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A healthy sex life can increase your confidence, reduce stress, and help you sleep better at night. But problems with stamina, premature ejaculation, or other sexual performance issues can be frustrating and embarrassing.

If you’re experiencing any changes to your sexual performance or are unable to maintain an erection during an entire sexual encounter, you may be asking yourself — how can I last longer in bed?

The truth is diagnosing the cause of these changes can be challenging sometimes. These issues may resolve naturally over time, or they could possibly indicate a larger, underlying medical issue.

There are several treatment options that you can try out on your own, or you can consider reaching out to your doctor to discuss your options, too.

You might not be lasting as long in bed as you would like for many reasons. Experts believe there can be emotional and physical reasons.

You may be experiencing premature ejaculation (PE), which causes ejaculation to happen sooner than you or your partner would like, or you may be experiencing erectile dysfunction (ED), which causes difficulty becoming erect or keeping an erection long enough to have penetrative sex.

PE and ED are two separate conditions, and to address the “how to last longer in bed” question, it’s important to establish which of the two (or possibly both concurrently) conditions you have. For example, someone may not have any trouble becoming erect but find that they are reaching climax much faster than usual — indicating PE and not ED.

If someone is having difficulties becoming erect, it could be difficult to tell if PE is also a concern until they are able to stay erect throughout sex. In this case, that person would want to meet with their doctor or a healthcare professional to explore and prioritize ED treatments first since ED and PE treatments are often very different. In this case, PE may no longer be a problem once ED is treated.

The duration of sex varies and can be difficult to define when you include elements like foreplay, how long it may take both partners to reach completion, and other activities that can extend the length of a sexual encounter.

Scientifically speaking, research shows that, on average, it takes a person with a penis about 5 to 7 minutes to become erect and ejaculate, but this window of time will vary. For people experiencing PE, this amount of time can be much shorter.

One 2005 survey showed the median time for some 500 couples, conducted over a 4-week period, was approximately 5.4 minutes for vaginal sex. This average is based strictly on the start and end of vaginal sex and doesn’t include any time spent during foreplay. The overall range was from approximately 30 seconds to 44 minutes.

It’s also worth noting that the couples in this study were all heterosexual and had been involved in stable relationships for at least 6 months.

However, these estimations are based on an average range and don’t necessarily account for the time needed for a partner to also reach climax. In these instances, sex may last longer.

Stress, anxiety, and depression can all contribute to ED. Many underlying health conditions like sleep apnea, diabetes, and heart disease, as well as attention deficit hyperactivity disorder (ADHD) and other mental health conditions, can also play roles. You may not even know you have one of these conditions.

Age may also be a factor. The likelihood of ED increases with age, but experts are now seeing it more in younger people. ED in young people is often ignored or overlooked but it can be an indicator of future cardiovascular conditions.

Prescription medication can help improve erection quality and sexual performance by increasing blood flow to the penis. Prescription ED medications include:

As with all prescription medications, they come with some risks. ED medications can lead to numerous side effects. For a quick rundown on what you might experience, check out this article.

Generally speaking, ED medications are associated with flushing, headaches, visual changes, upset stomach, and nasal congestion. In some cases, side effects can be dangerous for people taking nitrate drugs or blood thinners or those with heart problems and diabetes.

Natural solutions may not present the same risks or drug interactions, and some may actually improve overall health.

1. Quit smoking

Smoking could be to blame for sexual dysfunction, among other conditions. Smoking can impair circulation, increase your risk of ED, and decrease your sperm count and viability.

2. Exercise

Managing your weight and getting regular exercise can improve your sexual performance. By fine-tuning your cardiovascular health, you could also build bedroom endurance.

3. Therapy

Though you may assume that ED is a result of your biology or physical health, there is a frequent connection seen between ED and mental health. In many cases, ED can stem from depression, anxiety, and other mental health conditions — all of which can benefit from therapy and meeting with a mental health professional.

However, it can be a case of “chicken or the egg” when trying to determine the cause. According to a 2018 meta-analysis on the subject, some people experiencing depression were more at risk for ED, while others currently with ED were at a higher risk of depression.

In a 2017 study that focused on people assigned male at birth, 28 participants under 40 with ED symptoms showed a significant improvement after they underwent cognitive behavioral therapy.

