Why can't I get an erection?

Erectile dysfunction may be caused by psychological stress, vascular disease, hormone imbalance, drug side effects and bad lifestyle habits. Common causes include long-term anxiety, arteriosclerosis, low testosterone levels, the effects of antihypertensive medications, and smoking and alcohol abuse.

1. Psychological factors:

Long-term mental stress, anxiety and depression can inhibit the conduction of sexual excitement. Work pressure or relationship conflicts may lead to abnormal regulation of erectile signals by the cerebral cortex, manifesting as on-the-spot psychogenic erectile difficulties. This situation can be improved through psychological counseling or behavioral therapy with partners.

2. Vascular disease:

Insufficient blood supply to the corpus cavernosum of the penis is the main organic cause. Vascular endothelial damage caused by hypertension and diabetes can hinder blood perfusion. About 40% of atherosclerosis patients have erection problems. Diagnosis needs to be confirmed by ultrasound, and symptoms can be relieved by controlling underlying diseases.

3. Hormone abnormalities:

Insufficient testosterone secretion directly affects sexual desire and erection quality. The testosterone level of middle-aged and elderly men decreases by 1%-2% every year. When it is lower than 300ng/dl, morning erections may disappear. With symptoms such as hot flashes and loss of body hair, six items of sex hormones need to be tested.

4. Drug effects:

Some antidepressants inhibit sexual function by interfering with the serotonin pathway, and beta blockers in antihypertensive drugs can reduce blood flow to the penis. Sedatives, antihistamines, etc. may also cause temporary dysfunction. Consultation is required before adjusting the medication plan.

5. Living habits:

Smoking 20 cigarettes a day can increase the risk of erectile dysfunction by 50%, and alcohol can inhibit central nervous system excitability. When obesity leads to lack of exercise, adipose tissue overproduces estrogen to antagonize the effects of testosterone. It is recommended to do 150 minutes of aerobic exercise every week.

Improving erectile function requires comprehensive intervention: a Mediterranean diet helps maintain blood vessel elasticity, and moderate intake of zinc-rich foods such as oysters and nuts can promote testosterone synthesis.； Kegel exercises can enhance blood supply to pelvic floor muscles ； Avoid wearing tight pants that compress the perineum. If the symptoms last for more than 3 months or are accompanied by systemic symptoms such as chest pain and blurred vision, cardiovascular diseases and neurological diseases need to be investigated promptly. Nocturnal erection monitoring can be used as a reference to differentiate between psychogenic and organic erections.