Why am I losing my erection during sex?

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How erections work

If you’re asking, “Why does my erection go away so fast?” it helps to know how an erection works. When you’re sexually aroused, your brain sends signals down the spinal cord and nerves, triggering the release of a chemical messenger called cGMP.

This causes the smooth muscles in the penis to relax, which allows blood to flow in. At the same time, veins that usually drain blood away are compressed, helping the blood stay put. The result? An erection.

That means your brain, nervous system, hormones, blood vessels, and more all need to work together. If any part of that chain gets disrupted, even temporarily, it can affect your ability to stay hard.

The good news is that there are options. A provider can help you understand what’s going on and what you can do about it.

Why can’t I stay hard during sex? 14 reasons for losing an erection

Losing an erection during sex doesn’t always mean you have ED.

From everyday stress to cardiovascular health, here are 14 possible reasons you might lose an erection during sex.

1. Stress or anxiety

Stress can interrupt the signals between your brain and body and make it more challenging to get or maintain an erection during sex.

A study found that chronic stress can contribute to atherosclerosis, or the hardening and narrowing of arteries. The condition results in decreased blood flow throughout the body, including to the penis. Without adequate blood flow, it’s pretty much impossible to maintain an erection. Plus, being stressed doesn’t exactly put anyone in a sexy state of mind.

A scientific review found that up to 37% of people with an anxiety disorder such as post-traumatic stress disorder, obsessive-compulsive disorder, social anxiety disorder, or panic disorder also have ED.

Additionally, research has found anxiety disorders to be associated with an increased risk of cardiovascular disease, a well-known contributor to ED.

Whether you’re dealing with occasional stress or an ongoing mental health concern, stress or anxiety could affect your bedroom performance.

2. Depression

Depression can also play a role in losing an erection during sex. The connection between mental health and sexual function is well studied, and research shows that people with depression are more likely to experience ED.

One large review of nearly 50 studies found that the likelihood of having ED increases when depression is present. The review also found that the association goes both ways; the likelihood of developing depression when ED is present goes up, too.

Another review found that people with depression face about a 50%–70% higher risk of developing sexual dysfunction, which can include difficulty maintaining an erection.

Depression can create negative thought patterns that fuel performance anxiety and make it harder to stay aroused. It may also affect body systems that control stress and hormones, which can interfere with normal sexual function.

3. Using tobacco

Smoking is tied to many health problems, and erections are no exception. People who smoke are significantly more likely to have ED—studies show the risk can be up to three times higher compared to non-smokers.

Why? Smoking can damage blood vessels and make it harder for blood to flow properly to the penis, which is key for getting and keeping an erection.

And it’s not just cigarettes: Another clinical study on vaping found people who use e-cigarettes are more than twice as likely to experience ED as those who have never used.

4. Drinking alcohol excessively

Having a couple of cocktails or glasses of wine before sexual activity is common. Unfortunately, though, the dreaded whiskey dick (or alcohol-related ED) is also common.

If you occasionally lose your erection during sex because you’ve had too much to drink, it’s probably not cause for concern. You just might want to keep that in mind next time you think you’re going to get lucky.

Alcohol dependence or heavy drinking,* on the other hand, can be an issue both in and out of the bedroom, as it’s a disease that can affect physical and mental health.

In a clinical study of 100 patients with alcohol dependence, 62% experienced sexual dysfunction, 36% had difficulty achieving an erection, and 34% had difficulty maintaining an erection.

* Heavy drinking is considered 15 or more standard drinks per week for men, where a standard drink equals one 12-ounce regular beer (5% alcohol), one 5-ounce glass of wine (12% alcohol), or one 1.5-ounce shot of liquor/spirits (40% alcohol).

5. Using recreational drugs or steroids

While more studies are needed to confirm how (or if) cannabis use directly impacts erections, some research suggests that ED may be more common among cannabis users. One review found that ED could be more than twice as likely in people who use cannabis compared to those who don’t.