4. Acupuncture

Acupuncture is a treatment method of traditional Chinese medicine (TCM) that’s been practiced for over 2,500 years. The practice of inserting small needles into certain points across the body stimulates the nervous system and affects natural opioids and hormones.

Research into the use of acupuncture to treat ED is limited. Only small studies are currently available, but some results seem promising.

In fact, a 2019 review analyzed many of the clinical trials exploring acupuncture as an ED treatment and found the results to be very positive. However, the review also notes the limited number of studies available and relatively low sample sizes from those studies, which could influence the overall results.

Despite its limited evidence as an ED treatment, there are still other benefits that are believed to come from acupuncture, like stress and chronic pain reduction, that can better your overall wellness and may be worth considering.

5. Talk with your doctor about underlying health conditions

As mentioned, ED can be a symptom of several serious health conditions, like sleep apnea, diabetes, and cardiovascular problems. Make an appointment with your doctor for a physical to determine if ED is a sign of something more serious.

Dehydroepiandrosterone (DHEA)

DHEA helps create sex hormones, including testosterone and estrogen. Natural DHEA levels decrease as a person gets older. While some studies suggest that DHEA supplements could help ED, others have found no evidence to support this claim.

Side effects of DHEA can include:

  • fatigue
  • headaches
  • acne
  • irregular heartbeat

Yohimbine

Yohimbine is the main component of bark from Pausinystalia yohimbe trees, and it’s thought to be an aphrodisiac.

The National Center for Complementary and Integrative Health reports that there’s not enough evidence to show that yohimbine from tree bark can treat ED.

Plus, studies have linked yohimbine with severe side effects, including heart attacks and seizures. Other side effects include stomach problems, anxiety, and high blood pressure.

Yohimbine hydrochloride, a different form of yohimbine, is available as a prescription drug for ED. This is a different product than dietary supplements made from tree bark.

Horny goat weed

Epimedium grandiflorum, also known as horny goat weed, is a traditional remedy for increasing fertility. But there’s not enough evidence to support its use.

This supplement is often well-tolerated. Side effects can include nausea, vomiting, irregular heartbeat, and dry mouth.

If you start noticing regular symptoms of ED or a loss of libido, make an appointment with your doctor.

Talk with a urologist about PE if you almost always ejaculate within 1 minute of beginning intercourse or if you’re almost always unable to delay ejaculation when you want to.

As mentioned above, ED can be caused by underlying health conditions that may need to be treated before you get back to your usual sex life.

Why can’t I last longer in bed?

If you are finding that you are unable to become erect or lose your erection too early, the most likely cause is ED.

However, pinpointing what is causing your ED symptoms isn’t always easy. Anyone with a penis can experience difficulties maintaining an erection from time to time, especially during periods of heightened stress, depression, or sudden or significant changes to your lifestyle or diet.

If you’re experiencing ED symptoms several times a week over a month or two, it’s likely your symptoms aren’t just temporary, and it would be time to talk with a doctor.

ED can occur from a buildup of the phosphodiesterase type 5 (PDE5) enzyme that can impact blood flow and ultimately interfere with blood flow to the penis. If your doctor believes this is the cause of your symptoms, medications like Viagra or sildenafil — also known as PDE5 inhibitors — can work to block PDE5 from distributing blood flow.

Are there pills that can help me stay hard longer?

There are several Food and Drug Administration-approved pills that treat ED. These include sildenafil (Viagra), avanafil (Stendra), tadalafil (Cialis), and vardenafil (Levitra). These medications are used to counter the symptoms of ED and assist in restoring blood flow to the penis.

If you’re not experiencing ED symptoms, these medications may not be as effective and even in some cases can cause serious health conditions, like priapism, when misused.

There are also supplements that advertise improved stamina, stiffer erections, and increased sex drive, but scientific data on their efficacy is often mixed or missing entirely.

Many people will experience concerns in the bedroom at some point in their lives, but the condition is highly treatable.

The first step is to contact a doctor to help you troubleshoot the root cause. There are medications approved by the Food and Drug Administration to treat erectile dysfunction. There are also many herbal supplements to help you last longer in bed, but certain lifestyle measures can often yield positive results.