Why do erections fail?
How an erection fails—in terminology men can understand
Neurogenic ED? Vascular erectile dysfunction? Psychogenic impotence? With all these clinical pathways, could learning why an erection fails be any more confusing?
Morganstern simplifies complex healthcare.
We created a layman’s guide to help every man become an ED expert in minutes.
How and Why an Erection Fails
From a clinical perspective, the causes of erectile failure are really pretty simple. “Erectile dysfunction” is just like a car engine that is not functioning or is running sluggishly.
It’s a generic term for when a penis fails to perform as expected.
Thus, saying, “I have ED” is like saying your car engine’s not running properly.
What’s the first thing you would do when fixing a poorly performing motor?
Accurately diagnose the underlying reasons your car engine is malfunctioning to determine which remedy is best suited to get you operating at peak performance again, right?
Continuing with this car engine analogy, we’ve created a metaphorical comparison with a car’s motor to educate patients about the 5 most common causes of erection failure/male engine failure.
While there’s countless other health factors that can come into play when it comes to achieving optimal erection performance, they pale in comparison to the 5 primary sources for clinical erectile dysfunction.
You could liken these 5 erection-building blocks to the internal combustion system of a vehicle engine.
Understanding these key principles allows you to better understand your sexual health and avoid being duped by “miracle cures” that don’t exist.
5 Medical Causes of Erectile Failure
There are 5 core clinical causes for erectile dysfunction.
These 5 erection-building components can be compared to a vehicle engine’s internal combustion system.
Also, as with a motor vehicle, a man can have more than one of these root causes occurring simultaneously.
Because each of these disorders is fully independent of one another inside male physiology, there can never be a single solution for erectile dysfunction.
Once you comprehend these core principles, you can speak more intelligently about your sexual health and ensure you always receive optimal care.
Psychogenic and Neurogenic erectile dysfunction is akin to a problem in your car engine’s wiring harness
Every erection (aside from “morning wood”) starts and ends within the human brain.
We hear something, see something, touch someone, or someone touches us. This triggers the brain to send a signal to rapidly pump blood into the two thick “sponges” inside the penis known as the corpus cavernosa.
At the same time, the outer edges of those sponges open extra wide to allow the maximum amount of blood to enter the penis.
When it’s full of blood, the tissue “locks” in place.
In urology that’s called a “full engorgement,” but at home most men refer to this state as a “rock hard erection.”
Subsequently, the brain sends another message to release the blood following orgasm or if a man experiences fear.
There’s an erection auto release valve in the event of fear.
Almost all cases of ED begin with a vascular, hormonal, or fibrotic cause.
However, once a performance failure occurs, men sometimes worry that failure might happen again the next time they are when intimate.
This “fear trigger” sends a message from the brain to release the blood within an erection. This is how ED can become psychosomatic.
Men can began to unconsciously release the blood within their erection by becoming fearful it will fail to perform.
This aggravates what started as a minor health issue into full blown ED.
Psychogenic & Neurogenic Erectile Dysfunction
Psychogenic ED
Your feelings play a major role in getting and maintaining an erection. Feeling relaxed, confident, and aroused is essential.
Problems with erection may arise if you experience nervousness, anxiety, frustration, or fatigue.
The most common source for psychogenic ED is after performance failure from a vascular, hormonal, or fibrotic ED cause.
The fear of failure during intimacy can cause the ED symptoms to worsen, causing a mild case of ED to exhibit symptoms of severe ED.
This is another reason detailed testing is so crucial.
Alcohol use and drug use can also have an impact since they interfere with conscious cognitive processes in the brain.
Finally, certain drugs, medical treatments, and illnesses can also trigger psychogenic ED.
Neurogenic ED
Your brain, spinal cord, and nerves are all part of your central nervous system.
Together, they send electrical impulses that facilitate movement and sensation throughout your body, including the penis.
If they become damaged or are impaired by medications or healthcare-related treatments, they can cause the penis to malfunction.
