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By Karen Asp
Posted On Aug 01, 2016

Erection issues can—and most likely will—happen. But rather than spend life on the sidelines, there’s plenty you can do to keep your body in top working condition and your confidence high.

By Karen Asp

You might not think you could ever lose your ability to perform. Yet things go south at one time or another for the majority of men, and several factors can make erections more difficult.


To best understand what’s going on, let’s take a refresher course on the physiology of erections. Your penis requires blood flow to expand and become rigid. That flow starts when one of your senses is aroused. As a result of that stimulation, your central nervous system sends impulses that boost penile blood flow—about six to eight times the normal rate—says Dudley S. Danoff, M.D., a urologist and founder of the Cedars-Sinai Medical Center Tower Urology Medical Group in Los Angeles, as well as the author of Penis Power.


Over time, penile function wanes. Age is one of the biggest and least controllable factors behind erection woes. “The ability to get enough blood into the penis for a firm erection and sustain that erection can decline as you age,” Danoff says.


There are other physical causes, some of which you can control, says Abraham Morgentaler, M.D., director of Men’s Health Boston and author of The Truth About Men and Sex. For instance, the nicotine in cigarettes acts as a vasoconstrictor, limiting blood flow to your vessels. Prescription medications, like those for high-blood pressure and depression, can also wreak havoc, as can low testosterone levels and alcohol consumption.


Of course, the body works in tandem with the mind, which is why psychological issues, including stress, depression, fatigue, anxiety, and relationship issues can be to blame. “Most people don’t realize how strong the interplay between biology and psychology is,” says Michael Krychman, M.D., executive medical director of the Southern California Center for Sexual Health and Survivorship Medicine in Newport Beach, California. Dr. Krychman has seen an increase in the number of men who are struggling with erection issues because of psychological factors.


Take chronic stress, for example, which can lower testosterone levels and cause libido and desire to plummet. As a result, you might not have good sex, which then stresses you out more. This often leads to performance anxiety so you wind up having less, or worse sex, according to Krychman.



While you can’t change your age, you can take measures to bring those erections back to life. In many cases, the problem requires little or no treatment. (If it does continue, you might be facing a more severe issue called erectile dysfunction.) Know, though, that what works for one man may not work for another, which is why you often need to experiment a little.


Your starting point, especially if erection issues are becoming regular and causing distress, should be to seek medical help to rule out underlying medical issues. “Conditions like cardiovascular disease, hypertension, and diabetes can masquerade as blood flow compromise, which can present as erectile difficulties,” says Krychman.


Once you’ve ruled out the forementioned physical problems, consider mental factors—especially stress. A survey from the American Psychological Association has found that 22 percent of Americans consistently reported experiencing high levels of stress. For many men, stress (plus fatigue, anxiety, and depressed moods) is often at the root of their erection issues, Krychman says. Get that stress under control by engaging in yoga, meditation, mindfulness activities, exercise, or hobbies.


Another key strategy? Work on your relationship. An important step can be introducing novelty into it, especially if you’ve been with the same partner for a long time. “‘New’ and ‘different’ is critical for men, which is why you need to prevent sex from becoming routine,” Danoff says. Novelty could be as simple as varying sexual positions, the locales where you have sex, or even the times when you have sex.



Aphrodisiacs to improve sexual performance have existed for centuries. That’s why it’s no surprise that the market is flooded with nutraceuticals to solve erectile problems. The list is lengthy and includes things like anthocyanins, ginseng, saw palmetto, Tribulus terrestris, sarsaparilla, yohimbine, maca, nettle, and ginkgo biloba. Many claim to work by increasing arousal and improving circulation, which Krychman describes as “the first step to regaining sexual prowess and improving or enhancing erectile strength and performance.” Do any hold merit, though?



Unfortunately, the jury is still out because studies are either inconclusive or lacking. “Most nutraceuticals have no scientific evidence and work mainly because of the placebo effect,” says Danoff, who adds that in terms of erectile function— assuming no physical problems—only one percent lies between the legs. “The remaining 99 percent is between the ears.”


That’s not to say some supplements don’t hold potential, though. Krychman, for instance, points to L-arginine-based supplements, which increase nitric oxide, an integral part of vasodilation and enhancement of blood flow. “Studies have found that in some men, it can improve erectile function,” he says. Consider ArginMax or Stronvivo, a brand that also includes ingredients like magnesium and zinc, both of which have been found to improve erectile function. Studies have also shown that Stronvivo may reduce low testosterone symptoms.

Yohimbine, which comes from the bark of the yohimbe tree, has also been heralded for its healing erectile powers. While mainstream medicine doesn’t necessarily support this, one study did find that it can help impotency problems, Danoff says.


No matter which supplement you decide to try, however, understand that there is limited data about all of them and that what works for one man may not work for another, Krychman advises. Proceed with caution, as some remedies do have side effects. Do your homework before taking them.


Another holistic treatment that may help—though it’s not a supplement—is acupuncture. Although the exact mechanisms haven’t been identified, acupuncture may work by affecting hormone levels, stress, and improving sleep, all of which could aid erectile function, says Krychman.



You don’t have to wait until the first sign of trouble to take action. Simple lifestyle changes, can give you more staying power down the road.


For starters, quit smoking, get regular exercise, keep your weight under control (losing weight if necessary), follow a healthy diet, and make sleep a priority. “Being chronically sleep-deprived can impact hormone levels and blood vessels,” says Morgentaler. “This can interfere with your brain’s ability to enjoy sex.”


Meanwhile, positive thinking is crucial “Selfdoubt can be a killer,” says Danoff. So, too, is developing strength in the pelvic region by working the muscles in the abdomen and lower back. This will help your penis function more dynamically.


At the end of the day, there’s one step that might trump all other: Fall in love. As Danoff says, “Love is the biggest aphrodisiac.”