The Physical Biology of Erections

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Those men who carefully investigate the whole process of gaining an erection may realize through their introspective observations that the seemingly simple process of gaining and sustaining an erection arises out of a massive complex of co-operative and interdependent factors. Visual cues, imaginative fancies, psychological processes, tactile stimulation and biological machinery all combine in the most marvelous fashion to produce an upstanding member.

Certainly, the whole process is complex and multi-layered; and, as a result of this apparent complexity it can be extremely difficult to pinpoint a central, efficient cause to explain a man’s difficulty in achieving a satisfactory erection. However, for the purposes of this short article we shall simply (and briefly) describe the process of erection from a biological point of view. This is useful for those who, having difficulty with achieving erection, would seek to understand why certain methods such as male enhancement pills might work.. For others, I hope that this description is interesting for its own sake.[i] [ii]

Biologically, the penis becomes engorged with blood when endothelial cells that line the blood vessels of the penis are signaled to dilate and increase blood flow. The most studied and most critical chemical signaling molecule is nitric oxide. Nitric oxide works in the body by causing an increase in production of another molecule, cGMP (cyclic guanosine monophosphate) which starts a large cascading chain reaction of chemical processes that allow for increased blood flow to the spongy tissue of the penis – in particular the corpus cavernosum, a two-columned tissue structure in the penis capable of engorgement with blood to effect an erection.[iii] [iv] [v] [vi]

The gradual engorgement of the corpus cavernosum mechanically constricts the blood vessels responsible for draining blood from the penis. By this mechanical method, an erection is maintained, until such time as further neurochemical signalling begins processes leading to the exit of blood from the penis.[vii] [viii] [ix] [x]

Perhaps now it may be clearer for some readers why healthy blood flow, healthy arteries and healthy hearts are important for gaining erections. Indeed, any intervention that is going to help the biology of “erection gaining” must include methods, substances and strategies that support blood vessel health and cardiovascular fitness. Substances that affect nitric oxide (or cGMP) physiology in the body will also be prime contenders for supporting the ability to gain an erection. Lifestyle, diet, stress and behavioral factors are all implicated in proper functioning of the penis – not a great surprise really, but certainly good to know, a solid foundation for the knowledge

[i] Kolodny L. (2011) Chapter 17: Men’s Health: Erectile Dysfunction (pg. 971). In: Bope E., Kellerman R. (Eds.), Conn’s Current Therapy (1st ed). Saunders, An Imprint of Elsevier.

[ii] Sadeghi-Nejad H, Brison D, Dogra V. Male Erectile Dysfunction. Ultrasound Clinics. 2007;2(1):57-71.

[iii] American Urological Association; Managing Your Peyronie’s Disease. In: Ferri’s Netter Patient Advisor (pg. 988) Copyright 2012 Saunders, an imprint of Elsevier, Inc.

[iv] Kolodny L. (2011) Chapter 17: Men’s Health: Erectile Dysfunction (pg. 971). In: Bope E., Kellerman R. (Eds.), Conn’s Current Therapy (1st ed). Saunders, An Imprint of Elsevier.

[v] Heidelbaugh JJ. Management of erectile dysfunction. Am Fam Physician. 2010;81(3):305-312.

[vi] Sadeghi-Nejad H, Brison D, Dogra V. Male Erectile Dysfunction. Ultrasound Clinics. 2007;2(1):57-71.

[vii] Ibid.

[viii] Kolodny L. (2011) Chapter 17: Men’s Health: Erectile Dysfunction (pg. 971). In: Bope E., Kellerman R. (Eds.), Conn’s Current Therapy (1st ed). Saunders, An Imprint of Elsevier.

[ix] Heidelbaugh JJ. Management of erectile dysfunction. Am Fam Physician. 2010;81(3):305-312.

[x] National Institutes of Health; Impotence.NIH Consens Statement. 1992;10(4):1- 33.