Your Morning Wood Recovery Plan: A Urologist’s Guide to Staying Hard During Aging

You remember them fondly from when you were younger: awakening in the morning or in the middle of the night with an erection. 

As you grow older, they’re probably happening less and less. It’s like losing touch with an old friend. 

This type of erection is called morning wood in slang or nocturnal penile tumescence in scientific terms.

“Morning wood is healthy and is a sign that your sexual function is working properly,” says Dr. Paul Thompson, a urologist and surgeon for more than 30 years. “I consider it a red flag when my patients are no longer getting erections when awakening. In some cases, but not all, the absence of morning wood correlates with erectile dysfunction.” 

What Is Morning Wood?

Morning wood is when you wake up with an erect penis either in the morning or at night. The formal term for this occurrence is nocturnal penile tumescence. It happens more in young men, but older guys can experience it, too. 

Most morning erections occur during rapid eye movement (REM) sleep and disappear when you reach a deeper phase. Morning erections can also happen throughout the night. Typically men, especially when they’re younger, can have four or five erections during the night.   

During REM sleep, the system in your body responsible for erectile function is most active. Levels of testosterone, a hormone linked to sexual function, are also high during REM, especially the first REM episode after you fall asleep.(1)  

REM sleep is named for the rapid eye movement that occurs during this stage. It’s the stage of sleep where you dream. REM is a more wakeful state compared to Non-REM sleep, and it’s usually the stage you’re in just before awakening in the morning. 

Erections when you’re sleeping can be caused by:

• Sexual arousal and sexual stimulation, even from rubbing against bed sheets.

• Hormonal fluctuations in testosterone

• Levels of hormones that stop erections during waking hours fall during sleep. 

According to the Cleveland Clinic, a full bladder may also cause some erections upon awakening. A full bladder presses on the sacral nerve, which triggers erections.(2) 

“The sacral nerve is part of the parasympathetic nervous system, which regulates several bodily functions, including sexual arousal,” explains Dr. Thompson. “The parasympathetic nervous system kicks into full gear when you’re sleeping, which is why erections sometimes happen during this time.”

How Morning Wood Is Linked To a Better Sex Life

Morning erections are a way for your body to signal that all sexual systems are a go. In other words, your body is test-driving your sex drive to make sure it’s in top shape. If you’re having erections while asleep or awakening, your sex life is probably in good shape because your erectile function is healthy.  

“Spontaneous nighttime and morning erections that you experience throughout your life provide insight into your overall and penile health,” says Dr. Thompson. “Morning wood is a sign that blood is flowing smoothly in your penile tissue and that your erectile function is at peak operating capacity.” 

At What Age Does Morning Wood Stop?

How long you continue to have morning erections as you get older is different for every guy. Whether you’re able to continue having morning erections can depend on your overall sexual health. 

In one study, the frequency and duration of erections during sleep decreased progressively with age.(3) Compared to men in the younger age groups, most of the men above age 60 did not have full sleep erections.

What Does It Mean If I Don’t Have Morning Wood? 

If you’re not having erections during sleep, Dr. Thompson suggests considering a couple of options. First, it’s possible that you have them while sleeping and didn’t know it. Another option? When you wake up in the morning, if you weren’t in REM sleep just before awakening, then you likely won’t have an erection. 

Morning erections also become less frequent with age and don’t last as long. Regardless of your age, if you’re not having morning wood, it’s a good time to get a check-up at your doctor.  

“If my patients don’t awaken with an erection at least sometimes,” says Dr. Thompson, “that’s a red flag that there is sexual dysfunction happening.” 

Dr. Thompson’s Plan to Bring Back Morning Wood and Hardness

Dr. Thompson has a nearly foolproof plan for bringing back the erections you experienced in your younger years, whether they’re erections while you’re awakening or while you’re having sex. Here is his plan for staying hard as you age:

Address Underlying Health Issues

First, Dr. Thompson tackles any health concerns his patients are experiencing that may interfere with their ability to have a satisfying sex life. These include diabetes, high blood pressure, cardiovascular disease, and more. It’s always a good idea to visit your doctor and get a full physical exam to see if any health condition could be getting in the way of better sex. 

