Men who want to last longer in bed and build sexual stamina might want to think about their heart health first. The heart is the boss of your boner, after-all—not just in a romantic way, but in a cold, physiological way. The blood pumping into your penis has to come from somewhere. “Anything that helps the heart can help erections,” Dr. Jamin Brahmbhatt, a urologist and professor at University of Central Florida College of Medicine, told Fatherly. “The better blood is flowing, the better the blood will flow into the penis. A better heart can also make you last longer, because your body’s overall stamina is up.”
Premature ejaculation is defined as ejaculation that always or almost occurs within one minute about of vaginal intercourse, and rises to clinical significance when this results in depression, frustration, or avoidance of intimacy. But since this definition did not exist until 2014, it is unclear how many men actually suffer from PE. Conservative estimates have come in as low as 4.7 percent—liberal estimates, relying on self-reporting, have thrown around numbers as high as 83.7 percent. Suffice to say, most men who complain about their stamina are lasting longer than one minute, and thus are not technically experiencing PE.
But reassurance than anything longer than one minute is fine doesn’t usually do the trick. So men start asking about Viagra. Which makes no sense—because Viagra may help you get an erection, but it won’t help you maintain one. “Viagra is supposed to help get you erect,” Brahmbhatt says. “Taking it to improve their stamina is not an indication for Viagra.”
So what does work? Studies suggest masturbation, diet, and exercise can all help increase sexual stamina. But those are also habits that are generally good for circulation and heart health. Taking preventative measures to reduce the risk of high blood pressure, such as limiting salt and alcohol consumption, can help too (especially since blood pressure medications tend to cause erectile dysfunction as a side effect). This makes some physiological sense. And erections is simply an hydraulic process: blood flows to the penis, and stays there until it drains away. The process is mediated by nitric oxide, a chemical messenger molecule that relaxes arteries to increase blood flow. The relationship between blood flow and erections means atherosclerosis (accumulation of plaque within blood vessels) can cause erectile dysfunction as easily as it can cause heart attacks and strokes.
But for most men, poor performance isn’t so much a matter of heart health, as much as it’s a matter of keeping expectations in check. Brahmbhatt often advises his concerned patients stop watching so much porn. The average sex-session lasts only about five to six minutes, studies show, and yet adult films feature edited encounters that can last hours. There’s evidence that stress can also affect erections and ejaculation, so Brahmbhatt suggests calming down and communicating with your partner about how you both can enjoy fooling around—regardless of what your unpredictable appendage has to say about it.
“We can’t be Superman all the time,” Brahmbhatt says. “I always tell my patients to be happy with what they are doing and not set standards based on what they see or hear. As long as you and your partner are happy, that’s all that should matter.”