During an erection, blood flows to the penis, which makes it hard. It’s normal to have difficulty with erections on occasion. Many people have erection problems (erectile dysfunction, impotence) as they get older. Some of these problems include:
- trouble getting an erection
- the penis isn’t as hard as it used to be with an erection
- erections don’t last as long as they used to
You can still have orgasms during sexual touching or stimulation, even if you don’t have an erection.
Causes of erection problems
Erection problems can be caused by:
- blood vessel problems
- nerve problems
- heart disease
- diabetes
- smoking
- cancer treatments involving the pelvis like pelvic radiation therapy or pelvic surgery
- depression, anxiety, or stress
- drinking too much alcohol
Chemotherapy can also affect the ability to have an erection because it can affect sexual desire. If this happens, sexual touching might be needed before an erection can happen.
If you’re having trouble with interest in sex or with erectile function, think about erections in a different way: as a response to sexual touch. Erections may happen with sexual touching instead of happening on their own when you think about or feel the urge to have sex.
Orgasm and ejaculation
Orgasm is different than ejaculation. Many people think orgasm and ejaculation are the same thing, but they aren’t. You can have an orgasm without ejaculating. Ejaculation causes fluid to come out of the penis. For most people, this happens when they orgasm.
Sometimes after surgery or pelvic radiation, some nerves are damaged and others nerves aren’t. Even if nerves are damaged, you can have an orgasm without having an erection. This is because the nerves that help you feel pleasure are different than the nerves that cause an erection.
If your prostate has been removed, you can still have an orgasm, but you won’t ejaculate. The prostate gland makes the liquid part of semen. So if it is removed during surgery or damaged by radiation, you will have dry orgasms. Some people say that the quality of the orgasm is different, but many say it’s just as enjoyable.
If you do not ejaculate, your sperm will not reach the egg during vaginal intercourse. Learn more about cancer treatments and fertility.
Enjoying sex without a firm erection
Many people think that sex with penetration is the only way to have sex. But most couples use touching and caressing as part of their routine and many couples keep having sex, even if one partner can’t get a firm erection. Orgasms can happen with caressing, oral sex, or other types of stimulation. Think about trying something new.
There is no risk when learning to enjoy sex without a firm erection. Some people may feel this option goes against their religious beliefs or values. If this is a concern for you, talk to your healthcare provider.
Consider these tips for having sex without a firm erection:
- Try different ways to caress each other that you haven’t tried before. Try things more than once if they don’t work well the first time.
- Make sure you understand your partner’s body, and where and how they like to be touched. Talk to your partner about what you like. Be open to trying new kinds of touch.
- If you or your partner has a hard time reaching orgasm, think about getting a sex toy or using a vibrator when you have sex. A vibrator works well if you’re tired or if you get tired using your hands to stimulate your partner. You can also lie facing your partner and rub your genitals against each other or use a vibrator between you. Make sure to use a good lubricant to make it feel good and decrease pain from friction.
- Add in new ways to increase your excitement, like thinking about a sexual fantasy or reading an erotic story to each other.
- Use a lubricant when stimulating the penis by hand or with a vibrator.
- Think about masturbating on your own or with your partner. This can help you know how you like being touched best. Sometimes, this can change after surgery or cancer treatment. Anything that increases the blood flow to the penis, including masturbation, helps keep the tissue healthy.
Treatment for erection problems
There are many ways to treat erectile problems including:
