Does No Morning Wood Mean Erectile Dysfunction?

Not getting "morning wood"—also known as nocturnal penile tumescence (NPT) or nocturnal erections—can be a sign of erectile dysfunction. However, that's not always the case.

Learning more about what causes morning wood can help you better understand what's happening to your body.

This article explains the causes of morning erections, what the lack of one means, and when you should be concerned.

What Causes Morning Wood?

An erection—the enlarged, rigid state of the penis—can occur throughout an assigned male's life.

The cause of morning wood is not well understood, but there are two main thoughts:

• Hormone theory: Norepinephrine is the hormone that counters the effects of nitrergic hormones, which are the ones that promote erections. During deep sleep, levels of norepinephrine drop, causing nitrergic hormones to spike. This leads to an erection while you sleep that may still be present when you wake.
• Bladder theory: A full bladder at night can provoke a reflex to prevent urination. The sacral nerves responsible for an erection can be compressed by the enlarged bladder, which can cause what's referred to as a "reflex erection." This can linger into the morning, usually until you pee.

Erections tend to start as an assigned male enters puberty and increase in frequency as they get older. Morning erections, or a "morning glory" are common in adulthood.

Why ED Can Affect Morning Erections

Erectile dysfunction (ED), defined as the inability to get and keep an erection firm enough for sex, is one possible reason some assigned males don't have morning wood.

• Physiological causes for ED refers to problems with the nerves, hormones, blood vessels, and smooth muscles that enable an erection.
• Psychogenic ED is a form of ED caused by psychological issues such as relationship problems, performance anxiety, low self-esteem, or depression.

If ED is purely psychogenic, you can still get nighttime and morning erections. Tests can confirm this.

Before assuming that not having morning wood means that you have erectile dysfunction, it may help to know that some healthy assigned males have a.m. erections that they aren't even aware of.

Morning wood may be present, but begin to resolve while you are transitioning to a waking state. As such, it's possible to have a morning erection that subsides before you even realize it was there.

Could You Have Erectile Dysfunction?

If you suspect that your lack of morning wood is due to ED, you will likely be having problems with erections during sex as well. It would be odd to have one without the other.

If you are not sexually active, not having morning wood may be the first sign of ED.

There are a number of risk factors that may support your suspicions, some of which include:

• Older age
• Prostate problems
• Type 2 diabetes
• High blood pressure
• High cholesterol
  
• Use of medications, such as antidepressants and diuretics
• Alcohol or drug use
• Smoking
  

If you believe that you are experiencing ED, speak with a healthcare provider. Tests can be performed to diagnose ED, a condition that affects around 40% of assigned males over 40 and 70% of assigned males over 70. If ED is not present, you can be examined for other concerns.

Other Possible Causes

ED may be a symptom of an underlying condition.

A number of health conditions are known to manifest with ED, including:

• Alzheimer disease
• Atherosclerosis
• Chronic kidney disease
• Chronic obstructive pulmonary disease (COPD)
• Depression
• Diabetes
• Epilepsy
• Guillain-Barré syndrome
• Leukemia
• Liver cirrhosis
• Multiple sclerosis
• Peyronie's disease
• Sleep apnea
• Stroke
• Thyroid disease

You should speak with your healthcare provider if ED persists despite treatment. Additional tests may be needed to explore other possible causes of your symptoms.

Summary

Morning erections are thought to be caused by changes in hormones during sleep or by a full bladder that presses on the nerves that trigger an erection.

The lack of morning wood may mean nothing, but it could be a sign of erectile dysfunction if your case is due to physiological issues, such as nerve or blood vessel problems.

Be sure to speak with your healthcare provider if you aren't having morning erections or if you have problems achieving or maintaining an erection. You may also ask for a referral to a urologist, a doctor who specializes in the urinary tract and assigned male fertility.

This is especially important if you are young and don't have any of the common risk factors of ED, or if you have any unusual symptoms. ED may end up being a sign of a more serious condition, like prostate cancer, that requires immediate attention.