Why am I unable to get an erection while standing?

Difficulty in achieving an erection while standing could be due to several factors. Some common causes include:

### 1. **Circulatory Issues**:
   - **Blood Flow**: Erection requires strong blood flow to the penis. Standing may cause slight changes in blood circulation, which could make it harder for some men to maintain an erection.
   - **Varicoceles or Venous Leak**: These are conditions where blood flow out of the penis is not properly restricted, making it harder to maintain an erection, especially when standing.

### 2. **Anxiety and Stress**:
   - **Psychological Factors**: Performance anxiety, stress, or worrying about whether you can maintain an erection while standing might make it more difficult.
   - **Mind-Body Connection**: Stress can impact how your body responds in intimate situations, affecting your ability to stay aroused.

### 3. **Pelvic Floor Strength**:
   - **Weak Pelvic Floor Muscles**: These muscles play a role in maintaining an erection. If they are weak, you may find it harder to stay erect in a standing position.

### 4. **Fatigue or Physical Condition**:
   - **General Tiredness**: Fatigue or feeling physically worn out may reduce sexual performance, including achieving an erection while standing.
   - **Health Conditions**: Conditions like diabetes, high blood pressure, or cardiovascular problems can also affect erections in different positions.

### 5. **Hormonal or Medication Effects**:
   - **Testosterone Levels**: Low testosterone can affect erection quality in general.
   - **Medications**: Certain medications for blood pressure, anxiety, or depression may affect your ability to achieve an erection, especially in certain positions.

### When to Seek Help:
If this issue is persistent and affecting your sexual health or confidence, it’s a good idea to consult with a healthcare provider or urologist to rule out any underlying medical conditions.