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Erectile Dysfunction
June 25, 2024
5 Mins

Erections 101: How They Work, What Prevents Them, How To Deal With Erection Problems

This article explains how an erection works, how long it lasts, and what to do if it doesn't get hard or last. We also provide information on how to receive ED treatment from the comfort of your own home through online medical treatment.

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What are erections?

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Erections, sometimes called “boners”, are a physiological phenomenon that occurs when the penis becomes hard. There are two types of erection: central erection, in which the excitement of the cerebrum is transmitted to the central nervous system in the spinal cord due to sexual stimulation, and reflex erection, which is caused by physical stimulation.

In a central erection, sexual arousal causes special chemicals to be released from certain nerves, which send signals to the corpus cavernosum of the penis. This signal causes blood to flow into the corpus cavernosum of the penis, filling it and causing an erection.

How Do Erections Work/What Causes Them

The penis has two erection chambers that are made of spongy muscle tissues. The chambers extend from the penile head all the way into the pelvis. When we are sexually aroused, our brain sends a signal which causes a hormonal response, allowing the arteries that supply blood to our penis to open fully.

When these arteries are open, blood enters at a rate so fast that it does not have enough time to exit through the veins. Blood is then trapped in the chambers, which results in your penis becoming firm – and voila, an erection occurs.

Once you achieve an orgasm, the hormonal response stops, because your brain is no longer sending signals of sexual arousal. The arteries return to their normal state, the spongy muscle tissues contract, your erection comes down, and your penis is once again flaccid.

How Long Should An Erection Last?

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An erection should typically last for 10 minutes. But this can vary depending on the situation and individual differences.

Things that prevent erections

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Physical Causes

A number of physical causes can obstruct erections. These especially are ones that arise from health issues such as cardiovascular diseases, diabetes, high cholesterol and high blood pressure. Some of these include:

1. Insufficient blood flow to the penis

Health issues such as diabetes, heart disease, high blood pressure or hardened arteries reduce the blood flow into the penis which makes it difficult to get an erection.

2. Damage to the spongy muscle tissue

When a man has gone through radiation treatment or surgery near the pelvis or lower abdomen (i.e prostate, bladder or colorectal cancer), it often leads to erection problems/erectile dysfunction.

3. Your brain is not seding the correct signals to your penis or the signals are not reaching your penis: 

This can happen due to neurological diseases, injury or surgery in the pelvic area where the nerves to the penis are harmed.

4. Diabetes:  

If you have diabetes, it can cause small vessel disease or even nerve damage to the penis which affects your ability to achieve an erection.

Psychological/Mental Causes

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Psychological causes are mental issues that affect your ability to achieve an erection. As we just covered the importance of our brain in sending signals to help us get an erection, any disruption to this process can cause erectile dysfunction (ED). 

Common psychological issues include: 

How do I know if I have erection problems? 

Although penile hardness can be subjective, there are still some indicators that can help you evaluate whether your penis is hard enough for sex. This can be measured with the Erection Hardness Scale (EHS): a 4-point scale used to evaluate erectile dysfunction. Typically anything under Level 2 will need prescription medications to allow more blood to flow to the penis to have a harder, longer-lasting, erection. 

Level 1

The penis becomes larger but is not hard at all. 

Level 2

The penis is slightly hard. But still not hard enough for penetrative sex. 

Level 3

The penis is hard enough for penetration, but still not completely hard. Because of this, your erection might not last long enough and become soft midway during sex. 

Level 4

The penis is completely hard and fully rigid. This is an ideal erection.

What to do if I have erection problems?

While it is recommended to consult a doctor to address any medical issues such as erection problems. There are some things you can do on your own to help with your situation:

1. Managing Your Weight

Obesity is one of the main causes of erectile dysfunction. Keeping a healthy weight through diet, proper sleep, and exercise can help reduce obesity and improve erectile function.

2. Reducing Stress

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Chronic stress can also cause difficulty in getting an erection. Try mindfulness meditation, deep breathing exercises, and activities you enjoy to help relieve stress

3.  Exercises that help with erection problems/ED

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Kegel/Pelvic Floor Exercises

Kegel exercises mainly train your pelvic floor muscles (the ones found on your thighs, buttocks and lower abdomen). These exercises mainly help with bladder control. But also help you in maintaining erections by increasing blood flow to the penis.


Yoga can hit 2 birds with one stone as it combines physical movement, mindfulness and relaxation techniques to relieve stress. Some poses like the "Compass Pose" can open up the hip joints to allow more blood to flow to your penis.

4. Foods that can help with erection problems/ED

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Certain foods like ginseng, watermelon, oatmeal, and many more are sometimes known as “natural viagras” as they can help boost your libido and improve erectile function. However, note that current research surrounding the effectiveness of these foods and supplements are either minimal or have mixed conclusions.

Prescription Medications for Erection Problems/ED

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Prescription oral medications such as Viagra and Cialis are often prescribed as a first line of treatment for erectile dysfunction. They work by inhibiting phosphodiesterase-5 (PDE5) to degrades cGMP, a molecule that relaxes the muscle tissues in the body. By relaxing the muscles present in the blood vessel walls, this ultimately leads to an improved blood flow to your penis. 

It is important to know that these medications do not magically increase your sex drive/libido. After taking them, you will still need to be sexually aroused to get an erection. 

If you are experiencing erection problems/erectile dysfunction, it is advisable that you consult a doctor. Here at Noah, our doctors are best equipped with the knowledge to help you ascertain the root cause of your ED and can determine whether generic Viagra is right for you. They will be able to advise you on the best treatment suited for you, and can also prescribe you the right medication should you need it.

Find out what your BMI indicates

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BMI provides an estimate of weight classification. For a thorough analysis of your weight and medical options, arrange a teleconsult with a Noah doctor.

*Medical treatment may not be appropriate for you even if you have a high BMI
Your estimated weight loss in 1 year*
*In a 56-week trial with 3,731 non-diabetic overweight (BMI ≥27) or obese (BMI ≥30) participants, those who finished (1,812 patients) lost an average of 9.2% body weight with Saxenda, alongside diet and exercise.
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