Morning Erections Gone Missing? Here’s What Your Body’s Trying to Tell You

By Dr. David Samadi

Let’s face it—waking up with a morning erection (yes, we’re talking about the infamous “morning wood”) might not be your favorite breakfast companion, but it is one of your body’s best natural health check-ins. So, what happens when those a.m. salutes start to fade? Is it just age? Stress? Or could your penis be raising a red flag about something more serious?

Let’s explore the science behind these early risers and what happens when they stop showing up for roll call.

What Exactly Is a Morning Erection?

Medically known as nocturnal penile tumescence (NPT), a morning erection isn’t just about dreams gone wild. These spontaneous erections occur during REM (rapid eye movement) sleep cycles, typically 3 to 5 times a night in healthy men. Even babies and young boys experience them, which should tell you: this is a deeply embedded, non-optional biological process.

It’s your body’s way of testing the erectile system overnight—no different from your computer running a software update while you sleep. Except this one happens below the belt.

Why It Happens: A Team Effort Between Nerves, Hormones, and Blood Flow

Several players are behind the scenes here:

• The parasympathetic nervous system, particularly the sacral nerve (S2-S4), activates during REM sleep, triggering increased blood flow to the penis.
• Testosterone, the kingpin of male hormones, peaks in the early morning hours, helping to fuel spontaneous erections.
• A healthy vascular system ensures that blood flows easily into erectile tissues.

Now flip that: if your testosterone is tanking, blood vessels are narrowing, or your nerves are out of tune, you’re unlikely to wake up standing at attention.

When It Stops: What It Could Mean

Occasional lapses are normal, especially after a poor night’s sleep, stress, or alcohol use. But if your morning erections are consistently missing for weeks or months, it’s time to pay attention.

Possible culprits:

• Low testosterone
• Testosterone levels naturally dip as men age, about 1% per year after age 30. Low T is linked to fewer or weaker erections, decreased libido, and even depression or brain fog.
• Poor cardiovascular health
• Erectile issues are often the canary in the coal mine for heart disease. If your arteries can’t deliver blood efficiently to the penis, they probably aren’t doing great in other parts of your body either.
• Type 2 diabetes and high blood pressure
• Both can damage nerves and blood vessels needed for healthy erectile function.
• Obesity and sedentary lifestyle
• Carrying too much visceral fat increases estrogen, lowers testosterone, and reduces blood flow. In other words: triple threat.
• Sleep disorders like obstructive sleep apnea
• No REM sleep = no morning erection. Fix your sleep, fix your wood.

Other Signs Your Testosterone Might Be Low

Beyond bedroom clues, here are some other classic signs your testosterone might be taking a nosedive:

• Loss of muscle mass
• Breast tissue development (gynecomastia)
• Increased belly fat
• Mood swings or low motivation
• Persistent fatigue
• Poor concentration or memory

These symptoms deserve more than just toughing it out—they need medical attention.

Time to Call a Urologist? Here’s What to Expect

If your penis has hit the snooze button too many mornings in a row, don’t Google yourself into panic. Instead, make an appointment with a urologist. You’ll undergo a full work-up that may include:

• Hormone panels (total and free testosterone, LH, FSH, estradiol)
• Cardiometabolic screening (blood pressure, cholesterol, fasting glucose/A1c)
• Physical exam and discussion of symptoms and lifestyle factors

Treatment: From Lifestyle Tweaks to Testosterone Therapy

Depending on the cause, your doctor may suggest:

• Lifestyle changes: exercise, weight loss, better sleep, and less alcohol can all raise testosterone naturally.
• Medications: managing blood pressure or blood sugar if needed.
• Testosterone replacement therapy (TRT): if hormone levels are significantly low and symptoms are present.

TRT isn’t for everyone and must be monitored closely, but in the right patient, it can restore morning erections and energy, mood, and sexual desire.

Bottom Line: Don’t Ignore the Morning Report

Morning erections aren’t just a quirky bodily function but a vital sign. A reliable one. If they start slacking off, it’s often a warning signal that something else in your body needs attention.

So, pay attention to your mornings. Your penis might be trying to tell you something your heart—or hormones—already know.

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board-certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, and Prostate Cancer, Now What? A Practical Guide to Treatment, Diagnosis, and Recovery, both available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.