I really hope to get an answer from this as I am in need of guidance. I'm a 26 year old male who at times have a very hard time getting and keep an erection. I've had this problem for some time. I am with a very beautiful and attractive girlfriend whom I love and our relationship is great. I have no problem getting aroused by her at times...however, when it comes to the actual time to "penetrate", I lose my erection very fast. I'm not sure, but it may be the fact that when I am erect and having sex that I am not able to last very long at all. I'm talking minutes. It's very depressing for me and I don't know how to solve it. As my fiance loves making love to me (when we can) I want to be able to make love to her as well without this problem. Please Help Me!

An erection is the result of blood flowing into the two cylindrical, sponge-like structures that run parallel to the urethra and along the length of the penis. Three steps need to take place in order for this to occur. First is sexual arousal. The second step is the brain's communication of the sexual arousal to the body's nervous system (which activates the blood flow). Thirdly, a relaxation of the blood vessels that supply blood to the penis must occur, allowing the erection to take place. If something affects ANY of these three steps, arousal, nervous system response or the vascular system response or the interplay between them, difficulty acquiring or maintaining an erection occurs.

Sometimes a problem like you describe is associated with a physical problem such as “venous leakage,” a condition where blood leaks from the penis. You did not mention if you are using a condom when you actually attempt penetration. Many men find it difficult to maintain an erection when using condoms due to loss of sensation.

Losing an erection can frequently be a symptom of performance anxiety. This occurs when a man feels so anxious about pleasing his partner and being a "good enough" lover that it overshadows his ability to relax. He then can trap himself in the typical anxiety cycle where his fear of not being able to rise to the occasion can actually perpetuate losing his erection. Currently the most common form of treatment involves using Viagra. Psychologically speaking, "Don't panic!" Loss of erection is reversible. Slow down and go back to foreplay. Usually returning to a previous level of arousal will occur once conditions that helped you get an erection are revisited.

It is important for you to consult with a professional. You can locate a qualified sex therapist in your area on this site or by contacting The American Association of Sex Educators, Counselors, and Therapists (AASECT). - Answer provided by Karen Brash McGreer, RN, MFT, kbmcgreer@comcast.net, www.IntentionalMarriage.com.

There are many unanswered items in your question. Is this the first time this problem has existed? Does it seem to be only with certain girls? Can you stay hard while masturbating? Sometimes erectile problems are only with certain people due to performance anxiety. I'd suggest a good physical and even though you are only 26, I'd ask for a testosterone level to be done if this is a problem even with masturbating. Smoking long term or a pelvic injury can cause constriction of the blood vessels to the penis and create a poor erection. Too much alcohol is also a big reason for poor erection. Some medications are at fault. If everything checks out, there are medications that can help such as Zoloft or Paxil for premature ejaculation or Viagra for blood dilation. - Answer provided by Dr. Shay Roop, RN, LMHC, Ed.D, Clinical Hypnotherapist, Board Certified by the American Board of Sexology, shay@drshay.org, www.drshay.org.

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