Erectile dysfunction (ED) occurs when a man cannot get an erection or maintain an erection firm enough for sex. The individual may still be interested in sex, but the penis cannot stay erect long enough to complete intercourse.

ED is common, affecting about 30 million males in the United States, according to the Centers for Disease Control (CDC).

Many males have occasional trouble getting an erection, but ED occurs when the problem happens regularly or prevents a fulfilling sex life.

This article looks at what erectile dysfunction may feel like and how to tell whether a person has it.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Males with ED may feel the penis returning to a flaccid state before they have ejaculated or can complete intercourse with a partner.

A person with ED may also:

  • be unable to achieve an erection at any time
  • be able to achieve an erection that does not last long enough for sex

Psychologically, ED can make a person feel embarrassed, ashamed, and frustrated. It may lead to depression, anxiety, and self-esteem problems if it goes untreated.

According to the CDC, erectile dysfunction does not refer to the following:

  • having occasional difficulty achieving an erection
  • having less interest in sex
  • having problems with ejaculation, which can indicate different structural problems with the penis

Doctors generally do not recommend that people test for ED themselves, as they may not get an accurate result. If someone suspects ED, they should contact a healthcare professional for an official diagnosis.

The following tests may help in the diagnosis of ED, but a person should be aware that they may be inaccurate.

Sexual health inventory for men (SHIM)

SHIM is a questionnaire meant to indicate the likelihood of a person having ED.

A person will have to answer a collection of multiple-choice questions about their erections and sexual health.

A doctor can conduct the SHIM in their office, but people can also do it at home. However, this test is not meant to diagnose ED and only indicates the possibility of ED.

A person can find an example of the questionnaire here. However, they should always seek an official diagnosis from a medical professional if they think they may have ED.

Nocturnal penile tumescence and rigidity (NPTR) tests

The purpose of the NPTR test is to determine whether the cause of a person’s ED is physical or psychological. People usually conduct this test once they already know they have ED.

People can conduct the NPTR test at home or in a lab supervised by professionals. It involves two silicone rings placed at the tip and base of the penis, connected to a machine that takes readings throughout the night.

The device tests for nighttime erections and measures the intensity and duration of each erection as they occur. Most men have three to five erections each night.

If the test shows that a person has erections during the night, it may indicate that the ED is not due to a physical issue. The cause is likely psychological, and counseling or consultation with a sex therapist could be helpful.

However, this test might not be accurate. A person should speak with a medical professional before doing an NPTR test.

Learn more about self-testing for ED.

ED can affect a person’s mental health, relationships, and more.

Mental health

ED can profoundly affect mental health.

One 2021 study found that the most common first reaction to ED was a feeling of emasculation. This can magnify any existing difficulties and take a significant toll on personal feelings and relationships.

Many men feel isolated when dealing with ED, leading to further distress. Once a single episode of ED has occurred, performance anxiety can exacerbate the issue, as stress is a known cause of ED.

Relationships

Partners of those with ED often describe it as a more significant problem in the relationship than the men themselves do.

In the same 2021 study, 75% of men with ED reported sexual dissatisfaction, compared with 82% of their partners. In these same relationships, 69% of men described ED as a problem, while 74% of their partners did.

The partners of men with ED often express feeling rejected, guilty, ashamed, frustrated, and unloved. They may want to withdraw from sex, which may exacerbate the issue.

Self-esteem

Sexual health is powerfully connected to happiness and fulfillment in the lives of men.

A different study from 2021 took a group of 80 men — 40 with ED and 40 as a control group — and measured their self-esteem and depression.

Researchers found that the group with ED had significantly higher scores on the depression scale and lower self-esteem despite typical sexual frequency in their life.

Researchers concluded that treatment and prevention of ED would increase men’s self-esteem.

More than 95% of men can be treated for ED, according to the CDC. There are a variety of treatments available. These include:

The only way to know the best treatment is to speak with a doctor and discover whether the source of ED is physical or psychological.

A person should contact a doctor if they lose erections more than a quarter of the time during sex.

A doctor will complete an evaluation, including asking questions about sexual health and history. This will help them determine the cause of ED and set up a treatment plan.

A person should contact a healthcare professional if they suspect that medication side effects are causing ED. The dosage may be incorrect or adjustable. A person should only stop or change dosages after speaking with the doctor first.

This section answers some frequently asked questions about what erectile dysfunction feels like.

How does a man with erectile dysfunction feel?

ED can be emotionally difficult for a male. It can be isolating, emasculating, and distressing.

They may fear being unable to please their partner or losing their partner. This can lead to withdrawal of intimacy at a time when the partner is also feeling rejected and confused.

It is normal to feel embarrassed or apprehensive about discussing ED with a medical professional or partner. However, talking about ED with doctors and counselors is the first step to getting treatment and regaining a fulfilling sex life.

It is equally important for a person to open lines of communication with a partner. Discussing how ED affects them and their relationship will help partners develop healthy coping strategies.

How do I know if my erectile dysfunction is physical or mental?

The best way for a person to determine whether ED has a physical or psychological cause is to ask themselves the following questions:

  • “Do I wake up with strong erections in the morning?” If so, this could indicate a psychological rather than a physical cause.
  • “Is the problem still present during solo masturbation?” If not, then a psychological issue, such as performance anxiety, could be causing ED.

However, to accurately determine a cause, a person should speak with a healthcare professional and have a full medical evaluation.

As part of this, they may perform an NPTR test to check for nighttime erections. This test will evaluate whether the penis gets hard on its own during the night.

If it does, the cause is not physical, and the doctor will explore psychological reasons.

Does erectile dysfunction go away by itself?

Problems with erections may be temporary if they are due to passing stress in life.

Similarly, if a person experiences difficulty with erections when they are under the influence of alcohol or drugs, this may be a temporary problem that will resolve once the substances have exited the body.

However, ED can be more long lasting. The cycle can perpetuate and worsen if the first incidence of ED creates performance anxiety that causes further stress.

In many cases, ED is due to underlying health issues and needs a physician’s attention.

Erectile dysfunction occurs when a male cannot get an erection that is firm enough for sex. It is a common condition, particularly as males age, but it is not a normal part of aging and should be treated at any age.

A man with ED may emotionally feel arousal, but the penis may be unable to maintain an erection. This may lead to frustration, feelings of inadequacy, emasculation, and shame. A person may fear being unable to fulfill the sexual needs of their partner.

A visit with a doctor to evaluate the cause of ED can pinpoint whether something physical or psychological needs adjusting and set a course of treatment. Most causes of ED are treatable, with good outcomes.