The hard truth for anyone wondering is that even the most confident guys can (and often do) feel embarrassed when they can’t get aroused.

It’s awkward, it’s a disappointment for everyone involved and — if it becomes a pattern — it can also be a sign that there may be some health issues to address.

How any intimate issues affect your relationship is really up to you and your partner. ED can either be a rock in the path that you can get around, or a snowball at the top of a hill that only gets bigger. How you and your partner handle it will play a large part in determining the size of the obstacle ahead.

We think this is all part of the reason why it’s worth examining  why men feel embarrassed when they can’t get hard, who’s to blame when it comes to ED, why it happens in the first place and — critically — how to deal with it.

To start, let’s look into the psychology of a guy when he’s experiencing ED.

Are Guys Embarrassed When They Can’t Get It Up?

While every man is different, it’s safe to say that ED is a big deal to even the most zen of men. If a man can’t get or stay hard, he’ll experience a range of emotions: worry, shame, embarrassment and, perhaps, a sense of failure. Men are expected to perform every time.

As women, men and nonbinary folks eventually learn, this isn’t always the case; it’s perfectly normal for men not to have a 100 percent success rate. Still, this knowledge doesn’t necessarily stop a guy’s instinct to feel like a failure when he can’t get it up. And if this happens a handful of times, there’s a chance his stress around his inability to perform becomes a self-fulfilling prophecy.

No man likes to consider the possibility that he may not be able to perform in an intimate situation. After all, your manhood, so to speak, is a significant part of your identity, and, sometimes, failing to get a hard on can make some men question their self worth. But clinical terminology and treatments often negate the equally important mental health side of things.

And that’s why the most important thing for everyone involved to understand is that it’s not his fault, your fault or anyone else’s fault.

Why Can’t He Get Hard: Causes

So, what’s happening when a man is struggling to get hard?

ED is a condition in which the proper arousal function of a man’s privates is interrupted, prevented or fizzles out because of insufficient blood flow.  It can be caused by any number of things, from poor exercise and dietary habits to certain diseases and health conditions. Even a man’s mental health can cause ED.

There are a number of reasons one might lose arousal, including:

• Heart disease and other health conditions that affect blood flow

• Hormone imbalances such as low testosterone levels

• Medications and recreational drugs with unintended side effects on bedroom health

• Weight and obesity problems

• A lack of sleep or exercise

• Poor diet

• Bedroom performance anxiety

• Depression and other psychological causes of ED

Painting a portrait of the ED experience isn’t difficult, but painting a portrait of the person who has ED is a lot harder than you might expect. Many men experience ED — at many different ages and stages of life. A journal study suggests that one out of every four new patients with ED is under the age of 40. So young men, while known for their high libido, aren’t exempt from this condition.

Many men are likely to experience arousal issues at some time in their life, and those who repeatedly find themselves flaccid can end up with self-esteem issues, performance anxiety and other long-term effects on their mental health. And guess what? Science says these can exacerbate or cause ED in and of themselves. It’s all a bit unfair.

While these are the long-term factors for ED — there are also day-to-day triggers.

Causes of Short-Term ED

Even if your partner has never experienced ED in your presence (or anyone else’s) before, there are several ways ED can be triggered by something as simple as a particularly bad day.

Common examples of short-term ED triggers include:

• Stress. Stress can keep him from focusing on the situation at hand. Plus, if he’s had arousal issues in the past, performance anxiety in future encounters can be a source of stress in and of itself.

• Alcohol. While having a drink or two may relax him and lower his inhibitions, drinking too much might prevent him from performing in the bedroom. He may also find that alcohol contributes more significantly to arousal issues as he gets older.

• Fatigue. Sometimes his body is simply too tired for intercourse. Fatigue can not only decrease his ability to perform, but it may also lower his desire for intercourse – this is particularly true if you two typically go at it at night.

