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As a man, it’s easy to get used to waking up with an erection. In fact, most of us take morning wood (or nocturnal penile tumescence, as it’s formally known) for granted, making it a bit of a shock to one day wake up without an erection.
Morning erections are completely normal and healthy. They occur in men of all ages and could be the result of one of several processes, from brain relaxation to changes in your sex hormone levels as you sleep.
They’re also an important, useful indicator of general sexual health. Morning wood is normally a good indicator that your vascular and nervous system is functioning properly. On the other hand, the absence of morning wood can also, in some cases, be an indicator of ED issues.
In this guide, we’ll look at how morning erections happen and what they mean for your general and sexual health. We’ll also look at what a lack of morning wood could mean for your erection and overall health as a man.
Why Does Morning Wood Occur?
Morning erections are caused by several different processes. Right now, none of the theories about morning erections (or NPT, as it’s often referred to in scientific literature) are completely backed up by studies. However, experts believe there are three different key factors.
The first factor in morning wood is the hormonal change that occurs in your body while you sleep. During sleep, your body produces numerous important hormones, including male sex hormones such as testosterone.
Testosterone is the primary male sex hormone, responsible for everything from male sexual characteristics such as a deep voice and facial hair to sex drive. Since the average level of testosterone in your bloodstream is highest just after sleep, it can cause a morning erection.
This factor could also be why morning wood becomes less common with age. As people get older, the circulating levels of testosterone decrease, resulting in a lower sex drive and fewer morning erections.
There’s also a mental factor in morning erections. While you sleep, your body produces lower amounts of cortisol -- a glucocorticoid hormone that can negatively affect everything from your immune system to your ability to maintain an erection.
After waking up from REM sleep, with cortisol levels low and testosterone levels high, there’s a higher-than-average chance you’ll have an erection.
Finally, there’s often a physical component to morning wood. During sleep, physical contact with your partner (or even just pressure from your sheets, pillow or clothing) can stimulate your penis and cause you to develop an erection.
All three of these factors combine to make morning wood happen, meaning that a deficiency in one aspect (for example, low testosterone levels) can prevent you from getting morning wood even if the other factors are perfectly normal.
Morning Wood and Erection Health
Morning wood is a good indicator of both erection health and general health. If you usually wake up with an erection, it’s a good sign that your body is physiologically capable of achieving an erection and that you likely aren’t affected by physical ED.
It’s also perfectly normal to occasionally not wake up with an erection. Most men get an erection anywhere from one to five times during sleep. Sometimes, you’ll snap out of sleep at the wrong moment and wake up without an erection. As long as it’s occasional, it’s usually not a problem.
However, if you frequently wake up without an erection, there’s a risk that it could be the sign of an underlying health issue such as physical ED.
If you’re concerned that you’re not getting nocturnal erections you can try a simple postage stamp test. You take a length of connected postage stamps and secure them to your flaccid penis prior to going to sleep. If the perforated connections of the stamps are torn when you wake up
The most common causes of infrequent or no morning wood are hormonal issues, such as low testosterone, as well as health conditions such as obesity, high blood pressure, diabetes and high cholesterol.
There are also psychological causes of physical ED. For example, anxiety and depression can often lead to physical erection problems and make it harder to wake up with a morning erection.
Another factor that affects the frequency of morning wood is age. Older men --
Finally, medication can often affect morning wood. If you take prescription antidepressants or painkillers, there’s a chance that these could interfere with your body’s ability to get an erection and cause both a loss of morning wood and ED.
What Should You Do if You Don’t Get Morning Wood?
Because erections are multifactorial (that is, they depend on numerous factors, both physical and psychological) it’s important to talk to a doctor if you’ve noticed the signs of ED or lack of morning wood.
Occasionally waking up without an erection is completely normal. However, when this happens often, it could potentially be the sign of an underlying physiological or psychological issue.
As always, the best approach is to talk to a doctor about the situation. Most of the time, lack of morning wood or more persistent ED can be solved by making some changes to your diet and lifestyle or using medication.
This article was reviewed by Ho Anh, MD.
Important Safety Information
IMPORTANT SAFETY INFORMATION
Do not take Sildenafil (sildenafil citrate) if you:
- take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level
are allergic to sildenafil, as contained in Sildenafil and REVATIO, or any of the ingredients in Sildenafil
Discuss your health with your doctor to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or nausea during sex, seek immediate medical help
Sildenafil can cause serious side effects. Rarely reported side effects include:
- an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis
- sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking Sildenafil and call your healthcare provider right away if you have any sudden vision loss
sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking Sildenafil and contact a doctor right away
Before you take Sildenafil, tell your healthcare provider if you:
- have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
- have had heart surgery within the last 6 months
- have pulmonary hypertension
- have had a stroke
- have low blood pressure, or high blood pressure that is not controlled
- have a deformed penis shape
- have had an erection that lasted for more than 4 hours
- have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
- have retinitis pigmentosa, a rare genetic (runs in families) eye disease
- have ever had severe vision loss, including an eye problem called NAION
- have bleeding problems
- have or have had stomach ulcers
- have liver problems
have kidney problems or are having kidney dialysis have any other medical conditions
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Sildenafil may affect the way other medicines work, and other medicines may affect the way Sildenafil works, causing side effects. Especially tell your healthcare provider if you take any of the following:
- medicines called nitrates
- medicines called guanylate cyclase stimulators such as Adempas (riociguat)
- medicines called alpha-blockers such as Hytrin (terazosin HCl), Flomax (tamsulosin HCl), Cardura (doxazosin mesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl), Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of Sildenafil with alpha-blockers can lead to a drop in blood pressure or to fainting
- medicines called HIV protease inhibitors, such as ritonavir (Norvir), indinavir sulfate (Crixivan), saquinavir (Fortovase or Invirase), or atazanavir sulfate (Reyataz)
- some types of oral antifungal medicines, such as ketoconazole (Nizoral) and itraconazole (Sporanox)
- some types of antibiotics, such as clarithromycin (Biaxin), telithromycin (Ketek), or erythromycin
- other medicines that treat high blood pressure
- other medicines or treatments for ED
Sildenafil contains sildenafil, which is the same medicine found in another drug called REVATIO. REVATIO is used to treat a rare disease called pulmonary arterial hypertension (PAH). Sildenafil should not be used with REVATIO or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca tadalafil)
Sildenafil does not protect against sexually transmitted diseases, including HIV.
The most common side effects of Sildenafil: headache; flushing; upset stomach; abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision; stuffy or runny nose; back pain; muscle pain; nausea; dizziness; rash.
Sildenafil (sildenafil citrate) is prescription medicine used to treat erectile dysfunction (ED).
Sildenafil is not for women or children.