Assess Whether ED Drugs Are Necessary

The good news about ED drugs is that according to research, they improve nighttime erections in healthy men and men who had prostate removal surgery.(4)(5)

“The bad news is that ED drugs often stop working over time,” says Dr. Thompson.  “There’s research that they can stop working in one to two years, and I’ve seen it happen over and over again in my clinical practice.”

A lot of Dr. Thompson’s patients also don’t like the side effects of the medications including muscle aches, heartburn, nosebleeds, difficulty falling asleep, numb arms, hands, feet, or legs. 

The drugs also can cause more serious side effects such as chest pain, sudden loss of hearing or vision, burning during urination, and erections that last longer than four hours and are sometimes painful. 

"If you want to get those morning erections back and stay hard during aging, don't worry because there are other options besides ED medications," says Dr. Thompson.

Start Acoustic Soundwave Therapy 

According to Dr. Thompson, one of the best ways to improve erectile function is with acoustic soundwave therapy, otherwise known as low-intensity extracorporeal shockwave therapy or Li-ESWT for short. This type of therapy works with your body by sending gentle shockwaves through penile tissue. You can find this type of therapy in men’s clinics or use an at-home Li-ESWT device instead.

“The at-home version is just as effective as in-clinic therapy and it’s more affordable and convenient,” says Dr. Thompson. “Many of my patients report excellent results and even experience morning erections again for the first time in years.”

Boost Nitric Oxide

Part of the reason you have erections is due to a molecule called nitric oxide, which widens the blood vessels and allows blood flow into the penis.(6) Nitric oxide is released by nerves and cells in spongy erectile tissue running along the shaft of the penis (the corpora cavernosa).

So how do you boost nitric oxide levels? “You can take supplements like the amino acids L-arginine or L-citrulline,” says Dr. Thompson. “But often the easiest way is to eat more dark leafy vegetables and drink beet juice. Exercise also boosts nitric oxide levels.”

Using this approach together with acoustic soundwave therapy, says Dr. Thompson, is highly effective at restoring erectile function. 

Frequently Asked Questions About Restoring Morning Erections

Why do they call it morning wood?

Morning wood is a slang term for an erection that happens as you’re starting to wake up in the morning. They can also occur in the middle of the night. You don’t need to be sexually aroused or experience physical stimulation to experience them, but even something like rubbing against the bed sheets could trigger one. 

The first half of the term comes from the time of day when they often occur, and the second half of the term is because the penis is as hard as wood when it happens.

Does no morning erections mean low testosterone?

Fluctuations in testosterone levels can affect whether you have erections in your sleep. Testosterone is a hormone responsible for libido, sexual desire, and other aspects of sexual health. Research shows that higher levels of total and free serum testosterone levels are connected to nocturnal penile tumescence.(7) Likewise, low testosterone levels are linked to having fewer erections upon awakening. 

Is morning wood healthy?

Yes, waking up with an erection is healthy because it shows that you’re getting enough blood supply to the penis and that your erectile function is in good shape. If you’re not having this type of erection, it can be a sign of sexual dysfunction or even a precursor to erectile dysfunction. 

Why do I have painful erections when I'm sleeping?

Sleep-related painful erections aren’t common, but they do happen. The pain can be bad enough to interfere with sleep. Doctors may use a drug called baclofen, which suppresses pain and acts as a muscle relaxant. Most of the time, men with sleep-related painful erections don’t feel any pain when they’re having an erection during sex. 

Sources:

1. https://pubmed.ncbi.nlm.nih.gov/10591612/

2. https://health.clevelandclinic.org/men-get-morning-erections-5-answers-questions

3. https://pubmed.ncbi.nlm.nih.gov/3418036/

4. https://pubmed.ncbi.nlm.nih.gov/12065465/

5. https://pubmed.ncbi.nlm.nih.gov/25813656/

6. https://pmc.ncbi.nlm.nih.gov/articles/PMC8109295/

7. https://pubmed.ncbi.nlm.nih.gov/3964067/