• Drugs. Many over-the-counter medications like cold medicine, pain relievers and sleep aids can contribute to short-term ED, as can some prescription drugs for blood pressure, depression or anxiety. Read the fine print on the packaging to see whether a drug he’s taking could be contributing to ED. By the way, this also includes tobacco, which has been linked to ED in many studies.

• Inexperience. Sometimes an inability to perform is simply a matter of experience. If he’s still learning about what you do and don’t enjoy in an intimate setting, it can deflate his arousal. Like anything in life, great intercourse takes time and practice.

How to Support Him When He’s Asking “Why Can’t I Get It Up”

While many men can become defensive when something upsetting happens, others like to pretend it never happened at all. Neither of these strategies are great coping mechanisms, whether we’re talking ED or something else.

If your partner internalizes his feelings and acts like the problem never occurred, communication is the first and most important step in the process.

If he’s struggling to stay hard often, it’s important that he speaks to his healthcare provider to get diagnosed and figure out the right treatment options, which may include:

• ED medication pills (like Viagra)

• Psychological counseling

• Dietary and lifestyle changes

• Addressing other health issues, like heart disease

Before, during and after that, however, there are a number of things you both can do to avoid embarrassment, deal with the problem and build trust:

• Try not to panic. ED is a treatable condition, and it may even be short-lived. Panic can lead to anxiety, which may make things temporarily worse.

• Have a conversation about it. Talk to your partner about what’s going on, normalize it and remember not to place or suggest blame. Support will help him get treated faster; blame or shame could do the opposite.

• Don’t internalize any negative feelings. Nobody is to blame here: You are not unattractive and he is not rejecting you. In short, ED has nothing to do with your partner’s opinions of you. The sooner you realize this, the sooner you can return to being an ally and begin dealing with ED in your relationship.

• Be patient. Medication may take time to work. Therapy may take time to work. Getting the courage to go talk about the problem with a healthcare provider may take him time. While you very well may be back to great intercourse the next morning, it might not be so simple, so remember to be kind.

Am I Why He Can’t Get Hard?

We’ve mentioned it before, but it’s worth emphasizing again: The truth is that ED is no one’s fault.

ED has nothing to do with whether or not he’s attracted to you, and he’s not causing his own ED by neglecting his bedroom health or mental health.

While you may be quick to point to any number of ways these potential causes seem preventable, the fact is that no guy chooses — willingly or unwittingly — to have ED. Furthermore, nobody can cause ED in a way that would delineate “fault.”

This is a blameless condition — it just happens. How do we know this? Because not a single study of ED patients showed any of them being “happy” or “satisfied” with their lack of arousal function.

ED isn’t a blame game — it’s a problem to solve and requires teamwork, patience and compassion.

Is It Embarrassing When a Guy Can’t Get Hard? Takeaways

When medical professionals talk to a man about his intimacy life, they tend to forget that there’s a human being behind the biological and chemical problems that he may be experiencing. In all the talk of blood vessels, heart disease, the side effect risks of medication and men’s health in general, it’s easy for doctors and nurses to forget the embarrassment element of ED treatment.

Instead of closing yourself off (or letting him shut down), offer support and gently talk to him about what’s going on. Remember:

• This may be the first time and may be the last time — occasional ED isn’t necessarily a sign of anything other than stress or fatigue.

• If he’s struggling repeatedly with ED, ED treatments, including medication and online therapy with a therapist, are available to him. There are even discreet chewable ED meds hard mints with the same generic ingredients as those of Viagra (sildenafil), Cialis (tadalafil) and other ED medications.

• Remember that simple changes to your intimate times might help. Fun “pre-bedroom time,” new positions or toys make more than the spice level go “up.” And they can help you enjoy things even if he’s not getting hard enough to penetrate.

If nothing else, just remember to show them love, compassion and support. That’s what intimacy is about anyway, right?

This article originally appeared on Hims.com and was syndicated by MediaFeed.org.

More from MediaFeed:

12 Reasons Men May Experience ED (& What to Do About It)