What Are the Best Sex Positions for Men With ED?

Key Points

• Erectile dysfunction can become overwhelming and may cause men dealing with the issue to feel helpless or hopeless.
• There are many different treatments for ED, from medications to therapy.
• Although more research is needed, anecdotal evidence suggests certain sex positions may help guys with ED.

The causes of erectile dysfunction vary from physical (hypertension, diabetes, high cholesterol) to psychological (anxiety, depression) to certain medications. No matter the cause, if you're trying to have sexual intercourse with erectile dysfunction (ED), the sex position you use may make a difference.

Some sex positions may be more conducive to ED, while other positions could be more difficult if you are having difficulty maintaining an erection. Here are some positions you might want to try if ED is affecting your sex life.

Is it true that some sex positions can help with my erectile dysfunction?

There isn't much conclusive evidence or literature on the relationship between sex positions and erectile function, according to Susie Gronski, D.P.T., a men's pelvic and sexual health specialist in Asheville, North Carolina.

"There's no solid evidence to prove one position is better than the other when it comes to erectile function or predictability," Gronski said.

However, some anecdotal evidence suggests some positions may be easier for men with ED.

What are the best sex positions for a man with erectile dysfunction?

Because a successful erection requires an adequate blood supply to the penis, sex positions that call for more physicality will need more blood flow to the muscles, which could theoretically take away blood from an erection.

For the penis to fill with blood and become erect, it has to go against gravity. Sex positions in which the man is standing, for example, could be more challenging for someone who has ED.

Positions that may be easier tend to be side-by-side, and those in which the man penetrating is on top and the receiver is on bottom.

There's no one-size-fits-all solution when it comes to sex positions for men with ED, and much depends on the type of ED the man has.

Some men cannot achieve an erection at all, no matter the position. Some men may get an erection but then lose it because of performance anxiety. Other men may have a physical condition called venous leak, or when blood does not stay in the penis.

The following several positions may be more feasible for men with ED, according to sex therapists.

Missionary

The missionary position in which the man is on top of his partner is one of the best postures for men with ED because it allows for the man's penis to enter at a 90-degree angle, said Tom Murray, Ph.D., a sex therapist in Greensboro, North Carolina.

Because the missionary position is face-to-face, it can offer emotional connection and allow for eye contact, which may help men feel more relaxed and connected during sex and thus result in a stronger erection.

"Missionary may work for some but not for others," he said. "It requires a lot of upper body strength. If one isn't fit enough, they struggle."

Doggy style

Doggy style is when the receiving partner gets on all fours and the man enters from behind. This position enables the man to thrust his penis while squeezing the pelvic muscles. Watching their penis during penetration is arousing and stimulating to some men, which could help them maintain an erection.

Deep penetrations often favor the doggy-style position, Murray said.

"It will be advantageous for the person with ED in this situation to have total control over their penis," Murray said. "The patient with ED may not be able to complete deep penetration. However, by continuing to squeeze the base during the exercise, they may restore stimulation."

Reverse cowgirl

In the reverse cowgirl position, the partner sits on top of the man with their back to them, straddling them while facing away.

"This posture enables the downward angle to satisfy both partners when the erection is incomplete or soft," Murray said.

This position is visually exciting for the man and may lead to a firmer erection. The partner on top can reach down to stimulate the penis, which may add to the hardness.

Spooning

Spooning is a cuddling position where the partner lies on their side with knees bent while the man penetrates from behind. This position does not use as many muscles as other positions.

Although spooning won't provide the most penetration, it's preferred for a softer erection.

"Both people may shift their bodies easily in this posture to obtain the ideal angle," Murray said.

Some men have told Murray that spooning, and positions where both partners are lying on their side, can reduce pressure on the pelvic area and make maintaining an erection more manageable.

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Why do some sex positions work better than others when you have ED?

The angle of the position, gravity, muscular exertion and stimulation, and blood flow involved with the position may all factor into how well a particular sex position works for a man with ED.

The position that may be most effective for the man is something he enjoys and can relax with, allowing for full arousal. Men typically want a sex life that reflects what's familiar, Murray said.

"Straying too far from their preferences can further deteriorate their self-esteem," he said. "My goal is to help people achieve a sexual style that is pleasure-based. Given that ED correlates with aging, many men report a growing interest in sensual aspects of sex."

What should I do if these positions don't help with my sexual dysfunction?

If these sex positions don't help with your ED, you're not alone. ED is common. It's OK to ask for help and get support.

Men can benefit from the services of a mental health professional, such as a sex therapist who is qualified to help navigate sexual dysfunction concerns. Sex therapists and counselors can offer solution-oriented advice, Gronski said. They may suggest positions you haven't tried before or simply offer a space for you to be able to talk about your erectile difficulties.

"Many men dive into having these conversations if they feel that their provider is willing and open to having these discussions with them," Gronski said.

Connect with someone willing to have a conversation about your erectile difficulties and who will take your concerns seriously, Gronski said. Pelvic health physical therapists are equipped to have these conversations, she added.

The bottom line

While the research on sex positions and ED is lacking, many men, as well as sex therapists, report that certain sexual positions can help make penetrative sex easier.

No sex position is guaranteed to work for every man with ED. Try experimenting with different positions with your partner and see which works best for you.