Morganstern is America’s only clinic with technology to repair arterial deficiency.
Hormonal and/or Nutraceutical Imbalance ED
To run (or even start), a car’s engine typically requires adequate, clean gas.
Your body’s equivalent to this fuel is your levels of important nutraceuticals and select hormones that are critical for healthy sexual function.
If there is insufficient fuel in your tank or if the fuel you have is being affected by other medications, your “automobile” will have difficulty starting or maintaining high rates of speed.
Sometimes the source of the problem is that your body is no longer properly creating the fuel you need.
It could also be that our diet is leaving us deficient with an essential macronutrient for good sex, or a prescription medication we are taking for another issue is diluting the quality of your fuel.
In this case, we can recommend a replacement prescription to your primary care provider.
What percentage of men that Morganstern tests are diagnosed with hormonal or nutraceutical deficiencies?
- 41% of men we test suffer from one or more of these deficiencies.
ED born from hormonal or nutraceutical imbalances is comparable to an empty gas tank or fuel that’s the inappropriate octane for the car
If this is a source of your problem, symptoms can include everything from complete failure of function to occasional poor sexual performance.
How are ED “fuel levels” tested at Morganstern?
- Detailed blood test panels
- Patient interviews regarding prescription medications and medical history
Vascular ED: Deficient Penile Arterial Flow
A car’s fuel pump is very similar to the human body’s arterial blood flow mechanism.
Arterial flow is defined as the amount and force with which blood enters your penis following arousal, through the arteries at the base of the penis.
If the blood flow is inadequate, the penis will not get fully firm.
If blood enters too slowly, the process where the blood gets “locked” within the organ (causing that “rock hard” finish) may fail to function properly.
If there is a “kink” somewhere further up our body’s fuel system, or the fuel pump is no longer working properly, a man won’t be able to get or keep a quality erection.
Also, penile arterial flow insufficiency is sometimes an early indication of a heart problem.
What percentage of men that Morganstern tests are diagnosed with penile arterial insufficiency?
- 46% of men we test suffer from penile arterial insufficiency, (AKA Arteriogenic erectile dysfunction.)
Inadequate penile arterial flow is akin to a faulty fuel pump on a car
If this is a source of your problem, symptoms can include everything from complete failure of function to occasional poor sexual performance.
How is penile arterial flow tested at Morganstern?
- Penile arterial flow is measured by a Duplex Doppler ultrasound sonography test.
Fibrotic Erectile Dysfunction
Have you ever seen what happens when a car’s carburetor is clogged or dirty, preventing the right fuel mixture from reaching the engine?
The car’s engine loses horsepower, runs sluggishly, or stops working altogether.
Carburetor carbon or sludge is very similar to any penile plaque or fibrosis in your penis, which will block the blood flow needed for a strong enough erection.
Fibrotic erectile dysfunction is caused by significant or minor amounts of fibrous plaques within the organ restricting proper blood flow within the organ necessary for good erections.
What is penile fibrosis & how does it happen?
The most common source of minor cases of penile fibrosis is from various microtraumas to the organ over many years during sporting activities or sexual experiences.
Fibrosis from microtraumas rarely give men trouble until later in life when various Peyronie’s Accelerators from aging trigger fibrotic growth.
This means symptoms such as sudden curvature when erect, indentions during erection, or ED from a piece of fibrous plaque restricting the arterial flow needed for a healthy erection.
Penile fibrosis is comparable to an engine with a dirty carburetor
If this is a source of your problem, symptoms can include everything from complete failure of function to occasional poor sexual performance.
How is ED caused by fibrous plaques tested at Morganstern?
- Duplex Doppler ultrasound sonography testing
What percentage of men that Morganstern screens are diagnosed with meaningful or significant penile fibrosis?
- 23% of men we test are diagnosed with penile fibrosis
Morganstern leads the world with technology that effectively removes penile fibrosis.
Vascular Erectile Dysfunction: Venous Leakage
Vascular erectile dysfunction (also known as “venous leakage” or “venogenic erectile dysfunction” occurs when the valve in the dorsal veins that is designed to keep blood from escaping does not work properly.