We still don’t fully understand why this might happen. A theory is that cannabis may affect the endocannabinoid system, which is a network of receptors in the brain and body involved in regulating mood, stress, and sexual function.

Using steroids, especially anabolic steroids, can affect your hormone levels and has been linked to issues getting an erection. Over time, taking these drugs may make it harder for your body to function normally in the bedroom.

Other recreational drugs, like opioids, can also affect your ability to get or keep an erection.

6. Eating poorly

As the saying goes, everything should be enjoyed in moderation. That includes your favorite foods, so occasionally digging into a burger and fries shouldn’t be cause for concern.

But regularly overindulging in certain items like red meat and processed foods could have an impact on erectile function, as they can cause issues with blood flow and inflammation.

Diets high in processed foods and unhealthy fats can lead to plaque buildup in the arteries, restricting circulation throughout the body (including to the penis). This can make it harder to maintain an erection.

This diet can also raise blood pressure and contribute to conditions like diabetes and heart disease over time, which are major risk factors for ED.

7. Carrying excess weight (obesity)

If you’re losing your erection during sex, it could even be related to your weight. One study found that 73% of those with abdominal obesity had some degree of ED. Another study found that those with obesity had three times greater risk of sexual dysfunction compared to the general population.

Extra weight can affect erections in a couple of ways. Carrying excess weight can damage blood vessels and reduce blood flow to the penis, making it harder to stay firm. Obesity is also linked to lower testosterone levels, which can decrease sexual desire and function.

8. Medication

ED is a known side effect of many prescription and over-the-counter medications. Common culprits include:

Most antidepressants, especially SSRIs (selective serotonin reuptake inhibitors)
Cimetidine (used for heartburn)
Ketoconazole (an antifungal medication)
Spironolactone (a diuretic that affects hormone levels)
Sympathetic blockers, such as methyldopa, clonidine, and guanethidine
Thiazide diuretics (used to manage blood pressure)
Stimulants, such as amphetamines and Adderall
Other antihypertensives, though the risk varies

Not all blood pressure medications carry the same risk. ACE inhibitors and calcium channel blockers are less likely to cause ED. Beta-blockers may have a mild effect, while alpha-blockers have actually been shown to improve erectile function in some cases.

If you suspect a medication might be affecting your sex life, talk to your healthcare provider about alternatives or adjustments. Never stop a prescribed drug without medical guidance.

9. Vascular disease

Vascular diseases—conditions that affect blood vessels and circulation (for example, high blood pressure, atherosclerosis)—are a major cause of ED, so much so that there’s a term for ED caused by these conditions: vasculogenic ED.

When blood flow is reduced because of narrowed or hardened vessels, the body has more difficulty directing blood to the penis. This can make it harder to maintain an erection during sex, not to mention achieve one in the first place.

10. Nerve damage and neurological issues

ED can also result from neurological issues. Neurogenic ED occurs when nerve damage disrupts the signals needed to trigger an erection.

Since the nervous system controls communication between the brain, spinal cord, and penis, conditions like diabetes, multiple sclerosis, Parkinson’s disease, and spinal cord injuries can interfere with this process.

Additionally, surgery in the pelvic region, such as prostate or colorectal procedures, can sometimes damage nerves that affect the area, making it harder to achieve or maintain an erection.

11. Injuries

Injuries, such as a pelvic or penile fracture or radical pelvic surgery, are another potential cause for losing your erection.

As is the case with nerve damage, injuries that disrupt the body’s ability to send the correct signals can result in difficulty maintaining erections. Reduced blood flow due to an injury can also be a culprit.

If you’ve sustained an injury and are now unable to maintain erections, you should seek medical care to avoid complications.

12. Hypogonadism / low testosterone

Hypogonadism is a condition in which the body produces low (or no) sex hormones. Biological males with hypogonadism often have low testosterone levels and may experience sexual dysfunction as a result of the condition.

