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Erectile dysfunction is the most common sexual problem affecting many men regardless of age.

When erection problems happen, it can be devastating for a man, it creates a great sense of shame and inadequacy. Sometimes, a single event of erection problem can kick start performance anxiety that is hard to shift. For other men, erection problems are the results of negative beliefs about sex, usually learnt in childhood. And for others, the cause is medical.

Luckily, there are many things you can do to resolve erection problems.

First, it is important to see your GP and have an investigation to rule out medical causes. Erection problems can be an indicator of:
– Undiagnosed heart problems.
– Diabetes.
– Low testosterone levels.

If the problem is not medical, we can assume it is psychological. Don’t worry. It is very common. Here are my 10 tips to get better erections:

1. Address anxiety: The more you focus on your penis, the more you will have erection problems. The less you think about it, the easier it gets. Learn to recognise your anxiety thoughts. They sound like: ‘what if I don’t get an erection?’, ‘It will happen again’, ‘I must get hard this time’, ‘why is this happening to me?’. Once you catch those thoughts, you can challenge them: ‘It is normal to lose erections once in a while’, ‘It happens to everybody’, ‘I am still a good lover even without an erection’, ‘I can take my time’, ‘There is more to sex than just an erection’, ‘My body is fine, there is nothing wrong with me’. Try to notice when these anxiety thoughts come: sometimes they can come hours or days before you’re going to have sex. Other times, they come just before you’re about to have sex or during sex. The more you challenge the anxiety thoughts with reality-based thoughts, the more likely you are to get an erection.

2. Ditch performance anxiety: Sex is not a performance, it is a pleasurable experience between people. It can be pleasurable without an erection. If you forget about the pressure to get hard, it will be easier to get hard.

Related: What is good sex? Here are six sexual health principles to follow

3. Kegel exercises: Having more control over your pelvic floor muscles is helpful. To know the muscles that you need to work out is simple: they are the muscles you use when you pause urinating mid-flow. Once you have identified those muscles, you can contract them (without using your abdominal muscles or your buttocks) for five seconds and then gently rest them again for five seconds and start again, for about 30 times. You can do it once in the morning and once in the evening.

4. Waxing and waning: This is a great exercise for erections. Gently touch your penis with your hand until you get an erection, once you have one, stop touching yourself and let your erection go down. Then start again, do it three to four times in one session, once a day. This will train your mind and body that if you lose an erection, you can get it back.

5. Mindfulness: It is the best practice for reducing stress and anxiety but it is difficult. You can start with an app to help you (there are many you can choose from), or you can go to a mindfulness class. If you’re using an app, you can start with small steps: do it for 10 minutes, and if you like it, you can increase the duration. A daily mindfulness practice is really helpful. You can also do yoga: it is a good mind-body work out that combines mindfulness and a form of Kegel exercises.

6. Body issues: One block that can make erection harder is what you think about your body. Be kind to it and learn to love your body as it is. Sex will become easier.

7. Lifestyle: You are more likely to get good erections if you don’t drink heavily, haven’t got a hangover or haven’t over-eaten (a bloated feeling is not a ‘sexy’ feeling and erections will be harder to get).

8. If you lose your erection, or find it difficult to get one, don’t panic: Instead tell yourself that it’s an opportunity to enjoy sex in other ways, you can use your creativity. No erection doesn’t have to mean no sex: use other parts of your body to feel pleasure and to give pleasure. Your partner will usually be OK with it because erection difficulties are common and most men can relate to it.

9. You can try Viagra or Cialis to help with getting some confidence back: You can now get Viagra without a prescription, but it is important to consult your GP before taking such medications, especially if you have a heart problem or other medical conditions.

10. Reading: The New Male Sexuality by B. Zilbergeld is not gay men specific but it is a good book about the updated sex education for men. Erection problems can arise from a lack of appropriate sex education. Many gay men have erection problems because they unconsciously (or consciously) think gay sex is dirty or shameful, especially if growing up in a homophobic environment. You can read books on being gay like: The Velvet Rage by Alan Downs or Straight Jacket by Matthew Todd.

Having a good, relaxed, fulfilling sex life is important. Enjoy!

Silva Neves is a psychotherapist, psychosexual relationship psychotherapist and clinical traumatologist. You can visit his official website here, and follow him on Twitter here.

Related: Struggling with your partner’s different sex drive? There are 7 ways you can make changes