Dear Dr. Joe,
My erection isn’t at as high an angle as it once was (it’s a little droopier). Is there anything I can do to get that standing-at-attention look back?
— Droopy Dog
The firmness of your erection is based upon a number of factors -– nerve stimulation, blood supply, and psychological attitude. Depending upon your age, deficiencies in any, or all, of these components can lead to weaker erections. This decrease in turgor will cause your erection to appear a bit “droopier.” Let’s get one thing straight, though. As men age, erections weaken a bit – that’s just an unfortunate fact. While a healthy man should be able to attain erections adequate for sex for his entire life, the strength of that erection is unlikely to be the same at 50 as it was at 18. So don’t be too critical with yourself.
First off, have you had any recent trauma, especially to the lower back or the groin area? Have you been diagnosed with any medical problems, especially diabetes or high blood pressure? Many medical conditions can lead to disruption of the nerve stimulation or blood flow required for an adequate erection. In fact, erectile dysfunction is known to be one of the first signs of cardiovascular disease, and it is associated with an increased risk for a heart attack in the future. If you have (or suspect you have) a medical problem, your first step is to have these conditions evaluated and properly treated by a medical professional.
If you are otherwise in decent health, an exercise program can certainly help. Strong erections require adequate blood flow to the penis. Just as regular cardiovascular conditioning can improve blood delivery to your heart and muscles, it can also improve blood flow to your penis. And, if you smoke, quit. Besides being probably the best thing you will ever do for your overall health, quitting smoking may help you regain that ready-to-go look.
While you’re getting in shape, be sure to exercise your pelvic floor muscles too. Most people assume kegels are just for women, but as men age or gain weight, the muscles surrounding the genital structures can begin to atrophy. Contracting and relaxing these muscles regularly may result in stronger erections, increased stamina, and more intense orgasms.
Don’t underestimate psychological factors. We men are sensitive creatures. Stress in any form can lead to decreased libido and erectile strength. Financial difficulties, relationship problems, job pressure, boredom with or lack of attraction to your partner – all can weaken the ol’ fella. If you think stress is playing a role, attack that problem first, or see a counselor if you have complex issues to address. A little time off, if possible, may help. Decreased anxiety is one of the reasons vacation sex is so great. Alcohol, on the other hand, is not a good solution. While a drink or 2 may loosen you up, too many drinks can cause “whiskey dick,” and excessive drinking is bad for you in general.
Finally, if none of these remedies help and your erection isn’t firm enough for intercourse (which actually doesn’t like your problem), you may be a candidate for pharmacologic treatment. Phosphodiesterase inhibitors, such as Viagra®, work by amplifying the neurological signal from the brain. This signal stimulates increased blood flow to the penis. While these medications are indicated for those with physiological conditions leading to weakened erections, they also work very well (and are commonly prescribed) for men with psychosocial stressors. There are a number of contraindications and side effects with these drugs, so see a doctor before using them (check out my article). By the way, an abundance of “male enhancers” are marketed in nutrition stores and online, but I don’t know of any herbal or over-the-counter remedies that have been clinically proven to improve erections.
So, to simplify: eat well, exercise, get adequate sleep, quit smoking, limit alcohol consumption. If these measures don’t work – see a doctor.
— Dr. Joe
Dr. Joe earned his undergraduate degree in Molecular Biology from Princeton University. After attending the Loyola University Stritch School of Medicine, he completed his residency training in urological surgery at the Los Angeles County Medical Center. He lives and works in Chicago, IL. Keep an eye out for his upcoming blog at docjoe.net.
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