4 Types of Erectile Dysfunction and How to Address Them

Cosmopolitan

09-06-2025

A common misconception against penis-owning people is that their erections should always happen on-command, in the right way, every single time, for a long time. And while that can certainly be a goal for many people, that's just not how it works for most penis owners. Several factors can get in the way. Los Angeles sex therapist Dr. Nazanin Moali, host of the Sexology podcast, says erection issues are a lot more common than people think, affecting nearly a third of people with penises.
Another important truth? Erectile dysfunction does not, in any way, dictate whether someone's "good in bed" or how good of a partner someone is. Sex is about so much more than getting hard. Ultimately, it's about pleasure and connection, and there are several ways to achieve that that don't involve penetration.
Nevertheless, we know erectile dysfunction can be frustrating. But the good news is, there are solutions—you just have to know how to spot the signs that there's an issue to begin with, and approach it gently, but proactively. 'Open and compassionate communication is key—[you or] your partner may be feeling embarrassed or frustrated, and [a partner's] support can make a big difference,' says Moali.
One good place to start is to refer to ED or other penis problems as "erectile difficulties" instead of "dysfunctions" of various varieties, suggests certified sex coach Lucy Rowett. Being told that your penis is 'dysfunctional' can add to the emotional distress the penis-haver is likely feeling about it already. ED is common, and it does not mean there's anything wrong with you or your partner. When we use more empathetic language, it makes broaching the topic and dealing with it a lot less overwhelming.
With the help of experienced sexperts and specialists, here are four of the most common erectile issues people with penises experience, and what both partners can do to help. With a little patience, kindness, and creativity, you can have great sex and find a solution that works for all partners involved.
This is one of the most obvious signs you're dealing with erectile dysfunction—not being able get or maintain penile hardness. According to a 2024 study published in The Journal of Sexual Medicine (that analyzed data from the 2021 National Survey of Sexual Wellbeing), 17.9 percent of people with penises aged 18-24, 13.3 percent aged 25-34, and 12.7 percent aged 35-44 met criteria for erectile dysfunction.
According to Rowett, some people can get an erection just fine when masturbating, but not during partnered sex. Others can't get an erection at all—either solo or partnered. Many factors can contribute: performance anxiety, stress, depression, or side effects from prescription meds, for example, says Dr. Aaron Spitz. Other lifestyle factors like smoking and excess drinking can also contribute to ED, adds Harry Fisch, MD, author of Size Matters. If your ED is persistent and lasts over six months, consider seeing a doctor to rule out any lifestyle or medical issues.
If your ED is less centered on side effects from medications or other life factors, it might be caused by a more emotional or psychological reason. 'If it's more emotionally based (and remember, it can absolutely be a combination of things), there are lots of things you can do to explore what the cause could be,' says Rowett. 'This is the time to consult a sex therapist, sex coach, or even a sexological bodyworker who can help you learn specific exercises to get your erections back.'
It's possible for a penis-owner to climax but not ejaculate at all. 'Not many people know that orgasm and ejaculation are two separate functions, even if an ejaculation is usually triggered by an orgasm,' Rowett says.
Usually, not experiencing ejaculation can be traced to medical factors like diabetes, pelvic-surgery complications, and blockages, says Dr. Spitz. Rowett also points to possible nerve damage in the penis or pelvic region. If this might be the case for you and/or your partner, consider visiting an MD to determine the cause and potential solution.
Another less-common reason is the #NoFap movement—when a penis-owner practices semen retention based on the (completely un-scientific) idea that masturbation isn't good for you, and that not doing it is somehow more masculine and superior. This can (unsurprisingly) cause issues. 'Some [penis owners] can take it so far that they struggle to get ejaculations,' Rowett says. 'While I believe that learning to get better control over your ejaculations and expanding your orgasmic potential is always a good thing for [penis-owners], be very careful around any dogmatic teachings.' And remember: Masturbation is good for you, it's healthy, and it's normal.
'What many people refer to as 'finishing too fast' is often a form of premature ejaculation—when someone reaches orgasm earlier than they'd like to,' Moali explains. 'This can be frustrating and anxiety-provoking, making some [penis-owners] feel disconnected from their bodies or like they've lost control.'
One solution? Gaining better control over the pelvic floor. Practicing kegels (contracting your pelvic-floor muscles as if you're stopping the flow of urine) can help. Kegels are only effective when they're done properly, so don't be afraid to seek help from a pelvic floor therapist if needed.
Another potential solution: Tune into yourself. While the age-old advice has often been to 'just think of anything else' in order to last longer in bed, the opposite is actually true. 'The better approach is actually [to] stay present. Tune into your body and mind, slow things down, and focus on sensation—not distraction,' Moali says.
Also, consider reframing the societal expectation that 'longer' intercourse = better sex! 'Many partners don't necessarily need extended intercourse to enjoy themselves," Moali says. 'Sometimes, the goal of 'lasting longer' gets overhyped, when what really matters is mutual pleasure, communication, and feeling emotionally connected.'
Pleasure is the measure, not how long a peen can stay hard. Keep this in mind to set yourself up for much more satisfying sexual experiences.
A few factors could be at play if you're able to climax alone but not with someone else. Rowett points to stress, relationship issues, medication side effects, or past trauma. It could also be psychological. 'Maybe you have performance anxiety, or maybe you're not feeling it with your partner but [are] pressuring yourself into having sex anyway,' she says. It's common and complicated, but there are a few things that might help.
If you only ever masturbate to porn, cut down for a bit to re-acclimate your body with fantasy and/or partnered experiences. You might even want to take a break from porn entirely just to see how your mind and body respond. This doesn't mean cutting out porn completely, it just means stepping back with the goal of learning more about yourself and your body. You can also change up the kind of porn that you watch. Try different kinds of scenes—specifically from ethically made production studios that focus on more realistic depictions of sex.
Also, use lube! Getting yourself off without lubrication can lead to a phenomenon called 'death grip,' where your penis becomes so used to this kind of stimulation that anything else (like a vagina or mouth) doesn't provide enough stimulation to get you to climax. Don't worry, this isn't permanent. With a little patience and practice, you can get right back on track.
When it comes to all erection issues, patience and open communication are key to finding solutions. If you're the one experiencing it, be gentle with yourself, lean on your partner's support, and see a doctor if it persists. If your partner is experiencing ED, leading with kindness can make a world of a difference. 'It's important to reassure your partner that you love them and can be intimate with them in other ways, and to refrain from using critical language,' Rowett tells us. 'Do your best to build [your partner up] and keep affirming to them that you still find them attractive and sexy.'
There are so many other expansive and inventive ways to experience pleasure. Take the pressure off the penis, get creative, and be open to new adventures.