Detailed Answer
The average duration of an erection varies significantly among men, with physiological and psychological factors playing key roles in determining how long an erection can be maintained.¹ According to the 2025 EAU Guidelines on Sexual and Reproductive Health, normal erectile function involves a complex interplay of vascular, neurological, hormonal, and psychological systems that work together to maintain penile rigidity sufficient for sexual intercourse.² The guidelines indicate that erection duration is highly individualized, with most men experiencing erections lasting between 5-30 minutes during sexual activity, though this can vary based on age, health status, and other factors.³
Erectile dysfunction (ED), defined as the persistent inability to attain and maintain an erection sufficient for satisfactory sexual performance, directly impacts erection duration.⁴ The EAU Guidelines emphasize that ED affects approximately 52% of men between 40-70 years of age, with its prevalence increasing with advancing age.⁵ This age-related decline in erectile function often manifests as decreased rigidity and shorter duration of erections, which is attributed to vascular changes, hormonal shifts, and neurological alterations that occur with aging.⁶
Various medical conditions can significantly impact erection duration. The guidelines highlight that cardiovascular diseases, diabetes mellitus, hypogonadism, and neurological disorders are strongly associated with compromised erectile function and reduced erection duration.⁷ Additionally, psychological factors such as performance anxiety, stress, and depression can trigger sympathetic nervous system activation, leading to premature detumescence and shortened erection duration.⁸ The guidelines recommend comprehensive assessment of these factors when evaluating patients with concerns about erection duration.
Treatment options for optimizing erection duration include oral phosphodiesterase type 5 inhibitors (PDE5Is), which the guidelines recommend as first-line therapy for ED.⁹ These medications enhance erectile function by prolonging the effects of nitric oxide, thereby extending the duration of penile tumescence. According to clinical trials cited in the guidelines, PDE5Is can significantly increase the duration of erections, with efficacy rates of 60-85% reported across various patient populations.¹⁰ Optimal effectiveness of these medications is achieved when administered within specific timeframes, which vary depending on the PDE5I used.
For men who do not respond to pharmacological therapies, the guidelines discuss penile implants as an effective solution.¹¹ Modern inflatable penile prostheses allow men to achieve erections on demand that can be maintained for extended periods, effectively addressing concerns about erection duration.¹² The three-piece inflatable penile prosthesis, in particular, provides the most natural erection with excellent rigidity that can be maintained as long as desired, with reported satisfaction rates of 92-100% among patients and 91-95% among partners.¹³
The guidelines emphasize the importance of realistic expectations regarding erection duration. Normal physiological erections are not designed to last indefinitely, and prolonged erections exceeding four hours (priapism) are considered a urological emergency requiring immediate medical attention.¹⁴ Patient education about normal variations in erection duration is recommended to alleviate unnecessary anxiety about sexual performance.¹⁵
Lifestyle modifications can also positively influence erection duration. The guidelines recommend regular physical activity, maintaining healthy body weight, limiting alcohol consumption, avoiding tobacco use, and managing stress as effective strategies for optimizing erectile function and potentially extending erection duration.¹⁶ These recommendations are based on evidence showing that vascular health is fundamental to erectile function, and interventions that improve cardiovascular health generally benefit erectile performance and duration.¹⁷
From the Guidelines
"Normal erectile function involves a complex interplay of vascular, neurological, hormonal, and psychological systems that work together to maintain penile rigidity sufficient for sexual intercourse." (p. 47)