On the other hand, sexual arousal is triggered by sight, hearing, smell, imagination, touch, and so on. On the one hand, the brain receives these stimuli and on the other hand, excitatory signals are transmitted from the brain regions that trigger erection through the spinal cord to the penis. At the same time, nitrogen oxide activates enzymes (cyclases) in the penile arteries, which convert or “cyclize” certain chemical compounds (GTP) into ring-shaped structures (cycloGMP). CycloGMP is chemically known as cGMP and causes the smooth muscle of the erectile tissue and blood vessels of the penis to relax. This causes increased blood flow. First of all, this causes tumors, which are swelling of the penis as it increases in length and girth.
With further sexual stimulation, the continued formation of more cGMP causes greater relaxation and further influx of blood, ultimately causing the penis to become completely rigid. The veins that normally drain blood from the penis back into the body are compressed by the erectile tissue, so that the erection persists due to high blood supply and blocked blood flow.
Disturbances in this process can be caused by physical, organic, physical and psychological causes. In more than 80 percent of men with weak potency, erectile dysfunction has organic causes. The focus is on circulatory disorders in the vessels of the penis, followed by neuropathy. Often these are patients who also suffer from lipid metabolism disorders, hypertension or diabetes. For most patients, drug therapy can improve erections.
Vein-related erectile dysfunction can also be congenital, for example if there is incorrect placement of the vein so that it bypasses the mechanism of penile engorgement. However, these major abnormalities can usually be easily corrected surgically. Causes of neurogenic impotence include spinal lesions or central nervous diseases such as Parkinson’s disease or brain tumors in which there is an imbalance of neurotransmitters. Alcohol abuse can also cause impotence. About five percent of men with organic ED have testosterone deficiency. Currently, it is generally assumed that erectile dysfunction is usually multifactorial, meaning that it has more than one cause.
With today’s knowledge about the gradual increase in male arousal and the processes involved in the central nervous system, spinal cord, and blood vessels in erectile tissue, it is possible to develop methods that can improve erections. These include medicines with vascular active substances, infections with vascular active substances as well as ointments and plasters for local treatment before sexual intercourse. Finally, as measures for men with erectile dysfunction for which there is no effective cure, there are vacuum pumps, penile implants, and cock rings. Supportive therapy options may include hormone therapy, psychological counseling and psychotherapy, pelvic floor exercises, electrical stimulation of the pelvic floor muscles and erectile tissue, acupuncture and hypnotherapy.