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Erectile Dysfunction FAQs (cont.)

How does a man achieve an erection?

For a man to have an erection, a complex process takes place within his body.

  • Erection involves the central nervous system, peripheral nervous system, hormones, psychological and stress-related factors, local problems with the penis itself as well as blood flow or circulation. The penile portion of the process leading to erections represents only a single component of a very complex cascade of events.
  • Erections occur in response to touch, smell, and visual stimuli that trigger pathways in the brain. Information travels from the brain to the nerve centers at the base of the spine, where primary nerve fibers connect to the penis and regulate blood flow during erection and afterward.
  • Sexual stimulation causes the release of chemicals from the nerve endings in the penis that trigger a series of events that ultimately cause muscle relaxation in the erection bodies of the penis. The smooth muscle in the erection bodies controls the flow of blood into the penis. When the smooth muscle relaxes, the blood flow dramatically increases causing the erection bodies to become full and rigid, resulting in an erection. Venous channels normally draining blood are compressed and close off as the erection bodies enlarge.
  • Detumescence (when the penis is no longer in a state of erection) results when muscle-relaxing chemicals are no longer released. Ejaculation causes the smooth muscle tissue of the erection bodies in the penis to regain muscle tone, which allows the blood drainage channels to open. As the extra blood drains from the erection bodies, the erection loses rigidity and the penis returns to its original flaccid state.

ED occurs when this process does not progress normally. Arousal and erections are physical and mental activities, so it is important to remember that the sexual partner plays an integral role. Effective management of erection problems and erectile dysfunction is often more successful if the sexual partner is involved with the evaluation and treatment.

Is impotence the same as erectile dysfunction?

Yes, the terms mean the same.

Premature ejaculation is often confused with erectile dysfunction. Premature ejaculation is a condition in which the entire process of arousal, erection, ejaculation, and climax occur very rapidly, often in just a few minutes or even seconds, leaving both the sexual partner and the one experiencing premature ejaculation unsatisfied. Premature ejaculation may accompany an erection problem such as ED but is generally treated differently.

Erection problems will usually produce a significant psychological and emotional reaction in most men. This is often described as a pattern of anxiety and stress that can further interfere with normal sexual function. This "performance anxiety" needs to be recognized and addressed by your doctor.

What causes erectile dysfunction?

Patient Comments

Currently, virtually any man who wishes to have an erection can obtain it, regardless of the underlying cause of his problem. Many reasonable treatment options exist. Your first step is to find a well-trained, experienced, and compassionate doctor who is willing to take the time to understand you and fully examine you to discover the cause and discuss the treatments available to you.

Your doctor will want to rule out any other causes for your concern such as high blood pressure, prostate cancer, vascular disease, and diabetes.

By seeing your doctor, you may very well be saving your life if the doctor detects – and treats – a life-threatening illness. Often, you can restore your sexual health by treating a condition such as high blood pressure with diet and exercise or controlling your diabetes.

For some men, erectile dysfunction develops with age or may be related to depression or another psychological cause. In these cases, psychological counseling with you and your sexual partner may be successful.

Medications can cause ED, especially drugs you might take to control blood pressure or depression (antidepressants) (see Impotence/Erectile Dysfunction for a list of medications that may cause ED). Anti-ulcer drugs can be a cause, as can alcohol or drug abuse. ED is a side effect. Talk with your doctor about medications that might not cause this side effect. Do not just stop taking your prescribed medication.

Other causes include damage to the erection bodies in the penis; diabetes; various hormonal disorders; blood flow problems; psychological factors, such as depression; and surgical complications from abdominal, pelvic, or back surgery.

Medically Reviewed by a Doctor on 11/16/2016
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