Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 1/14/2021
Erectile dysfunction can be two of the scariest words an adult man can hear. Our culture ties so much of our identity, sense of self worth, and confidence to sexual performance and virility that even the smallest “off night” can have us panicked about plumbing problems.
Having an off night doesn’t necessarily mean you have erectile dysfunction, and nobody should beat themselves up over the occasional failure to achieve a full erection, but by the same token, it’s not a problem you should ignore, particularly if it happens more than once.
There’s a difference between a single instance and an ongoing problem, and that’s the difference between a bad night and having the condition “erectile dysfunction,” so if you had a heavy drinking night end poorly and you’re up researching on your phone while hungover, do yourself a favor and treat the hangover first.
But if this isn’t the first time, and you’re starting to see a pattern of these soft and softened events—and particularly if it’s affecting your life or relationships—you may have erectile issues.
There are many factors at work that can cause erectile dysfunction, from poor diet and obesity to stress and anxiety. It can be caused by illicit or prescribed drugs and their side effects, emotions, antidepressants, lifestyle choices, and hormone imbalance.
Because it has so many common causes, it’s a fairly common disease, affecting an estimated 52 percent of U.S. men between the ages of 40 and seventy — between 30 million and 50 million men nationwide.
The National Institutes of Health (NIH) defines erectile dysfunction pretty clearly: “A condition in which you are unable to get or keep an erection firm enough for satisfactory sexual intercourse.”
Seems simple enough, right? But the reality is that the symptoms of ED can have a wide range of severity and can be more subtle than you’d think.
In some instances, even if you’re able to get an erection, you may still have ED.
Since ED is a urologic disease, one of the best resources is The National Institute of Diabetes and Digestive and Kidney Diseases.
They share a thorough list of dysfunction symptoms that could suggest erectile dysfunction.
The most obvious symptom of erectile dysfunction is, well, erectile dysfunction—not being able to get and keep “it” up. Erectile dysfunction can take on various forms though, including:
Erectile dysfunction isn’t about never being able to get it up, contrary to popular belief. In fact, achieving erection sometimes but not every time is one of the most glaring symptoms.
This can be the case whether you’re in the mood or not, and partial erections count as symptoms as well.
In case you forgot your sex education class, here’s a quick breakdown of what’s going on inside your member.
Inside the penis, there are two long chambers called the corpora cavernosa. The corpora cavernosa contain a lot of cardiovascular mechanics, including blood vessels and tissues, as well as one major artery each.
When you become aroused, your brain dilates the blood vessels, allowing blood to flow in. The blood becomes trapped in the corpora cavernosa, keeping you erect.
That’s how it’s supposed to work, anyway, but it’s not always the case. If blood flow is insufficient or it isn’t sealed inside, that causes erectile dysfunction.
Being able to get to full mast is a good sign, but keeping it up during intercourse is equally if not more important, right? That’s why sustaining an erection is also an indicator of erectile health. Whether you lose it immediately, or it comes and goes, it’s likely a sign you’re struggling with ED.
Physiological and psychological symptoms can manifest similarly or differently, but one sign that your symptoms may be psychological or emotional is inability to orgasm before losing an erection.
Whether you’re blaming it on stress or a wandering mind, losing hardness or focus before completion may still be a sign that you’re struggling with performance anxiety, stress, or fear of sexual failure — all symptoms of ED.
Previous issues with erectile dysfunction, fear of failure, low self esteem: they can all cause you to become avoidant of, or lose interest in sexual activity.
Many men with erectile dysfunction lose interest and motivation to pursue sexual activity to some extent, which can cause further harm to confidence, and to relationships.
Occasional and one-off ED issues can happen, particularly when medication or alcohol is involved, so if the problem is very occasional or usually correlated to substances, you might not have ED.
But there’s still reason to be vigilant.
It can be a side effect of bigger health issues, including heart disease, kidney disease, or diabetes.
And even if you’re not suffering from other conditions, impotence is a condition that’s best dealt with proactively, so talk to your healthcare provider if you’ve experienced multiple incidents, and make it a priority if these issues have been ongoing for more than a few weeks.
Performance anxiety can cause ED, and there are various psychological treatments and approaches to dealing with the problem. Learn more here.
Whether you’re still unsure if you have ED, or want to know what treatment options are available, click here to view our comprehensive guide to erectile dysfunction.