Erections 101 – What Can Go Wrong?

Having trouble getting or maintaining erections?

Wondering why it’s not working?

Patients become very familiar with erections at an early age. However, most know little about how their penis actually works and what can go wrong in the process.

How Does an Erection Occur?

Erections are first triggered by some form of sensory or mental stimulation. Subsequent to this activation, a message is sent to relax and open up the blood vessels of the corpora cavernosa (the penis “organ”, which looks like a thick sponge). Assuming adequate hormonal levels, the body will rapidly pump blood into the corpora through the cavernous arteries. The blood gets trapped under high pressure through the constricture of veins and muscles at the base of the penis to create optimal firmness for intercourse.

What Can Go Wrong with an Erection?

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.

Deficient Arterial or Penile Flow
Inadequate blow 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.
Loss of Sufficient Constricture at Base of Penis (Venous Leakage)
If the constricting veins and muscles at the base of the penis are not functioning properly it becomes impossible to maintain a quality engorgement in terms of both size and rigidity.

A Mental Trigger
For the protection of our sexual organs, the body has erection diffusing mechanisms triggered by fear or distraction. While failed erections are most often caused by physiological issues. However, once we’ve failed to perform as expected, we can experience fear of failure again and inadvertently trigger the erection release-valve. When this happens, the problem becomes systemic between physiology and psychology and very frustrating.

Neurologic Issues
The nerve endings and neuralgic wiring that triggers an erection and guides the process can become damaged or deficient. Any failure in this regard makes erections challenging to achieve.

Chronic Erectile Dysfunction Causes

Chronic ED is almost always rooted in some sort of penile vascular issue. The penis operates as intended completely by blood flow. Thus, if a patient isn’t getting enough force of blood flow to the penis due to arterial vascular insufficiency from a vascular insufficiency diagnosis, Type-II diabetes or a surgical procedure like a prostatectomy or heart stents, he won’t be able to get an erection. If the blood flowing throughout the penis is constricted from any one of a variety of sources, it will take prolonged periods to achieve an erection. If the patient is unable to maintain an erection from loss of compressed blood retention necessary for engorgement (venous leakage), he won’t be able to keep an erection.

It’s this myriad of most common root causes combined with a host of potential ancillary complications that make detailed and expert evaluation of each case before talking about which solution is suitable essential to healing.

The Most Common Causes of Erectile Dysfunction:

  • Complications that affect the flow of blood into the groin area in order to achieve an erection
  • Complications that affect the flow of blood within the penis in order to achieve an erection
  • Complications that affect the flow of blood within the penis in order to retain sufficient blood compression to maintain an erection
  • Problems affecting the nervous system that serves the penis ( i.e. severe Type-II Diabetes )
  • Hormone insufficiency to fuel an erection: (low testosterone)
  • Previous or recent penile injury or trauma: resulting in Peyronie’s Disease (which blocks blood flow)

Maintaining Good Penis Function with Age

Your Penis isn’t “designed” to ever quit working, even after age 90!

If it malfunctions, it’s because there’s an underlying vascular issue. Although such issues more commonly manifest as we grow older they can and do occur in patients in their early 20’s.

Approximately 30 million men in the US (half of all men between the ages 40 & 70) suffer from ED symptoms. ED is not in itself a diagnosis! More commonly, it is a symptom of another health issue. It’s often the earliest indicator of an impending heart problem. Most people don’t realize, ED is not “supposed” to happen at any age. Our penis doesn’t “quit working” as we age. Rather, over time, aspects of the erection process need repair & maintenance over time. The body is designed to achieve & maintain erections until death.

Vascular Health, Not Virility

When performance comes up short, a lot of men internalize that failure as some sort of reflection of their declining virility. Nothing could be further from the truth.

If you looked at your penis as most guys view the functionality of their car, you would feel better. The mechanisms share a lot in common. Like the oil that flows through your car engine, blood supply to your penis starts in your heart and flows through arteries in the belly to even smaller arteries that branch off to carry blood into the penis. Sexual stimulation causes your blood vessels to increase blood flow rapidly. If blood vessels are blocked (atherosclerosis) by coronary artery disease, you may not be able to achieve or maintain an erection. . . Kind of like a clogged fuel line!

Erectile Dysfunction Symptoms

Here’s a bit of irony, your ED symptoms could actually save your life.

Doctors understand more than most that it’s challenging to get men to stay on schedule with annual health check-ups. One of the only health conditions that will properly motivate a male patient to see his doctor is failure with sexual performance.

Relationship Between Erectile Dysfunction and Heart Disease

ED and heart disease are considered two signs of the same disease process. The smaller arteries in the penis are affected by atherosclerosis sooner, perhaps three or more years before they cause heart disease symptoms. This clogged fuel line that first affects the penis, can later, if not repaired, shut down the engine known as your heart.  According to the Mayo Clinic, erectile dysfunction may be a precursor to heart issues in men.

Research now shows that the reason erectile dysfunction precedes issues with the heart in men is related to the inner lining of blood vessels and their inability to supply the heart and the penis with proper blood flow.

A large international study found that men with erection issues were more likely to die from heart causes (i.e.: heart attack, stroke or be admitted to the hospital with heart failure) than men without.

Your Sexual Heath Can Improve Permanently

When first facing ED symptoms few men are comfortable talking about it: male sexual prowess is a rite of passage many guys embrace from early childhood. You may reduce your risk of erectile dysfunction by improving your heart health. Healthy lifestyle choices encourage you to stop smoking, lose weight & increase physical activity.

Under typical circumstances, if erectile dysfunction persists, oral medications are a common first treatment for ED. If oral medications don’t work, a patient is sometimes treated for hormone imbalances or asked to try shockwave therapy. If none of those are effective, you’ll likely be told a penile implant is the only remaining option or organ-damaging and humiliating PGE injections. The implant is concealed inside the body. It offers support for an erection whenever desired.

At Morganstern Urology, we don’t “guess” regarding what’s not working and why – saving patients money and anguish.

Erectile dysfunction (ed) isn’t a diagnosis! Rather, it’s an indication that something else is wrong. Our job is to identify the underlying cause, fix it & get you back to your old self quickly & safely. This is what we do; repairing erectile dysfunction issues is our specialty! We’ve been doing it longer than anyone else in the southeast. We’re “the best at it”. We exclusively own proprietary tools not available to others.

There are many treatments available to help combat erectile dysfunction, but most just treat symptoms. If you fail to garner and address your dysfunction’s underlying cause? It’s still there setting you up for a lifetime of treatment-dependence or a cumbersome penile prosthetic implant.

New Treatment Solution Corrects Erectile Dysfunction

Our doctors provide a non-surgical solution for chronic cases that is a total body holistic solution to sexual health. Meaning, we not only address the immediate concern, we solve the long-term problem. Our four-step ExoSurgel® technology is unique, patented, the most effective and only available at Morganstern Urology in Atlanta. It includes processes for improving overall circulation, focused revascularization and collagen care. We also provide customized hormone treatments and select performance enhancers, as needed.

Erectile Dysfunction:Solved!
Dr. Steven L. Morganstern, MD
3193 Howell Mill Road
Atlanta, GA 30327
(404) 352-8220