The most common and most acutely experienced sexual dysfunction in men is the weakening or complete disappearance of an erection, or simply impotence. This word alone can cause serious psychological trauma. No wonder Sigmund Freud called impotence the biggest failure in the life of men.
At all times, the loss of potency was considered the most painful of the blows inflicted on male pride. Such terms as “impotence”, “sexual impotence”, as if emphasize the failure of a man who has at one time or another a life period, perhaps even very briefly, erections suddenly began to weaken.
And only by the end of the XX century, doctors guessed to introduce a more accurate and correct definition of this disorder – erectile dysfunction. This term implies the inability of the patient to achieve a full erection or maintain it for a long time, which in some cases limits the sexual function of the man, and in others deprives him of the opportunity to perform sexual intercourse.
Currently, erectile dysfunction is usually divided into 3 main types: primary, secondary and selective. In the first case, the patient is not able to
achieve a normal erection in order to freely enter the penis into the vagina. This type of disorder affects the elderly. In young men, this kind of erectile dysfunction is very rare. With secondary impotence, an erection is achievable, but not always: a successful period can be replaced by sexual impotence at any time. This type of erectile dysfunction is more widespread. If a man has any disorders in the work of the genitourinary tract, he may periodically experience difficulties with potency.
Selective, or selective, erectile dysfunction is expressed in the fact that erections depend on external circumstances. A typical example is the case when a man who does not experience any difficulties with extramarital sex becomes completely impotent on the marital bed. To make it easier to understand the causes of such disorders, consider the mechanism of erection. The penis consists of a cylindrical shape of cavernous (cavernous) bodies located close to each other. They contain a large number of veins. holes that remain empty when the penis is relaxed. To the base member symmetrically drawn two muscles, bearing the name of the sciatic-cavernous. Their reduction can not cause an erection, but it contributes to it. These muscles block the veins located in the cavernous bodies, and the outflow of blood from them stops.
The small arteries, arterioles, and capillaries inside the penis are arranged in a spiral pattern. Thanks to this, during an erection, the penis lengthens. In this case, there is a stretching of not only soft tissues, but also all the vessels located in the cavernous bodies.
During an erection, there are 3 main physiological processes.
- Relaxes smooth muscles of the corpora cavernosa.
- The lumen of the arteries in the penis Expands.
- Due to the contraction of the sciatic-cavernous muscles, the outflow of blood through
the veins stops.
To achieve a full erection, all these processes must be clearly coordinated. The necessary coordination is provided by the nerve center located
in the spinal cord. From it come impulses that control the entire mechanism of erection.
In addition, an erection can be caused by signals coming from the Central nervous system and passing the same path through the spinal cord. This happens when a man begins to think about sex or experience sensations that lead to sexual arousal.
Experts distinguish 3 types of erections.
- Psychogenic. To this type of erections, a man is led by thoughts about sex or irritation of certain sensory organs, subjectively perceived as exciting, for example, the sound of music or visual impressions.
- Reflex. It occurs as a result of exposure to the genitals. And although in this case, all nerve impulses occur in the spinal center, this kind
of erection is possible not only in healthy people, but also in people who have suffered a spinal injury (spinal injury).
- Night. This kind of erection occurs in childhood. Its presence in adult men is the main indicator of sexual health. For example, in psychogenic
impotence, the nocturnal erection is completely preserved.
The mechanism of erection is quite simple: the smooth musculature of the cavernous bodies, getting the command from the nervous system begins to relax. At the same time, the arteries that supply blood to the penis expand. Then the veins located in the cavernous bodies are filled with blood, which causes an increase in the penis. The outflow of blood from the genitals stops due to compression of the veins. Just before orgasm, the sciatic-cavernous muscles squeeze the base of the penis, increasing its elasticity to the maximum.
Thus, in the climactic phase of sexual intercourse, the blood supply to the organ is practically absent.
This condition of the penis is short-lived. Then the muscles located along the walls of the prostate gland, the appendage of the testicle and the VAS deferens, contract, and sperm enters the urethral canal, which is ejected outside at the time of ejaculation. The volume of seminal fluid is usually 3-4 ml. After ejaculation, the penis relaxes, the blood drains from it, and the erection passes. This phase is usually called refractory. It is characterized by the fact that at this time sexual interest in a man is completely absent.
An erection cannot occur again until this stage is completed. The duration of the refractory period is strictly individual and largely depends on the age, health status and habits of the man. On average, this condition lasts for several minutes.
However, in middle-aged and elderly men, some phases of sexual intercourse, including refractory, are usually longer than in young men.
The penis, as well as all other organs of the human body, obeys signals coming from the nervous system. Their consistency in conjunction with the normal condition of the vessels inside the penis ensures the successful conduct of sexual contact. Conversely, if erections are weakened or completely absent, then there is a circumstance that hinders the flow of blood to the cavernous bodies.
In particular, it can be visual or tactile perception, as well as inappropriate sexual fantasy. At puberty, the boy needs an optimal level of sex hormones.
Dihydrotestosterone and testosterone. They cause timely puberty and contribute to the formation of secondary sexual characteristics. These same hormones increase an erection in an adult man.
However, the latter can be maintained without their participation: with a deficiency of dihydrotestosterone and testosterone, sexual desire only decreases and the amount of sperm released decreases. Therefore, in case of erectile dysfunction, uncontrolled use of hormonal drugs is unacceptable.
In the case of normal levels of hormones in the blood, they cause only an increase in libido, and as side effects provoke aggressiveness, short temper and irritability.
Almost every man has problems with an erection during his life. This can be caused by overwork, deterioration of health, taking strong medications, alcohol, or trying to perform sexual intercourse in an inappropriate situation. In all these cases, nocturnal erections are preserved. Their achievement is also facilitated by such an act as Masturbation. However, during intimacy with a partner, problems arise. Due to the fact that the functions of the penis are always the subject of increased attention of men, the weakening of the erection is perceived very painfully, as a partial or even complete loss
Perhaps this is due to the prevailing stereotype, which suggests that for “real” intimacy it is necessary to have a strongly erect, hard penis. However, at different stages of sexual arousal, the muscles and vessels of the penis are controlled by various kinds of nerve impulses. As a result, an orgasm can occur
even when the penis is not erect. Therefore, men with erectile dysfunction also have similar sensations.
Particularly interesting is the fact that patients with erectile dysfunction who are able to experience orgasm, consider the latter the main incentive of treatment, ahead of others – such as social status or family well-being. Thus, in a critical situation, the status of a “real man” is not so significant compared to the true ability of a person to enjoy life.