The Mechanism of an Erection

The Anatomy of the Penis

The penis consists of two spongy, cylinder-like vascular chambers (corpora cavernosa) that run along its length, parallel to the urethra which expels semen and urine. There are erectile tissues, two main arteries and several veins and nerves surrounding the urethra. The longest part of the penis is the shaft, at the end of which is the head known as the glans penis. The opening at the tip of the glans is the meatus, which allows urination and ejaculation.

The Mechanism of an Erection

When a man is stimulated sexually, nerve impulses lead to relaxation and cause an almost seven-fold increase in the blood flow to the corpora cavernosa. This sudden rush of blood expands the spongy tissues, and straightens, elongates and stiffens the penis to produce an erection. Sustained sexual excitation maintains this rush of blood and keeps the erection firm. After ejaculation, or when sexual activity ceases, the excess blood drains out of the spongy tissue, and the penis returns to its flaccid state.

The Causes of ED

If any factor affects/ disrupts any of the above steps or the delicate balance between them that lead to a complete erection, it may result in erectile dysfunction. Causes of ED could either be physical, nonphysical or both.

Physical causes
Physical causes account for about 80% cases of ED:

• Nerve damage from chronic diabetes
• Cardiovascular disorders that might affect blood supply to the pelvis
• Some prescription medications
• Some operations e.g. removal of the prostate gland
• Fractures that might damage the spinal cord
• Hormonal disorders
• Multiple sclerosis
• Substance abuse or addiction

Nonphysical causes
Nonphysical causes may account for the remaining 20% cases of ED:

• Stress, anxiety, fatigue and depression.
• Resentment, hostility or disinterest exhibited by any of the two partners.

Most often, the physical and the nonphysical causes tend to interact with each other. For example, a partial ED could lead to low self-esteem and anxiety, which could actually make the case even worse.

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Statistics for ED

Erectile dysfunction has many definitions, which makes estimating the incidence of cases difficult because it is difficult to incorporate the factors of all of these while considering the statistics. In 2002, the National Institutes of Health (NIH) estimated that between 15 and 30 million men in the US suffer from chronic degrees of ED. According to the National Ambulatory Medical Care Survey (NAMCS) in 1999, around 22 of every 1000 males in the US consulted medical help for ED.

Incidences of ED increase with increase in age. Chronic ED affects about 5% of men in their 40s and 15–25% of men around the age of 65. Partial ED affects up to 50% of men between 40 and 70 years of age.

Diseases like diabetes, kidney disease, alcoholism and atherosclerosis account for as high as 80% of chronic ED cases while psychological factors such as stress, anxiety and depression may account for about 10 – 20% of the total number of cases. About 35-50% of men with diabetes also suffer from ED.

Diagnosis of Erectile Dysfunction

The first step is to acknowledge that there could possibly be a problem, and then to seek professional medical advice. The physician usually conducts a complete investigation to determine the actual cause and time of origin of the condition. A list of medications is also checked against and a number of tests are conducted to eliminate other potential diseases like diabetes. If an apparent physical cause is suspected, blood tests are immediately conducted to check male hormonal levels. Additional specialized clinical tests may also be recommended to determine the adequacy of penile function.

Measures to reduce the chances of ED

Although most men experience episodes of erectile dysfunction from time to time, general practices to maintain good overall health may prevent or reduce the chances of developing ED at a later stage. Habits like smoking and drinking must be avoided or greatly minimized. Conditions of stress, depression, anxiety, etc. should be effectively managed and permanent solutions must be worked out. Regular exercise, complete peaceful sleep and routine checkups are extremely essential.

Coping with ED

Whether the resulting disorder has physical or psychological causes or a combination of both, ED may become a source of emotional and mental stress for both the man and his partner. It is important to note the following points which are essential in helping you cope with your problem:

• Communicate more frequently and openly about your problem with your partner. This will help you build your relationship. Treatment works better when the couple is in it together as a team. Good communication must be maintained throughout diagnosis and the treatment process.
• Seeking counseling is a great idea, because it may be prove to be very difficult to overcome ED on your own.
• Do not assume that you have a permanent problem if you experience ED occasionally. If you expect the problem to occur again during your next sexual encounter, chances are your psychological state might prevail.
• Do not consider just one incident of ED as the ultimate seal on your masculinity and virility. ED is more common than you think it is.
• You must remember to reassure your partner that your inability to have an erection is not a sign of diminished sexual desire.