Erectile dysfunction or impotence is the incapability to get and hold an erection strong enough for sexual intercourse. Having erection anxiety from time to time isn't essentially a cause to worry, since most men, at one time or another, experience it. However, if erectile dysfunction is a constant matter, it can cause tension, affect your confidence and subsidize relationship difficulties, leaving you wonder “Why can’t I get hard?” Problems with attainment or keeping an erection also can be a signal of an underlying medical condition, and a risk factor for heart diseases in the long run.

Why Can't I Get Hard?

Physical Causes

• Reduced blood flow to the penis: this is the most common cause of erectile dysfunction in men over the age of 40. Same as in other parts of the body, the arteries which transport blood to the penis can become constricted. As a result, the blood flow may not be sufficient to attain an erection.
• Diabetes: it can upset blood vessels and nerves.
• Diseases which affect the nerves going to the penis: for examples, strokes,multiple sclerosis,Parkinson's disease, etc.
• Hormonal changes: such as the lack of testosterone caused by a head injury. Such injuries can at times disturb the function of the pituitary gland in the brain. The pituitary gland makes a hormone that arouses the testicles to produce testosterone. So, while it may not at first seem linked, a previous head injury can in fact lead to erectile dysfunction and make you wonder “Why can't I get hard?” Other indications of a low testosterone level include a reduced libido and mood changes.
• Side-effect of certain medicines: some antidepressants, diuretics andbeta-blockers can cause erectile dysfunction if used chronically.
• Cycling: it is perhaps due to pressure on the nerves going to the penis, from sitting on the saddle for too long. This may disturb the functionality of the nerve.
• Alcohol and drug abuse.

Psychological Causes

• Relationship difficulties
• Stress
• Depression
• Anxiety

In most cases, if mental health issues are the cause of your erectile dysfunction, the condition usually start all of a sudden. And with the improvement of your mental condition, the dysfunction could go away. To determine whether your impotence is caused by psychological factors, ask yourself: can you sometimes get a normal erection? If the answer is yes, then physical conditions might not to be blamed for your unable to get hard.

How Is Erectile Dysfunction Diagnosed?

To answer the question of “Why can't I get hard?” you may need to go to the doctor for help. Inform him/her if you have any medical conditions, as it may help in finding or diagnosing the particular cause for impotency. Any sorts of medication you take should be disclosed, and tell the doctor exactly when you started it and the frequency of intake. A physical examination will be performed, including a visual assessment of the penis to make sure there are no exterior causes for your impotence, such as lesions from sexually transmitted infections or trauma. A blood test to check your blood glucose levels could also be performed to rule out diabetes as the cause. Other tests that may be ordered include an ECG (electrocardiogram), urine test or ultrasound.

What Can I Do About Erectile Dysfunction?

Lifestyle Changes

• Quit smoking to lead a healthy life. If you are having a hard time leaving it, try nicotine replacement such as nicotine gum or patch.
• Lose some weight doing physical exercises in daily routine. Exercises will also help in lessening stress and improving blood flow.
• Drinking too much or taking certain illegal drugs can deteriorate erectile dysfunction, so try to quit drinking or ask the doctor to prescribe some medications.

Medication

Oral medications to keep you from asking “Why can’t I get hard?” are one of the medical advances of the last decade. They are called phosphodiesterase (PDE) inhibitors as they increase the effects of nitric oxide, the chemical accountable for proper blood flow to the penis. These drugs include:

• Avanafil (Stendra)
• Sildenafil (Viagra)
• Vardenafil (Levitra, Staxyn)
• Tadalafil (Cialis)

Other medications include:

• Alprostadil self-injection: you can use a fine needle to inject alprostadil into the base or side of your penis. Each injection usually produces an erection that lasts for about an hour. Side effects can comprise of bleeding from the injection and prolonged erection
• Testosterone replacement: some men have erectile dysfunction that is further complicated by low levels of testosterone. In which case, testosterone replacement therapy might be suggested
• Alprostadil urethral suppository: this technique involves insertion of a little alprostadil suppository in the penile urethra inside your penis. The erection usually begins within 10 minutes and lasts between 30-60 minutes. Side effects consist of pain, minor bleeding in the urethra, and fibrous tissue formation inside your penis.

Other Methods

• Penis pumps: a penis pump is a hollow tube with a hand-powered or battery-powered pump. The tube is positioned over your penis, and the pump is used to draw out the air inside the tube. This creates a vacuum that pulls blood into your penis. Once you get an erection, you slip a tautness ring around the base of your penis to embrace the blood and keep it strong. You may remove the vacuum device.
• Penile implants: this treatment includes surgically placing devices into both sides of the penis. These implants involve either semi-rigid rods or inflatable. Penile implants are not usually recommended until other methods have failed.
• Blood vessel surgery: sometimes, leaking or obstructed blood vessels can cause erectile dysfunction, in which case a bypass procedure or vascular stenting might be useful.
• Couple counselling and sex therapy: these are most suitable if mental health difficulties are the cause of you asking “Why can’t I get hard?” Your sexual partner should be involved with you in this, as she might see your incapability to have an erection as an indication of reduced sexual attention. Connect responsively and honestly about your issues. This method is often used in combination with other treatment options.