Testosterone replacement therapy (TRT) may be an option for some people if low testosterone is contributing to ED. While it doesn’t always cause ED on its own, low testosterone is associated with chronic medical conditions, including heart disease and diabetes, that can also affect erectile function. Some research shows that low testosterone can also impair the ability of medications to help treat ED.

Speak with a healthcare provider to see if you need testing for low testosterone, because treatment options are available and may help improve your quality of life if you are eligible.

13. Cardiovascular disease

If you’re losing an erection during the excitement phase, blood flow may be part of the issue. Heart and blood vessel health play a big role in erections. Problems with circulation, such as heart disease, high blood pressure, or diabetes, can make it harder for blood to reach the penis.

One reason is that these conditions can damage the inner lining of blood vessels, making them less able to relax and let blood flow in. Hardening of the arteries (atherosclerosis) can also narrow vessels throughout the body, including those that supply the penis.

If you have — or are at risk for — heart disease, it’s important to talk with a healthcare provider. They can help you manage your heart health and your sexual health together.

14. Diabetes

Diabetes is well known to cause issues with blood sugar, but it can also wreak havoc on sexual dysfunction. Over time, diabetes can damage blood vessels, including those that supply blood to the penis, which can interfere with your ability to get and maintain an erection.

The condition can also lead to nerve damage, which can negatively impact erections.

Does losing an erection during sex mean I have ED?

Losing an erection during sex can be frustrating, but it doesn’t always mean you have ED.

Erections can go away fast due to stress, anxiety, health issues, or certain medications. Common causes include poor blood flow, performance anxiety, or side effects from prescription drugs. Frequent issues may signal ED and should be evaluated by a healthcare provider. Treatment may include lifestyle changes, therapy, or medications depending on the underlying cause.

It’s normal to have an off day once in a while. But if it happens regularly, it may be a sign of something more ongoing.

Watch for other symptoms of ED, which can include trouble getting an erection at all or a noticeable drop in sexual desire. If you’re frequently losing erections during sex, or if these issues are affecting your confidence or relationships, it may be worth checking in with a healthcare provider.

And if you ever have painful erections, don’t ignore them. This can be a sign of an infection or a condition like Peyronie’s disease, and it’s important to get it evaluated.

How to stay hard during sex: top 7 tips

Instead of stressing, try the tips below to help support more consistent erections and reduce performance pressure:

1. Take a pause and reset.	Losing an erection mid-sex can feel frustrating, but taking a short break can help. Try shifting your focus to other forms of intimacy, like oral sex, using your hands, or incorporating a toy. Reducing performance pressure in the moment can help you feel more relaxed, which may make it easier to get aroused again.
2. Check in with your body and environment.	Stress, alcohol, and new medications can affect sexual performance. If you’ve had a long day or drank more than usual, those factors might be playing a role. It may help to create a low-pressure, comfortable environment and check in with how you’re feeling both physically and emotionally.
3. Communicate with your partner.	Talking and being open with your partner about what’s happening can relieve some pressure when you feel like you need to perform. You might find that exploring different types of intimacy together can make the experience feel less stressful and more connected.
4. Focus on healthy habits.	Lifestyle changes around diet, exercise, and sleep hygiene may improve overall sexual function. Supporting your heart and blood flow can also encourage healthy erections. Consider incorporating foods that boost nitric oxide.
5. Limit alcohol and tobacco.	If you notice it's harder to stay hard after drinking, it may help to reduce your alcohol consumption and see if that helps. Smoking is also closely linked to erectile issues, and some people see improvements soon after quitting. If you’re having trouble cutting back, talk to a provider about tools that can help.
6. Consider a cock ring (with care).	A cock ring is a device worn at the base of the penis to help maintain an erection by slowing blood flow out of the area. It may be helpful if you’re losing your erection during sex. Just be sure it’s comfortable. A ring that’s too tight or worn too long can cause injury. If you’re unsure about how to use one safely, ask a healthcare provider.
7. Consult a therapist or mental health professional.	A therapist or psychiatrist can help you find strategies or medications that make it easier for you to manage anxiety or stress, which in turn can make it easier to maintain an erection. They can help you figure out whether it’s physical, psychological, or both, and work with you to find a treatment plan that fits.

