To improve your ability to get and keep erections, it is important to:
- Have sex only when you want to
- Meet your own conditions for good sex (for example having privacy, feeling relaxed, not feeling rushed, pressured, tired or distracted, feeling able to trust a partner)
- Learn to recognise when you are tense and identify techniques and ways to relax and overcome this
- Use self-exploration to identify the kind of stimulation you like and focus on this stimulation during partnered sexual activity
- Be able to enjoy having sex rather than worrying about your performance
- Feel confident to communicate and negotiate about sex with your sexual partners
Try not to use morning erections for sex. Morning erections are more often the result of a full bladder and a need to urinate than a sign of arousal. You might be tempted to try and use your morning erection before you lose it, but you could be putting unhelpful pressure on yourself.
Some people find wearing a cock ring helps them stay hard. A cock ring is band that fits over the base of the penis and restricts the flow of blood out of the penis when it's erect, which can help you stay harder for longer. If you’d like to try one, you can buy them from any sex shop. We recommend that you only wear a cock ring for a maximum of twenty minutes at a time.
You can purchase soft of stretchy rings (made of materials such as silicon) or adjustable cock rings (which use Velcro or another form of fastener). We do not recommend the use of solid or metal cock rings as these can be difficult to remove in an emergency.
If you have a bleeding disorder, take blood thinning medication or have any other long-term health conditions (e.g. diabetes, cardiovascular disease) please discuss use of a cock ring with your doctor before trying. Cock rings should not be used as an alternative to exploring treatable medical or psychological conditions which could be maintaining the erection difficulties
Lifestyle factors
A healthy lifestyle helps to reduce stress levels and improve cardiovascular health. In turn, this can enhance arousal and support sexual functioning. A healthy lifestyle can be supported by:
- Getting enough sleep
- Eating well
- Exercising regularly
- Stopping smoking
- Limiting the use of alcohol and recreational drugs
Visit www.nhs.uk/live-well for help and advice around maintaining a healthy lifestyle.
We know that there are three key elements that enable sex to go as well as possible: psychological arousal, physical touch, and being in the moment. These are known as the Conditions for Good Sex (Gurney, 2020).
Psychological arousal refers to how much of what is happening you find sexually arousing and turns you on. This can include how attracted you feel to your sexual partner(s), things in the environment (like lighting, sounds), the context (time of day, your role in the sexual experience), and also sexual fantasy and types of porn.
Physical touch refers to the types of physical stimulation that your body needs to feel sexually aroused. This can include the types of pressures your body needs, the speed and location of touch, the types of sex you enjoy and whether you enjoy using sex toys and/or lubricant (‘lube’).
Being in the moment refers to how much you are able to be in the present moment (rather than caught up in other thoughts or worries) and how much you’re able to focus on the physical sensations and psychologically arousing stimulation. This also includes how much you’re able to feel relaxed. Later in this booklet we have included suggestions about using mindfulness to increase being in the present moment.
The closer each of these elements are to our ideal conditions, the better the sexual experience will be. If we have high psychological arousal (are aroused and turned on), are receiving the types of physical touch we find pleasurable and are able to be in the present moment (and not distracted by other thoughts or worries) we have met the conditions we need in order for sex to go well.
Knowing your own conditions for good sex can help you to:
- understand what you need for sex to be its most enjoyable
- understand what might be disrupting the arousal process
- understand how these conditions might have changed or been impacted by sexual difficulties
It is not usually necessary for all of your conditions for good sex to be met throughout every sexual experience for the experience to be enjoyable. However, understanding your own conditions, and talking about them with sexual partners, can help to include more of your conditions more of the time.
Our pelvic floor muscles are like ‘a bowl of muscle’ underneath the pelvis. They provide support for the pelvic organs and help control when we go to the toilet. They also help to increase blood flow to genitals which aids arousal and increases pleasure. Contractions of these muscles also help produce sensations at orgasm.
The image below shows where your pelvic floor muscles are on your body. You can feel your pelvic floor muscles by contracting your anus as though you’re trying to stop a bowel movement, then imagine a zip closing forwards an upwards as if you’re trying to stop the flow of urine at the same time.
Pelvic floor muscles can become weaker over time, for example because of ageing or a lack of exercise. Pelvic floor exercises, sometimes called ‘Kegel exercises’, can help with this. They strengthen your pelvic muscles, which helps to create stronger and more pleasurable orgasms. Regular practice also improves the circulation of blood in the penis, which is necessary for getting erections.
To practice pelvic floor exercises, begin by squeezing and releasing these muscles 10-15 times in a row twice a day every day. Once squeezing and releasing the muscle becomes easier, you could add in more squeezes e.g. two sets of ten squeezes twice a day. Or you might want to try out longer squeezes (no more than 10 times with a 10 second hold) combined with shorter squeezes.
At first you might find that you’re tensing your stomach or thigh muscles as well, but with practice you can squeeze just the pelvic floor muscles.
Most people start to notice the results after around four to six weeks of regular practice. Build up gradually and don’t overdo it – just like the other muscles in your body it is possible to overwork your pelvic floor.
Earlier in this booklet we explained the importance of being in the present moment to fully enjoy sex. ‘Mindfulness’ has its roots within a wider set of Buddhist spiritual teachings and practices, the benefits of which have been known to Asian communities for centuries. More recently, a secular version of mindfulness practice has been adopted by Western cultures. Mindfulness practice can enhance our connection to the present moment, which can help improve a range of difficulties, including sexual ones.
When we get caught up with critical thoughts or trying to change things, this takes us away from the present. An important part of mindfulness is paying attention to your present experience without evaluating it. This means not judging the experience that you are having, just noticing it with curiosity and openness.
There are many ways to practise mindfulness. For example you could:
- Go on a walk and use all your senses to notice your present moment experience – the different things (like colours and textures) you can see, the smells and the sounds. Rather than ‘listing’ the things you notice, this is about really experiencing them in depth and detail.
- Sit in comfortable position, with your feet on the floor and your back straight but relaxed. Spend some time focusing on your breath as you inhale and exhale, focusing your awareness on the natural rhythm of your breathing.
It is completely normal for your mind to wander. When you notice this has happened, gently bring the focus of your attention back to the present moment.
It can take time to increase your ability to be mindful. You can start by practising for 10 minutes each day as you get more confident. Building up your day to day mindfulness skills can help you stay more present during sexual situations. Everyone responds differently to mindfulness practice, however. As with all suggestions in this booklet, only do what feels right for you and stop if anything causes you pain or feels distressing.