An erection is formed similarly to how a tire is inflated. You must allow air to enter, but you also require a valve to keep it inside.
If the valve is corroded or cracked, air may escape, causing a soft tire or a flat.
Similarly, an erection requires blood to come in and a properly working outflow valve to keep blood from exiting.
If the outflow valve fails to operate properly, blood escapes, causing the erection to diminish or disappear.
We liken venous leak to the loss of engine compression in our car engine/ED analogy.
For an engine to maintain power, it’s essential that the motor preserve engine compression.
If there’s loss of compression during function, the engine loses power.
If an engine can’t maintain compression, the engine simply will not run at all.
Varied losses of engine compression are a lot like venous leakage.
In urology, venous leakage is a condition where the penis is not adequately “sealing” the blood that’s pumped into the penile organ to create and maintain an erection.
Thus, blood “leaks” out when we need it most.
Leakage is like losing compression in a car engine
Mild cases of venous leak are sometimes described by patients as erections that are like an inflated balloon with a small pin prick slowly releasing air.
Severe venous leaks are like a car tire losing air as fast as it’s being pumped in.
Psychogenic and Neurogenic erectile dysfunction is akin to a problem in your car engine’s wiring harness.
If this is a source of your problem, symptoms can include everything from complete failure to function to intermittent performance.
How is venous leakage tested at Morganstern?
- Duplex Doppler ultrasound sonography testing reveals venous leakage both by its degree and specially which side (or both) of the organ are suffering from it
What percentage of men that Morganstern screens are diagnosed with meaningful or significant venous leakage?
- 48% of men we test have venogenic erectile dysfunction that requires some form of medical treatment.
Erectile Dysfunction FAQs
If a man cannot achieve or maintain an erection long enough for sexual activity? That’s erectile dysfunction.
There’s no singular cause which is also why there can never be a singular cure.
The most common source for ED is disorders within the blood vessels that supply blood to create or maintain an erection (they are separate issues), hormonal problems, mental health or neurological disorders, or the buildup of penile fibrosis from micro or major traumas to the penis organ.
Although erectile dysfunction can be diagnosed and treated by a medical professional, patients typically end up “trying” several remedies to improve the condition by trial and error.
Morganstern does not subscribe to this “trial and error” approach. We comprehensively test and diagnose patients before started therapies to resolve erectile dysfunction.
Erectile dysfunction can be diagnosed and treated by a medical professional but is commonly managed through trial and error by having patients “try” various treatments.
ED is often the first indication of another underlying problem, including heart disease.
It’s imperative that you speak with a medical expert if you have trouble getting and maintaining an erection.
There are other factors that can impact erection performance.
Your emotions have a big impact on your ability to get and maintain an erection.
It is essential to feel confident, relaxed, and energized. However, sporadic erection issues are not uncommon.
Anxiety, frustration, weariness, or anxiousness can all lead to problems with erection.
Drug and/or alcohol abuse may also have an effect.
It might also be the result of other ailments or a side effect of particular medications.
Unless he dies early in life, every man will eventually suffer from ED symptoms.
At any given time, it’s estimated about 35% of men are suffering from erectile dysfunction.
It occurs most commonly among men over the age of forty, but it can affect men in their early 20’s.
Sadly, lots of men fail to get help because of embarrassment.
- Erections that are unreliable (sometimes it works, sometimes it doesn’t)
- Being able to get an erection before sexual activity but failing to keep it up during sex
- A total inability to get an erection
- Needing tons of stimulation to keep an erection up.
The most common reason for ED is conditions that interfere with your body’s capacity to supply blood to your penis.
These include:
Deficient Arterial or Penile Flow
Inadequate blood flow force either coming into the penis or throughout the penis can hinder the formation of a quality erection.
Blockage within the corpora cavernosa
Penile plaque or fibrosis can occur within the organ from childhood or adult penile trauma and create blockage to the process of filling the corpora with blood.