How to treat erectile dysfunction (ED)

If you find you’re frequently losing an erection during sex, consult your healthcare provider. While there are a variety of ED treatments — like prescription medications, injections and suppositories, devices and surgery, and lifestyle modifications — the best one will depend on the root cause of your condition.

Here are some commonly recommended options by healthcare providers (and backed by research).

Prescription medications

The first line of treatment for ED tends to be phosphodiesterase-5 (PDE-5) inhibitors,* a drug class that includes Viagra (sildenafil), Cialis (tadalafil), and vardenafil.

PDE-5 inhibitors work in part by relaxing blood vessels and increasing blood flow. They’re shown to be highly effective, with an overall success rate of up to 76%.

To give these medications a chance, you should work closely with your healthcare provider and adjust the timing and dosage as needed to optimize your erectile function and minimize side effects.

In addition to these oral pills, you can find some PDE-5 inhibitors in other formulations. Ro Sparks, for example, is a sublingual (under the tongue) treatment that combines sildenafil and tadalafil, the active ingredients in Viagra and Cialis.

Another option is Ro’s Daily Rise Gummies, a low-dose daily approach to treating ED. These once-a-day, fruit-flavored gummies contain tadalafil and can help increase sexual spontaneity.

Though these last two formulations are not US Food and Drug Administration (FDA)-approved, they contain active ingredients that have been FDA-approved for ED.

ED injections and suppositories

If oral medications aren’t effective, ED can also be treated with localized therapies like injections or suppositories. These treatments work by directly increasing blood flow to the penis, often with faster or more targeted results.

Penile injections: This approach involves injecting medication into the base or side of the penis to help relax smooth muscle and allow blood to flow in.

The most commonly used drug is prostaglandin E1, but other drugs may also be prescribed. These options can be highly effective, even for people who haven’t responded well to pills.

Intraurethral suppositories (MUSE): MUSE, short for Medicated Urethral System for Erection, uses a tiny pellet of alprostadil inserted into the urethra with a special applicator. The medication dissolves and increases blood flow locally. As of June 2024, it is no longer available in the U.S.

Effectiveness can vary from person to person, and some may experience mild discomfort or burning during use. These therapies may be good options if you’re looking for non-pill ED treatments.

Devices and surgery

A penis pump or vacuum erection device is a non-surgical form of treatment consisting of a plastic chamber in which you insert your penis. It’s attached to a hand or battery-powered pump that creates suction to increase blood flow to the penis.

These options can have limitations such as decreased spontaneity, inconvenience, and discomfort or even pain, and should be used with caution.

Lifestyle habits

The same tactics of promoting a healthy lifestyle as ways to stay hard during sex are also commonly recommended for ED.

This means that managing stress levels, limiting alcohol consumption, and quitting drug and tobacco use can potentially help reduce the impact of ED.

Other key lifestyle changes that double as ED treatment include:

Regularly exercising: Research has found that people who exercise regularly, especially with moderate-to-vigorous aerobic workouts, have significantly improved erectile function. Getting enough physical movement can also boost the production of nitric oxide, potentially increase testosterone levels as part of a healthy lifestyle, and improve circulation, all of which are key to getting and maintaining erections.

Eating a balanced diet: While no one food can fix ED, consuming a variety of nutrient-dense foods, such as lean proteins, whole grains, and plenty of fresh produce, can help lower various risk factors for ED, including type 2 diabetes, heart disease, and obesity.

Prioritizing sleep: Not getting enough REM and deep sleep is linked to a higher risk of ED. Prioritize getting consistent, high-quality sleep to help support healthy sexual function.

Personalized ED treatment for you.