Why Do Erections Disappear Too Quickly?

Erections that disappear too quickly are typically a symptom of erectile dysfunction (ED), which affects approximately 52% of men between 40-70 years of age.¹ This condition, defined as the persistent inability to attain and maintain an erection sufficient for satisfactory sexual performance, can significantly impact quality of life and intimate relationships.² The European Association of Urology (EAU) Guidelines recognize that rapid detumescence is often related to the same underlying causes as general erectile dysfunction. According to the EAU Guidelines, the primary causes of erections disappearing too quickly include vascular problems (such as atherosclerosis), neurological disorders, hormonal imbalances, medication side effects, psychological factors, and lifestyle issues.³ For many men, the problem stems from insufficient blood being trapped in the penis, allowing it to escape too quickly and causing the erection to subside prematurely. This vascular component is particularly common in men with diabetes, hypertension, or high cholesterol.⁴ The EAU Guidelines recommend a personalized treatment approach based on invasiveness, effectiveness, and patient preferences.⁵ First-line treatments typically include lifestyle modifications (weight loss, exercise, smoking cessation) and oral medications such as phosphodiesterase type 5 inhibitors (PDE5Is), which have shown significant improvement in erectile function with good safety profiles.⁶ For men who don’t respond to these treatments, second-line options include vacuum erection devices, which can achieve satisfaction rates between 27-94%, and intracavernosal injections, which have efficacy rates of 70-85%.⁷ For men with severe erectile dysfunction who don’t respond to less invasive treatments, the EAU Guidelines support penile prosthesis implantation as a highly effective solution.⁸ There are two main types of penile implants: inflatable (two- and three-piece) and semi-rigid devices. The three-piece inflatable devices provide the most natural erections, while semi-rigid implants offer simplicity of use but result in a permanently firm penis.⁹ Satisfaction rates for penile implants are exceptionally high, ranging from 92-100% for patients and 91-95% for partners, making them an excellent option for appropriate candidates.¹⁰ The EAU Guidelines emphasize that psychological factors often contribute to erections disappearing too quickly, and recommend psychosexual counseling alongside medical treatments.¹¹ This combined approach addresses both the physical and psychological aspects of the condition, leading to better outcomes. For men considering penile implants, focused psychosexual counseling has been shown to improve sexuality and sexual well-being for both patients and their partners.¹² It’s important to note that modern penile implants are highly reliable, with mechanical failure rates below 5% after 5 years of follow-up for the most commonly used three-piece prostheses.¹³ Infection rates have been reduced to 2-3% with appropriate antibiotic prophylaxis, and can be further reduced to 1-2% with antibiotic-impregnated or hydrophilic-coated prostheses.¹⁴ These advances have made penile implants a safe and effective long-term solution for men whose erections disappear too quickly due to severe erectile dysfunction that doesn’t respond to other treatments.