The next most common source is hormonal deficiencies:
Inadequately Optimized Fuel
Our hormone levels and supporting macronutrients provide the fuel to support an erection.
As we age, these nutrients decline in production, but any guy can end up deficient with select macronutrients.
Generally-speaking, sources of erectile dysfunction are subdivided into four categories:
Hormonal Erectile dysfunction: The term “hormonal ED” describes ED caused by a lack of testosterone or, in certain situations, by thyroid problems.
Vascular Erectile Dysfunction: Affected blood veins that supply blood to the tissues in your penis that enable you to achieve and sustain an erection, as well as the penis’s natural blood-holding valves, are among the causes of vascular ED. ED that is vascular is the most prevalent kind.
Erectile dysfunction caused by psychosis: Conditions that impact your ideas, feelings, or behavior are known as psychogenic ED, and they can lead to ED.
Neurologic Erectile dysfunction: Nerve issues that obstruct the transmission of information from your brain to your penis to produce an erection are the cause of neurogenic ED. Trauma, pelvic surgery, radiation therapy, or neurological diseases such as multiple sclerosis (MS), spinal stenosis, and stroke can all cause this.
It is rare for ED to go away on its own without significant lifestyle adjustments or medication intervention.
A few lifestyle modifications, such as lowering your cholesterol, can help reduce your risk of when you get erectile dysfunction, but eventually every man ends up with it. Other tips that help with minor ED symptoms include:
- Sustaining your weight at a healthy level.
- Obtaining restful sleep.
- Increasing one’s physical activity level, particularly through aerobic activities like jogging, cycling, or running.
- Giving up smoking.
- Consuming wholesome meals like fruits, vegetables, and whole grains that are low in saturated fats.
- Cutting back on or giving up alcohol consumption.
If you’re taking medications for erectile dysfunction like PGE injections (trimix) or PDE-5 inhibitors and end up with a painful erection that lasts more than 2 to 4 hours, you should visit the closest emergency department.
This could indicate priapism, which, if left untreated, can permanently disable your penis.
Otherwise, ER staff are not suited for proper testing and care for ED issues.
A wide range of emotions can be triggered by men suffering from erectile dysfunction.
Anger, humiliation, frustration, guilt, embarrassment, or a sense of being “less than” could wash over you. Since an erection starts and ends in the human brain, these negative emotions only make symptoms worse.
ED is most commonly a vascular health issue, NOT a reflection upon manliness. Every man eventually gets ED. Get it treated soon!
Many people find discussing erectile dysfunction to be challenging.
If your partner is dealing with erectile dysfunction, you can be of assistance by following these tips:
- Promote candid dialogue. Express your concern for your partner’s emotions and happiness. Communicate with your partner at a moment when they won’t feel exposed.
- Make sure your partner knows they have support. ED is extremely common. At some point every man gets it. It’s most commonly a vascular health issue. It’s not about his attraction or feelings toward you.
- Talk about getting healthier. Emphasize the positive effects of a healthy lifestyle, including frequent exercise, nutritious eating, and reducing usage of substances that can trigger erectile dysfunction symptoms.
- Seek out knowledge. If you are well-informed on erectile dysfunction and the treatments available, your partner will feel more supported. Another suggestion is to offer to accompany your partner to doctor’s appointments.
Your “EDD” is derived from our comprehensive testing and scoring system on every factor affecting sexual performance.
Sadly, most men getting ED treatment never find out why their erections are failing, they just get convinced to try one therapy or another without a urologist having first determined exactly what’s not working and why.
Over the last 50 years, there have been 7 major urologic innovations for treating erectile dysfunction.
Our clinic is proud of the pioneering role we played with each of these important breakthroughs.
Most insurance policies, including Medicare, cover the costs of all the testing to determine what’s wrong and score your EDD.
We provide affordable solutions to get you back to your best performance.
Ready to make ED symptoms a thing of the past?
Click or tap above to learn how to get started at Morganstern Health today.
