Anyone with a penis can have problems with ejaculation or having an erection. It can knock your confidence, but there’s no need to feel ashamed. There might well be a simple reason for it, but if it keeps happening it’s important to get help.

Read on to find out more about the causes and treatments of erection and ejaculation problems. 

Erectile dysfunction, sometimes called ED or impotence, is when you cannot stay hard long enough to have sex or cannot get an erection at all. You may also have a low sex drive (loss of libido). 

What causes erectile dysfunction?

Erectile dysfunction is more likely to happen as you get older because of reduced blood flow to your penis.

Often, there’s a common cause such as tiredness, stress or drinking too much alcohol. It can also be a side effect of some medicines such as antidepressants. 

If you keep on experiencing erectile dysfunction, there may be other causes. These can include: 

  • high blood pressure or high cholesterol
  • diabetes
  • depression or anxiety
  • hormone problems

Treatment for erectile dysfunction

Erectile dysfunction might be a sign that you have a health issue that needs treatment. That’s why it’s important to see your GP if it happens a few times. 

Your GP may suggest lifestyle changes such as stopping smoking, cutting back on alcohol, eating a healthy diet and losing weight. If you have a health condition that’s leading to erectile dysfunction such as high blood pressure, they can treat this with medicine. Counselling or talking therapy might also be an option if they feel your mental health could be causing your erectile dysfunction. 

There are prescription medicines that can increase blood flow to your penis, including sildenafil (Viagra) and tadalafil (Cialis). You can buy sildenafil from the pharmacy, but always see your GP first so they can rule out any other health concerns. Vacuum pumps can also help but speak to your GP before you use one. 

Ejaculation is when semen (cum) comes out of your penis. The two most common problems with ejaculation are:

  • premature ejaculation – you ejaculate too quickly during sexual arousal
  • delayed ejaculation – there’s a long delay before you ejaculate, or you do not ejaculate at all 

There’s also a rarer problem called retrograde ejaculation. This is where your semen travels backwards into your bladder rather than out of your penis. It is sometimes called dry orgasm. 

What causes ejaculation problems? 

There are lots of possible causes of premature and delayed ejaculation. 

  • Premature ejaculation can be caused by prostate and thyroid problems, as well as by nervousness, depression and stress. It is more common when you’re younger and middle-aged. 
  • Delayed ejaculation can also be caused by depression and stress, plus physical conditions including diabetes and multiple sclerosis. It may also be a side-effect of taking certain medications. It’s more common as you get older.

Treatment for ejaculation problems

Like with erectile dysfunction, see your GP if you have recurring ejaculation problems, so they can check what’s causing it. 

If they do spot a health problem, your GP will need to treat this first. You may be offered medication and talking therapy for your ejaculation problems. With premature ejaculation, your GP may also suggest you try some techniques at home, such as using thicker condoms to reduce sensation.