I’m going to speak to you about how ED or erectile dysfunction occurs. Erectile dysfunction is a common condition, and it affects about half of men starting at age fifty, and it increases from there to about 90% of men by age ninety. It even affects some men in their forties. Although in a small number of cases there is a psychological factor, in the majority of cases it is a medical, physical condition, and it can be helped.
An erection is a physiological event, where there’s a signal from the brain triggers blood to flow into the penis. The penis fills with blood and then it traps the blood so that it becomes firmer and harder until there’s an erection that is satisfactory hard for penetration for intercourse. ED is a problem anywhere along that pathway.
First, a signal arises from the brain. Having a desire for sex is important. And testosterone at normal levels allows for that desire. Then the nerve pathways leading from the brain down to the penis must all be intact; that is the spinal cord as well as nerves that run through the pelvis, as well as nerves within the penis itself. Those nerves release chemicals that cause the blood vessels entering the penis to open up and allow more blood to flow through. That then enters a special type of spongy space within the body of the penis, which is a fine matrix of smooth muscles and blood vessel-like linings that are soft and compliant. And the signal makes them even softer so that they can fill up with blood expanding the size of the penis. And then the blood gets trapped, and so as more blood flows in, the penis becomes firmer, much like pumping up a bicycle tire. That’s the normal erection.
ED is a break down somewhere along that pathway. If a man’s testosterone level is too low, he may not have a desire to start the whole process. If he’s had a spinal cord injury or injury to the nerves of his pelvis from previous surgery, particularly a prostate cancer surgery, then the signal can’t get to the penis.