Can’t Get or Stay Hard? Here’s How to Know If It’s ED

Most men will experience changes in their erections at some point in their lives. Stressful weeks, poor sleep, alcohol, or anxiety can all affect sexual performance from time to time. But when erection issues start happening more often—or begin to cause worry—it’s natural to wonder whether it’s something more serious.

Erectile dysfunction (ED) is common, treatable, and far less dramatic than many people fear. Still, knowing where the line falls between normal fluctuations and true ED can be confusing.

This guide breaks down how to know if you have ED, the early signs to watch for, common causes of inconsistent erections, and when it makes sense to talk to a healthcare provider.

Note: Occasional erection problems are normal. ED is diagnosed based on patterns over time, not a single experience.

What Is Erectile Dysfunction (ED)?

Erectile dysfunction (ED) is defined as the ongoing inability to get or maintain an erection firm enough for satisfying sexual activity.

Most medical guidelines consider ED present when erection difficulties occur frequently and persist for three months or longer.

This distinction helps separate ED from temporary issues related to stress, fatigue, or situational factors.

How to Tell the Difference Between Normal Changes and ED

Not every erection issue means ED. Understanding patterns over time is key.

Normal erection changes often include:

• Occasional difficulty after drinking alcohol.
• Temporary issues during periods of high stress or anxiety.
• Erections that vary with mood, energy, or sleep.
• Short-term changes that resolve on their own.

Signs that may point toward ED include:

• Difficulty getting or maintaining an erection most of the time.
• Erections that are consistently weaker than before.
• Loss of morning or spontaneous erections.
• Avoiding sex due to fear of performance issues.
• Problems that persist for several months.

Note: If erection difficulties feel predictable or frequent rather than occasional, it’s more likely to be ED rather than a passing issue.

Early Signs of Erectile Dysfunction

ED often develops gradually. Many men notice subtle changes long before erections stop completely.

• Erections that don’t last as long.
• Needing more stimulation to maintain an erection.
• Erections that feel less firm.
• Increased difficulty with penetration.
• Inconsistent performance that causes anxiety.

Because these changes happen slowly, they’re easy to dismiss at first. Addressing them early often makes treatment simpler and more effective.

Why Are My Erections Inconsistent?

Inconsistent erections are very common and usually have more than one contributing factor.

Physical Causes

• Reduced blood flow from high blood pressure or high cholesterol.
• Diabetes-related nerve or blood vessel changes.
• Hormonal changes, including low testosterone.
• Medication side effects.
• Sleep apnea or chronic fatigue.

Psychological Causes

• Stress or burnout.
• Performance anxiety.
• Depression or low mood.
• Relationship tension.
• Fear of losing erections.

Many men experience a combination of physical and psychological factors, where one reinforces the other.

When to Talk to a Doctor About ED

You don’t need to wait until erections stop completely to seek help. Consider speaking with a healthcare provider if you are:

• Experiencing erection issues for more than a few months.
• Noticing impacts on confidence or relationships.
• Seeing erections become weaker or less reliable.
• Living with conditions like diabetes or heart disease.
• Curious about treatment options.

ED can sometimes be an early sign of underlying health issues, particularly cardiovascular concerns.

A Final Word on Knowing the Signs of ED

Wondering whether you have ED doesn’t mean something is wrong—it means you’re paying attention to your health.

If erection changes are consistent, affecting your quality of life, or causing worry, a conversation with a healthcare provider can offer clarity and support.

Take the ED Assessment Online