As it turns out, the penis is more complicated than you think. Well, not the penis itself, but the mechanism by which you get, eghhhm, aroused. You see when a man really, really loves a woman, something quite magical happens and then there’s some touching involved and then sometimes certain elements of clothing are removed and well….nature happens. That’s how I learned it anyway…
Well, ok it doesn’t always happen like that.
Anatomy and Physiology of An Erection
Let’s start with a little anatomy. Your penis is made of a series of tubes. There are two parallel larger tubes called the corpora cavernosa and one smaller tube on the under side of your penis called the corpus spongiosum. If you don’t believe me, please take a moment and inspect your member…..There you go, see!
In its normal state, like any other organ, arteries carry blood into the penis and veins carry blood out. When certain “sexual centers” of the brain are activated or when nerves in and around your penis are stimulated, (or sometimes when the wind blows just right), these nerves release a chemical which triggers muscle cells along these small arteries to relax. This, in turn, allows more blood to flow into these tubes. As more blood flows into the tubes, veins which normally drain blood away from the penis get compressed. So, like a roach motel, blood gets into the penis but it can’t get out and so the penis swells. Unfortunately, I’m so sorry to the many guys out there who are just finding out that there is no bone in the human penis. I, too, was devastated at first. But dog’s have one! So perhaps that’s where the term “boner” got started….I can only speculate.
So why is it that this marvelous piece of engineering doesn’t work right sometimes? And why is it that sometimes it works….well, too well? To answer this, let’s start with the second question first.
You see, erections are an important part of penile health. As nutrient and oxygen rich blood flows into the penis, cells are repaired, and the sinusoidal architecture is maintained. In other words, the “scaffolding” within the tubes that make up your penis can be repaired so to speak. As a matter of fact, most men have three to five erections every night while they sleep. Alas, this is the source of your morning wood. Even male fetuses in utero are prone to these spontaneous erections. Erections can start in the brain with a visual stimulus, fantasy or thought. However, erections can also be completely spontaneous, as a result of a reflex arc between the nerves in your penis and your spinal cord. Some theorize that a full bladder in your sleep stimulates these nerves in your spinal cord as one of the causes of nighttime erections.
What about when Mr. Johnson under performs. Unfortunately, this is a bit complicated. As you can see, there are so many components that go into an erection. There’s your brain which is responsible for thoughts, fantasy, emotions. The involved nerves need to be functioning properly. Your penis requires adequate blood flow with healthy arteries. Finally, you need appropriate hormones like testosterone and thyroid. So let’s see how these things can get in the way:
1. Brain: Certainly, people who have serious problems like strokes, tumors or Parkinson’s disease which can have serious implications in terms of erectile function. But even something as seemingly unrelated as depression can cause problems. Most of the time, erections start in the brain with a thought, image, fantasy or even a romantic connection with your partner. Unfortunately, the cloud of depression often inhibits this initial first step. In addition, many of the medications used to treat depression have decreased libido as a side effect. Some medications are less likely to have this side effect so it’s important to talk to your health care provider to find the medication that works best for you.
2. Nerves: Healthy nerves are also important to maintain erections. Men with chronically uncontrolled diabetes have too much glucose in their blood which causes nerve damage over time which can lead to a breakdown in the process by which your penis gets erect. In addition, some professional and recreational bikers can have problems with transient impotence due to the chronic pressure from the bike seat on the nerves of the pelvic floor.
3. Arteries: Like the proverbial “canary in a coal mine.” Erectile dysfunction can be the first indication that you may have unhealthy plaques in your arteries. These plaques can build up along the vessel walls making it difficult for oxygen carrying red blood cells to reach important organs like your heart and brain. Therefore your health care provider will want to check you for peripheral vascular disease.
4. Hormones: Occasionally men have a condition called hypogonadism which means the testicles are not secreting enough testosterone. Testosterone levels naturally decrease with age. However, low testosterone levels accompanied by other symptoms of hypogonadism like erectile dysfunction, depression or fatigue, may warrant testosterone replacement therapy. In addition, your thyroid gland controls your metabolism. If it is not functioning properly, it can cause fatigue, weight gain, and depression. This can sometimes be a factor in men with ED. In many cases, thyroid supplementation for men with low thyroid hormone can improve erectile health.
5. Medications: Any medication, including prescription, over-the-counter, and even supplements can have side effects. Make sure you have a list of all medications and supplements you take when you are discussing your erectile health with your provider.
So, GOD FORBID that you ever have a problem getting your soldier to salute. But it turns out it’s ok if you do. One study found that 40% of men at age 40 and 70% of men at age 70 have some problem with ED. The good news is that whatever the cause of your malfunctioning member, the treatments available today work pretty well. Medications like sildenafil, vardenafil and tadalafil work by getting those nerves in your penis to tell those smooth muscle cells in your arteries that it’s time to relax, which gets the blood to flow in the penis, which decreases blood flowing out, giving you the roach motel effect and a big, bulging hard-on in the process.
As with every medication, these medications can have side effects. Most commonly reported side effects include: decreased blood pressure, facial flushing, headache, nasal congestion, gastric reflux, and nausea. Rarely, these medications can cause an erection that won’t go away. Although this sounds like it might be a good thing. It actually becomes painful after about an hour and can lead to scarring, tissue death, permanent erectile dysfunction and gangrene of the penis if not treated. So if you get an erection that becomes painful and doesn’t go away after 4 hours, you need to go the emergency room. Don’t be that guy who gets gangrene of the penis!
Lastly, if you ever take one of these medications and you get chest pain, make sure you tell your medical provider this and any other medications you are on. Nitroglycerin, the most common medication used in the emergency room for heart attacks can cause an unsafe drop in your blood pressure if you have recently had any of the current ED medications.
So there you go gentlemen. When two men love each other very much, they hold hands and butterflies come and dance inside their belly buttons and they get a funny feeling and….boom, we have ourselves an erection. That’s my story and I’m sticking to it!
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