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Erections are frequently the subject of jokes, myths, lies, and exaggeration. Despite years of saturation in ‘raunch culture’ however, they are still not considered as a topic of regular and well-informed discussion in most circumstances. This can lead to some fundamental misunderstandings about how erections actually happen. 

It’s understandable that most men are reluctant to discuss any problems when it comes to their intimate private lives. Even the most confident of men probably feels rather daunted by the prospect of explaining to a doctor that he is having trouble getting or maintaining an erection long enough for a satisfactory sexual experience, for example.  

Difficulty achieving an erection is referred to as erectile dysfunction (ED) in medical terminology. It’s a very common problem that has a range of causes. In men under the age of 40, these are more likely to be mental or emotional than physical causes. Anxiety, stress, poor body image, depression and low self-esteem can all lead to ED. 

In men of middle age and beyond, the causes of ED are more likely to be physical, such as obesity, high blood pressure, or heart disease. Despite the fact that about half of all men experience ED at some stage, the majority of men find the issue difficult to discuss. This is a shame as it is a highly treatable condition in many cases. 

Understanding a little more about how and why erections occur can help to clear up some of the barriers to an open and honest discussion about sexual performance. One of the most common misunderstandings is that the penis is a muscle that hardens in response to stimulation.  

In fact, the opposite is true. The penis is a complex organ that actually requires the muscles and the base to relax and widen the blood vessels in order to become erect. When these arteries become damaged through health problems such as atherosclerosis or an injury, it is more difficult for enough blood to flow to the penis to produce an erection. 

The muscles that control the blood flow in the genital area are also sensitive to the workings of the parasympathetic nervous system (PSNS). This is a network of nerves around the entire body, and it helps the body perform essential functions such as digestion, sweating, and maintaining a stable heart rate and blood pressure.  

The PSNS also plays a central role in sexual stimulation. It tells the body that you are in a secure and relaxed state, and it’s safe to divert blood away from the vital organs and towards the peripheries, including the penis. Therefore the body is more responsive to sexual stimulation, and the arteries easily relax and dilate in preparation for sex.  

In contrast, the sympathetic nervous system kicks in when the body is in ‘fight or flight’ mode, and the heart expends all its effort into pumping blood to the larger muscles and organs. In the past, this would have allowed humans to more easily run away from predators. Nowadays, it can leave us feeling anxious and definitely not in the mood for sex. 

That’s why ED can have both physical and physiological causes and it’s important to discuss it with a doctor, however daunting that may seem.  

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