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If you can't get rock hard anymore, here's how to treat it

The truth is there are plenty of factors that could be causing your erectile dysfunction.

Written by
Lucinda Starr
Medically reviewed by
Dr Darran Foo
Last updated
May 15, 2024
min read
If you can't get rock hard anymore, here's how to treat it
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If you've found yourself Googling, "I can't get rock hard anymore", or "why can I only get a semi-hard-on", you're not alone.

Erectile dysfunction (ED)is really common and many blokes will encounter it at some point in their lifetime. In fact, it's the most common sexual dysfunction in men, affecting around 40% of men [1]. That's almost half of all men. And, erectile dysfunction can affect men of all ages.

So, what causes ED? The truth is there are plenty of factors that could be causing your erectile dysfunction. Luckily there are also plenty of treatment options out there.

We're here to answer all your questions and put some fears to rest by explaining the complex process involved in erections, why you could be experiencing erectile dysfunction and how to get your erectile function back on track.

How do I get an erection?

Erections are more complicated than you think. There are a bunch of functions involved, from hormones to blood vessels to nerves and even your mind.

An erection first starts with sensory and mental stimulation [2]. During sexual arousal, nerve messages begin to activate the penis, where impulses from the brain and local nerves cause the muscles in the corpora cavernosa (a spongy tissue containing blood vessels that fill with blood to help make an erection) to relax [3].

This prompts blood flow to the penis and creates pressure which makes the penis expand, therefore creating an erection.

How common are erection issues?

Erectile problems are much more common than you think — so if you're experiencing erectile dysfunction, you're definitely not alone.

Erection problems affect roughly 1 in 5 men over the age of 40 and about 1 in 10 men will suffer from erectile dysfunction at one point in their lives [4].

Why am I suddenly having trouble getting hard?

Chatting about your sexual activity and what happens in the bedroom can be a bit daunting. From premature ejaculation to erectile problems, many of your mates have probably encountered these challenges, too.

So, why might be you struggling to get and hold an erection?

There's no single answer to this question. First up, it's important to remember that having erection issues from time to time isn't something to be too concerned about.

Generally, erectile dysfunction is a gradual process that develops over time. But, sometimes sudden erectile dysfunction can occur which may be due to psychological factors or medications.

Suddenly not being able to get an erection may be a result of excessive alcohol and drug use, medications such as antidepressants, blood pressure medications, smoking or taking sedatives. It can also result from psychological factors like anxiety, depression, chronic stress, low self-esteem and performance anxiety.

If you've noticed a dramatic change in your erectile function in a short space of time, it's important to chat with your GP to see what factors could be at play.

Why can I not get my rock hard anymore?

When you were a teenager or in your early adulthood, getting an erection was probably a lot easier — sometimes even happening at inconvenient times (we've all been there).

But, with age, our hormones tend to slow down, on top of other medical issues and life stress that impact our erectile function which means erections may not last as long or aren't as hard.

There are other causes like having an underlying health condition or chronic illnesses and those who are overweight, smoke and don't exercise can all contribute to erectile dysfunction and your inability to get hard.

Plus, being able to get an erection and maintain it involves changes in blood flow within your penis. If something gets in the way of this complex process or something interferes with the function of blood vessels or nerve transmission, this can impact your ability to get an erection.

What causes erectile dysfunction?

Sexual function is incredibly complex and there are a bunch of different reasons why you could be experiencing erectile dysfunction.

Erectile dysfunction can be caused by physical factors such as medications and health conditions. Sexual dysfunction can also be caused by psychological reasons such as depression and anxiety or a combination of both physical and psychological reasons.

Let's run through the most common causes of erectile dysfunction in most men [5].

Physical causes

Physical reasons and having a medical condition are some of the most common reasons for erectile dysfunction so if you are experiencing erectile dysfunction, it might be worth heading to the doctor to check your medical history to get to the root cause of the issue.

Here are some potential physical reasons for erectile dysfunctions.

