ED Basics

Losing Erection During Sex? Here's What's Happening

April 28, 2022

Medically reviewed by

David Culpepper, MD

When you're young, you might take for granted the ability to achieve and maintain an erection that's firm enough for sex – and that lasts all the way through sex.

There are many factors involved in getting and maintaining a firm erection, and even the slightest disruptions can lead to erectile dysfunction

Almost every guy will encounter erection challenges during the course of their life. Guys can lose their erection because they're tired, nervous, or had a few drinks too many that night. But when losing erections becomes more common than keeping them, it could be a sign of a serious underlying medical issue.

How Do Erections Work?

It’s important to understand the sexual response cycle. While there is clearly a noticeable physical element, there are many mental or emotional factors at play in getting an erection as well. 

The first step in an erection begins when a guy experiences some form of stimulation, of which there are two types (and either one will do the job). 

  • Mental stimulation is the result of internal thoughts or daydreaming. 
  • Sensory stimulation is the result of physical touching or audio/visual experiences. 

Once a guy experiences adequate stimulation, he enters a state of arousal. In this state, messages are sent from the brain, down the spinal cord, through the nerves, and into the penis. These messages cause the muscles of the penis to relax, allowing more blood to flow through the dominant dorsal, cavernous, and bulbo-cavernous arteries into the penis. The muscles located around the base of your penis will also begin to tighten, preventing blood from exiting through the primary veins (responsible for blood returning to the heart) in the penis. 

At the same time, the substance nitric oxide is released into the bloodstream. This chemical dilates and expands blood vessels to allow for even more blood flow into the penis. Since more blood flows into the penis than out, pressure builds and an erection develops. As the erection develops, this also pinches closed the primary veins that normally remove blood from the penis, helping to maintain the erection.

During an erection, the penis can contain seven times its flaccid volume of blood. 

Continued stimulation is required to maintain the erection. After reaching climax and orgasm (which typically results in ejaculation), the muscles, nerves, and blood vessels begin to return to their regular function and blood flows out of the penis.

What Are Some Ways That You Can Lose an Erection?

A disruption during any of these steps can result in erectile dysfunction or loss of the erection before or during sex. If you're having a difficult time achieving or maintaining an erection, here are a few possible reasons.

Physical Reasons 

The key physical processes involved in creating an erection involve your circulatory and nervous systems. 

An erection is created when more blood flows into the penis than out of it. Any issues relating to blood flow can result in difficulties keeping an erection. 

For example, high blood pressure can cause damage to your blood vessels over time. This can result in arteries becoming more narrow, hardening, plaques forming, and even leakage or breakage. 

As a result, circulatory conditions can decrease your overall blood flow, meaning there may be much less blood entering your penis when aroused than it needs to get erect. 

Other issues related to blood flow that are known to cause erectile dysfunction include hardened or clogged arteries (called atherosclerosis), diabetes, high lipids, heart disease, and more. Each of these can impact the amount of blood flowing to your penis in different ways. 

Another key physical involved in erections is the nervous system. Without a way to deliver messages from your brain to your penis, your penis won’t be able to respond accordingly to stimulation. This is often why spinal cord injuries result in weaker erections and even a complete loss of function.

If you've been diagnosed with issues related to your circulatory or nervous systems, they're a likely reason you're having trouble with erections. Some of the most common are obesity or being overweight, diabetes, and heart conditions.

Psychological Reasons

While the physical aspects of an erection might be easier to understand, you shouldn’t underestimate the importance of your cognitive state. 

Stimulation and arousal are the first and last steps in the life of an erection. Issues regarding mental health can make it more difficult to achieve an erection or result in an abrupt ending during sex. Mental health issues that can affect sexual function include depression, anxiety, stress, and low self-esteem; all have been linked to erectile dysfunction. These emotions can disrupt the pleasure or stimulation from sex and severely impact erections. 

Another key factor is the state of your relationship with your sexual partner. It’s easy for relationship issues outside of the bedroom to carry inside of the bedroom, like financial, unhappiness, discomfort, or anger. If these issues in turn impact your erections and sexual performance, they can exacerbate the catalyzing problems and make them even worse. This cycle of stress causing ED, contributing to stress, then causing ED can be hard to break. Sometimes, prescription ED medications can help.

Whether you're experiencing psychological issues due to internal or external factors, it may be worth visiting a therapist for help working through it. There are even sex therapists that specialize in helping men, women, and couples together work through sex-specific struggles. 

Lifestyle Choices 

Although these issues technically fall under the “physical” definition, they deserve their own category — by engaging in unhealthy lifestyle practices, it’s possible that your own choices are directly tied to your erectile dysfunction. 

For example, your diet can have a significant impact on erection quality. 

Eating foods high in fat, sodium, and sugar can all contribute to cardiovascular damage your blood vessels and heart health. Fat can lead to plaque build-up, sodium can lead to high blood pressure, and sugar can lead to diabetes. Each of these medical conditions increase your risk of erectile dysfunction, though you don’t have to be medically diagnosed to experience difficulties. 

Another way you might be causing ED problems with your lifestyle choices is by drinking alcohol or smoking cigarettes to excess. 

Alcohol is a vasodilator that expands blood vessels.This leads to more blood flow throughout the body and into your skin and tissues. As a result, alcohol can cause a drop in your blood pressure and blood volume. Less blood going into your penis will make for a weaker erection. Chronic alcohol abuse can also damage your peripheral nervous system, hormone production, and cardiovascular health, leading to less rigorous erections and even ED.

By contrast, smoking has the opposite effect. Nicotine is a vasoconstrictor and can cause your veins and arteries to narrow, leading to a significant spike in blood pressure that will make it much more challenging to maintain an erection. 

Eating a healthier diet, reducing alcohol consumption, and quitting smoking are just a few of the ways that you can improve your erections.  

The Takeaway

There are many reasons why you might be losing your erection during sex — they typically boil down to physical conditions, psychological issues, or unhealthy lifestyle choices. 

By making a few changes and addressing potential problems in these areas, you may be able to improve the quality of your erections and maintain them for better and longer sex. 

If you're still experiencing ED, you may want to consider talking with a doctor about ED medications like Viagra®, Cialis®, or cheaper generic versions of each. Rex MD helps guys do it all online, with no doctor office visits, consultations included with your order, and medications shipped to your door at rock-bottom prices, if approved. Learn more about a free consult from Rex MD by clicking here


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Erectile dysfunction: A sign of heart disease? | Mayo Clinic

Impact of spinal cord injury on sexuality: Broad-based clinical practice intervention and practical application | NCBI

Erectile dysfunction and mental health in a general population of older men | PubMed

Erectile Dysfunction: A Womans Point of View | Medicine Net

Association of Diet With Erectile Dysfunction Among Men in the Health Professionals Follow-up Study | NCBI

Alcohol intake and risk of erectile dysfunction: a dose-response meta-analysis of observational studies). | PubMed

Effects of cigarette smoking on erectile dysfunction | NCBI