Erectile dysfunction (ED) is the inability to get or keep an erection firm enough for sexual intercourse. ED is very common, affecting up to 30 million men in the United States. Yet the topic remains difficult to talk about for many. Determining if you have ED is an important first step to identifying potential causes and exploring treatment options. Here are some key signs and symptoms to help evaluate if ED may be affecting you.

Difficulty Getting an Erection

The most obvious sign of ED is being unable to get an erection, or difficulty developing a full erection. You may notice this inability happens occasionally at first, like during periods of stress. But over time, it becomes more frequent and prolonged. An erection may fail to occur with sexual stimulation that normally prompts one. Or it may take much longer to get an erection.

Incomplete erections are another indicator of ED. Even with sexual arousal, the penis may only become partially erect. The erection may not be firm or large enough for penetration. Partial erections that do not fully extend are often an early warning sign of ED.

Reduced Rigidity and Duration

Even if an erection forms, reduced rigidity can signal ED. Erections may not get as hard, or they may soften too quickly. An erection should be hard enough and last long enough for satisfying intercourse. Erections that are short-lived, or do not have typical firmness usually required for sex, can indicate a developing issue.

Difficulty Maintaining an Erection

Being unable to sustain an erection for the duration of sexual activity is a hallmark of ED. You may be able to get an erection but then lose it far sooner than desired. The inability to maintain an erection is often due to insufficient blood flow and erectile tissue damage from conditions like diabetes, cardiovascular disease, or neurological disorders.

Lack of Morning Erections

Getting full erections during sleep is normal for most men. These involuntary erections often happen during rapid eye movement (REM) sleep. If you never or rarely wake up with a morning erection, it can signify a physical ED cause like reduced blood flow or nerve dysfunction. Note that factors like needing to urinate urgently upon waking can also inhibit morning erections.

Reduced Spontaneous Erections

Full erections without direct physical stimulation do not happen as often as younger men age. But if you lack regular spontaneous erections entirely, it can be a red flag for ED. Healthy men normally experience multiple random erections a day, especially during periods of REM sleep. The complete absence of spontaneous erections suggests a health issue may be contributing to ED.

Loss of Nocturnal Emissions

Wet dreams, or nocturnal emissions, during sleep can continue well into adulthood. While less frequent than the teen years, adult men normally experience periodic orgasms during sleep requiring changing of bed clothes. If you never have nocturnal emissions or they have diminished significantly, it can indicate lower testosterone levels or health conditions leading to ED.

Difficulty Achieving Orgasm or Climax

Men with ED may also notice they have trouble reaching orgasm or ejaculating. Orgasms may feel less intense, and ejaculation often produces less semen. Floppier erections make climax and ejaculation more difficult to achieve. Many men experience delayed or absent orgasms as an early warning of underlying health issues.

Reduced Libido and Sexual Desire

A lower interest in sex and reduced sexual fantasies or urges can signify ED. However, keep in mind that diminished libido does not always equal ED. Agerelated decreases in testosterone can lower libido without impeding erection ability. Differentiating between general low libido and specific disinterest in partnered sex may help identify the cause as either biological or psychological.

Reluctance to Get Help

Many men are reluctant to tell a doctor or partner if they experience ED symptoms. Feeling ashamed or embarrassed about erection difficulties leads to suffering in silence for too long. Do not let uneasiness about discussing sexual matters stop you from getting help for ED when needed. Sexual health is a key component of overall wellbeing.

Partner Observations

Talk to your partner to find out if they notice ED symptoms during intimacy. A partner's perspective can help identify issues like reduced erection firmness or rapid loss of erections. Their insights help give a fuller picture of your sexual health. Partners may first notice issues and changes that men do not.

Age and Health Conditions

Advancing age, obesity, diabetes, heart disease, depression, and other chronic illnesses increase the likelihood of developing ED. If you have one or more of these risk factors, get evaluated sooner rather than later. Certain medications also often cause erection difficulties.

Bottom Line

Noticing one or more signs of ED indicates you should make an appointment with your doctor. Getting evaluated for ED as early as possible raises your chances of identifying reversible causes. Do not remain silent about erection changes that are interfering with your intimacy and happiness. Help is available through various ED treatment options. You do not have to live with ED symptoms.