  • Heart disease
  • Atherosclerosis (clogged blood vessels)
  • High cholesterol
  • Multiple sclerosis
  • High blood pressure
  • Diabetes
  • Obesity
  • Smoking or vaping
  • Substance use
  • Low testosterone levels
  • Prostate cancer treatments
  • Metabolic syndrome
  • Certain medications such as blood pressure medications and anti-depressants.

Psychological causes

Your mind has a lot to do with sexual function and your sexual response. Sexual problems can be caused by a variety of life stressors, mental health issues and even performance anxiety that can make you worried about your sexual performance.

Depression, anxiety and other mental health conditions can interfere with sexual function and relationship problems as a result of stress and bad communication can impact sexual desire, sexual pleasure and sexual performance.

Treating erection issues

The good news is erectile dysfunction is not a permanent issue for most men and if you do suffer from erectile dysfunction, you can get your sex life back to normal with the help of a variety of treatment options.

Clinical treatment

Medical treatment is generally the first line of treatment used to target the enzyme responsible for the contraction of blood vessels in the penis. This helps to treat erectile dysfunction by improving blood flow and maintaining firm erections throughout sexual activity.

Pilot's clinical erectile dysfunction treatment plans offer both on-demand and daily options for whatever your needs are when you need to treat erectile dysfunction. With treatment, 78% of men achieve long-lasting erections.

We know it can be difficult and scary to talk about your sex life and erectile dysfunction with your doctor and sometimes face-to-face sessions can be daunting.

That's why Pilot offers judgement-free treatment through an online service with consultations with a practitioner. We also aim to take the stress out of getting treatment which is why we offer discreet shipping.

Psychological treatment

Additional treatment may also be required for men experiencing erectile dysfunction that take into account some of the psychological reasons.

Psychological treatments such as Cognitive Behavioural Therapy, ringing up a sex therapist for sex therapy and other treatments can be used in combination with medication to get your sex drive back and your penis fully functioning again.


Diet plays an important role in basically every medical condition. It also plays an important role to treat erectile dysfunction. In fact, The Royal Australian College of General Practitioners recommends a healthy diet in the management of erectile dysfunction [6].

We aren't telling you to run and purchase all the aphrodisiac foods you can find, but, eating a diet that's rich in natural foods like fruit, vegetables, whole grains and fish can decrease the likelihood of erectile dysfunction [7].

Various studies have also shown the benefits of the Mediterranean diet on erectile dysfunction, with one 2020 study finding that those with the most adherence to a Mediterranean diet were the least likely to develop erectile dysfunction [8].

If you want someone to tell you to eat more chocolate, here's your chance. Dark chocolate is a flavonoid-rich food that's full of antioxidants which can help aid in blood flow problems by increasing blood flow by making arteries more flexible and can lower blood pressure [12]. The same flavonoid-rich benefits of red wine have also been associated with ED.

Flavonoid-packed chocolate can also help your body make more nitric oxide which is found in many erectile dysfunction medications because it's the main agent that relaxes the penile smooth muscle. Remember that eating a balanced diet is super important and chocolate should be consumed in moderation.


A key to improving erections and your overall sex life is exercise [9]. Exercise is one of the most important lifestyle factors that is most strongly associated with erectile function so if you're looking to improve erections hit the gym, go for a run or whatever it is you like to do to be active [10].

Research suggests that moderate to high-intensity physical activity for 40 minutes, 4 times a week can result in significant improvement in erectile dysfunction symptoms on top of being great for your cardiovascular health [11]. Weight can also play a role in ED, so it might be worth exploring weight loss options with your doctor as a way to treat erectile dysfunction.

Despite being a common experience men encounter in their lifetime, talking about erectile dysfunction is often considered embarrassing and shameful.

Whether you're experiencing a sudden onset of erectile dysfunction or gradual erectile dysfunction there could be an underlying condition at play and you're definitely not alone. Luckily, there are plenty of treatments on the market that can get your rock functioning normally again.

Photo credit: Unsplash + Jeremy Thomas

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