can I do if I canot get any hard penis?

Answer:

What to do if I cannot get an erection = hard erect penis when I am with my girlfriend?

Inability to get a hard penis is called erectile dysfunction. Erectile dysfunction while having sex is probably the most common cause of impotence and sexual problems for men. Causes of erectile dysfunction can, among other things, be stress and mental stress, obesity, smoking, or but not very commonly some medications. In addition to eliminating medical causes of erection problems drug treatment for example with Viagra and other helpful drugs for erectile dysfunction.

Definition of erectile dysfunction: recurring problems getting an erection = hard penis sufficiently long time

First of all, it may be quite normal to sometimes not get any erection. Stress, sleep problems, high blood pressure or other causes occur for almost any man. Many men may have erection problem, suchas the penis is not long enough or hard enough for sexual contact. It is first important to clarify whether this is sometimes still possible. So when an erection is possible when you wake up in the morning or during masturbation, the cause may be psychological factors (fear of "failure", stress, tensions in the partnership). Being afraid, during sex "to fail" can occur also for a young man.

How to treat erectile dysfunction

Erectile dysfunction in men can also occur at a young age. 18,4 per cent of a group of American volunteers were reported such a problem. In addition to the known risk factors of hypertension and diabetes, common causes are lack of physical activity whci is a risk factor that you can influence.more about impotence problems and impotence
or causes for erection problems. Treatment depends on the one hand by removing the cause or even explanation of reasons and unjustified fear of a lasting impotence. When conventional drugs like Viagra fail to help getting a hard penis, there is help. One can try self-treatment with injections.

While drugs like Viagra does not help, a urological diagnosis for clarification is required. One can detect a probable cause determination.

Possible causes include smoking, diabetes, alcohol usage, hypertension or dyslipidemia (= too much cholesterol in the blood). In addition, certain medicines can cause erectile dysfunction. Hormonal disorders must be investigated.

The next step would be the so-called. SKIT-test, where, a drug is injected into the corpus cavernosum of the penis to produce an erection. With an ultrasound probe the urologist can then determine the blood flow to the vessels (arteries) and see if there is a "leak" in the veins of the penis. Usually this can produce an erection that gives a sufficiently hard penis for sexual intercourse . Then one has to learn to give this injection about 15 minutes before the sexual intercourse. This technique (SKAT = Cavernous auto injection therapy) helps even when medications fail.

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