Urology Centers of Alabama

Erectile Dysfunction

Erectile dysfunction (ED) is when a man cannot get an erection that is stiff enough for penetrative sex (vaginal or anal sex) or when he cannot maintain a stiff erection long enough to have penetrative sex.

To understand Erectile Dysfunction, you must first understand the anatomy of the penis.

Penile Structure

The two corpora cavernosa are the chambers in the penis that fill with blood and become rigid during an erection. The are composed of tissue that looks like a sponge. The arteries that carry blood to the corpora cavernosa are very small.  The urethra is the channel that carries urine through the penis; it is located on the bottom of the penis and is surrounded by spongy tissue called the corpus spongiosum. The head of the penis, called the glans, is connected to the corpus spongiosum and it also fills with blood duerection. When a man is sexually aroused, the two cavernosa and the glans become engorged with blood and swell causing the penis to get thicker, longer, and stiff; that’s an erection. After orgasm, the blood drains out of the penis and the erection goes away. Some men’s penis will be small when there is no erection, but really gets longer with an erection; other men have a larger soft penis that does not grow as much when it is erect (the “grower” and the “shower”).

There are a number of things that can cause ED: diabetes, high blood pressure, surgery or radiation therapy used to treat prostate cancer, spinal cord injury, cardiovascular disease, and as we men get older our blood vessels everywhere in the body are not as good at carrying blood and ED is more common. Because there is a loss of the normal blood flow into the penis during erection, when a man has ED there is a real loss of length of the penis the longer and longer ED remains untreated. One of the most common complaints men have when seen for ED is that their penis has lost length. Men also, nearly always, say that the no longer “feel like a man” when they have ED, and depression is common in men with ED. The partner of a man with ED will often wonder if they are the cause of a man’s ED; they worry he does not find them sexy or attractive, or that he is having an affair.

Whatever the reason you have it, ED is a big deal. But, it is ALWAYS treatable.

So…. how do you treat ED?

The first thing a man should try is oral medication. There are several pills available: viagra, levitra, cialis, stendra are some examples. Pills for ED are designed to improve blood flow into the penis when a man is sexually aroused. A man needs to give these medicines about an hour to get into the bloodstream before attempting sexual activity, so some planning is needed. Pills do not work well for every man, especially if he has had surgery for prostate cancer or severe erectile dysfunction. Side effects can occur such as headache, backache, nasal congestion (stuffy nose).  Also, pills can be quite expensive ($40-$50 per pill).

If a man has tried pills and they do not work, or no longer work, or are just too expensive, there are several other very effective treatments for ED.


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