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Erection
An erection occurs
when the soft spongy tissue in the shaft of a man's penis fills with
blood, causing the penis to enlarge and stiffen. Spongy spaces
(technically known as corpora cavernosa and corpora spongiosa) along the
length of the penis fill with blood in response to physical stimulation,
psychological stimulation, or both. This process requires that the blood
supply and the nerve connections to the penis are working properly.
Dilation of the arteries
that feed blood to the penis results in engorgement of the spongy
tissue. Simultaneous contraction of the muscles at the base of the penis
prevents the blood from draining out through the veins, thus maintaining
the erection. Nerves in the spinal cord also control erection, which
receive input from physical contact to the penis and/or surrounding
areas, sexual thoughts, dreams, or images, and sex hormones.
Barring an erectile
disease, and provided there is sufficient blood flow and nerve impulses,
a man is capable of getting an erection when sexually stimulated. It is
important to know that erections come and go. The ability of a man to
get an erection is an automatic, normal function similar to his ability
to breathe and blink his eyes.
An erection can take
place in as little as several seconds or it can occur gradually over a
longer period of time. In the later years of a man's life, beginning in
the 50's and increasingly in the 60's and 70's, it can sometimes take
longer to achieve an erection even with direct stimulation and a man may
notice that his erection is not as firm as when he was a teenager. This
is a normal part of aging, but causes some men distress because they
measure their maleness or ability to please a partner by the firmness
and speed with which they become erect. However, the older man has some
advantages over the younger one because his ejaculatory control is
usually greater, therefore he can maintain an erection for a
considerably longer period of time without feeling the ejaculatory
urgency common in younger men. This advantage may be lost in men who
have prostate problems because they often experience leakage of the
blood supply required to maintain an erection, and can have weaker
ejaculations.
Men of all ages
occasionally have concerns about the size of their erect penis and
whether it is sexually adequate. . Although a common worry, the
size of a man's erection is not related to his ability to please a
partner or enjoy sex himself. In fact, continually thinking about penis
size can interfere with achieving an erection, and with the giving and
receiving of pleasure. There is rarely a relationship between the size
of a flaccid penis and its size when erect. A small flaccid penis can
show a remarkable change as it erects and a large flaccid penis
sometimes changes very little in length or thickness, as it becomes
erect. An erect penis is typically between five and seven inches long
with a diameter between 1.25 and 1.5 inches. Of course there are
variations in this range, which allow for some larger and some smaller
penises.
It is not uncommon for a
man's penis to curve a bit when it is erect. The degree of the curve
varies from man to man, but it generally causes no discomfort or
interference with sexual activity. A very pronounced curve occurs in a
condition called Peyronie's disease. Although it is not certain, it is
thought to be caused by the development of hard, fibrous, inflamed
tissue in the shaft of the penis, and usually starts as pain during
erection, caused by stretching of inflamed penile tissue. As the disease
progresses, the pain subsides, and then fibrous tissue develops, causing
the penis to curve to the left, right, or upward. The majority of cases
of Peyronie's disease require medical attention and are generally
curable.
Another erectile
disorder, priapism, is the continual and pathological erection of the
penis. It is usually caused by nonsexual factors such as spinal cord
disease, leukemia or sickle cell disease, and, according to some
reports, with the use of cocaine. Sometimes it happens for no known
reason. In cases of priapism, the increased blood flow that causes an
erection is unable to drain from the penis in the usual way because the
release mechanism has been broken down by the disease or affected by
drugs or other unknown factors. It is extremely painful and may require
surgery if the problem does not respond to medical treatment.
Certain non-medical
circumstances, such as painful stimulation of the penis, or disturbed
emotional states such as fear, anger, guilt, anxiety, or shame can cause
a man to lose his erection or prevent him from getting an erection in
the first place. Emotional difficulties and the anticipation and worry
about possibly losing an erection are common causes of a man's erectile
difficulties.
If a man repeatedly
experiences difficulty achieving or maintaining erections, he should not
despair. In the last ten years much has been learned about treating
erectile problems. The first step is to contact a competent urologist
who can perform the necessary diagnostic tests to determine if medical
factors are contributing to the problem. In addition to a thorough
urological evaluation, the man and his partner should consult a
psychotherapist who specializes in sexual therapy. Regardless of the
origins of the erectile problem (medical, psychological, or in some
cases both), as with any change in normal functioning, there can be an
emotional impact on the man and his partner. Through counseling, the
unspoken fears and misunderstandings of both partners can be explored,
resulting in improved self-esteem and better communication.
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Sex
