How stop an erection?

Stopping an erection involves understanding the physiological mechanisms that maintain penile rigidity. Erections are maintained by increased blood flow into the penis combined with restricted outflow.¹ Several approaches can help terminate an unwanted erection, ranging from non-invasive techniques to medical interventions, depending on the situation’s urgency and recurrence pattern.

For occasional unwanted erections, some men try simple physical measures such as gentle physical activity, position changes, or applying cold compresses to the genital area. These approaches are not endorsed by the EAU Guidelines, which note that measures such as exercise, ice packs and cold baths have limited evidence of benefit and may even make priapism worse in men with sickle cell disease.²

An erection that lasts more than four hours (priapism) is a medical emergency that needs urgent treatment in a hospital, not self-treatment with devices. Vacuum erection devices (VEDs) with constriction rings are discussed in the guidelines as a non-invasive, drug-free treatment for erectile dysfunction.³ VEDs create an erection by drawing blood into the penis, and the constriction ring maintains the erection by limiting blood outflow. Removing the constriction ring allows blood to flow out of the penis, helping to end an erection created with a VED.⁴

In clinical settings, draining blood from the penis (aspiration) combined with intracavernous injections of sympathomimetic agents such as phenylephrine is the standard treatment for ischemic priapism (a medical emergency involving a persistent, painful erection).⁵ While this approach is primarily used in emergency situations, the guidelines note that some men with recurrent (stuttering) priapism may temporarily need to self-inject similar medications at home, as prescribed by their doctor. These medications work by tightening the muscle and blood vessels inside the penis, which lets blood drain out and ends the erection.⁶

For men with erectile dysfunction, the guidelines discuss several treatment options. Phosphodiesterase type 5 inhibitors (PDE5Is) are the first-line treatment for erectile dysfunction, but they require sexual stimulation to work and their effects diminish naturally after sexual activity concludes.⁷ For men who need more control over their erectile function, penile implants may be considered. Inflatable penile prostheses allow men to achieve an erection when desired and return to a flaccid state when no longer needed, giving them control over when an erection occurs.⁸

The guidelines emphasize that persistent or recurrent unwanted erections may indicate underlying medical conditions requiring evaluation. Priapism, a persistent erection lasting more than four hours, is considered a urological emergency requiring immediate medical attention. The guidelines recommend that men experiencing this condition seek emergency care, as delayed treatment can lead to permanent erectile dysfunction.⁹

For men with recurring concerns about controlling erections, consultation with a urologist is recommended to discuss individualized treatment approaches based on their specific situation and medical history.

It’s important to note that psychological factors can also influence erectile function. The guidelines acknowledge the role of psychological interventions in managing various aspects of sexual health, including erectile concerns. For some men, psychological techniques such as mindfulness or cognitive behavioral approaches may help with managing unwanted erections in certain social situations.¹⁰