What causes erection but not firmness?

Insufficient erections may be caused by psychological stress, abnormal hormone levels, vascular dysfunction, chronic diseases, or drug side effects.

1. Psychological pressure:

Long-term anxiety, depression or partner tension can inhibit the conduction of sexual excitement, leading to insufficient congestion of the corpus cavernosum of the penis. This kind of situation can be alleviated through psychological counseling, partner communication, and cognitive behavioral therapy if necessary. Accompanying symptoms include decreased libido and a tendency to premature ejaculation.

2. Abnormal hormone levels:

Insufficient testosterone secretion directly affects erection hardness, and is common in middle-aged and elderly men or those with pituitary dysfunction. Laboratory examination can reveal that free testosterone is lower than 8.5nmol/L, which may be accompanied by loss of body hair and muscle atrophy. It needs to be improved by hormone replacement therapy.

3. Vascular dysfunction:

Atherosclerosis or venous leakage can cause abnormal blood flow to the penis, and about 60% of organic erectile dysfunction is related to this. Typically manifested by decreased nocturnal erections, which can be confirmed by vascular ultrasound. Treatment requires controlling blood pressure and blood lipids, and severe cases require vascular reconstruction surgery.

4. Chronic diseases:

Metabolic diseases such as diabetes and hypertension can damage vascular endothelial function. Diabetic patients with a duration of more than 5 years have a three-fold increased risk of erectile dysfunction. Fasting blood glucose and glycated hemoglobin need to be strictly monitored, and drugs to improve microcirculation need to be used.

3. Drug side effects:

More than 200 kinds of drugs, including antidepressants and antihypertensive drugs, may interfere with erectile function, among which selective serotonin reuptake inhibitors are the most significant. It is recommended to record the medication history and consult with the attending doctor to adjust the plan to avoid stopping the medication on your own.

It is recommended to maintain aerobic exercise such as brisk walking or swimming three times a week to promote the repair of vascular endothelial function.； Increase the intake of arginine-rich foods such as deep-sea fish and nuts ； Avoid staying up late every day and make sure to fall asleep before 23:00. Regularly conduct self-assessments on the International Erectile Function Index. If the score continues to be lower than 21 points, you should see an andrologist as soon as possible. Nocturnal erection monitoring is an important means of distinguishing psychological and organic erections, and can be initially tested at home using the stamp method.