Problems of achieving a satisfactory erection are fairly common. If the problem does not originate from lack of lust and is great enough to make normal intercourse impossible, the condition is called erectile dysfunction (impotence). Erection problems are caused by combined physical and psychological factors.

THE ERECTION MECHANISM

The penis has three bodies containing a dense network of blood vessels along all its length. During erection blood is filled into the vessels of these bodies. The bodies then engorge, make the penis hard and rise it up. The filling of these bodies occur when the vessels leading blood to the penis relax and vessels draining the penis constrict their volume.

Before and during erection nerves lead impulses to the genitals. The nerve ends in this area then releases the substance nitrogen oxide. Nitrogen oxide will diffuse through the genital area and the penis and stimulate the reaction of the blood vessels in the penis.

PHYSICAL CAUSES OF ERECTION PROBLEMS

Erection problems can occur because of disorders in the nervous system sending impulses to the genital area, problems with the blood supply to the penis and anatomical problems in the penis or genital area. Specific causes can be:

• Accidents, stroke, surgery or tumours hurting brain areas or areas in the spinal cord responsible for erection impulses.

• Multiple sclerosis, a disease hurting the isolating sheets around the neural fibres in the brain and spinal cord, can give erection problems.

• Accidents or diseases hurting nerves from the spinal cord to the genital region.

• Atherosclerosis caused by age or an unhealthy lifestyle, giving narrowing and hardening of blood vessels to the genital region.

• Injury to the erectile bodies caused by inflammation, accidents or diseases.

• Congenital malformations in the penis or genital region, for example hypospadias and epispadias.

• Peyronie's disease, a common inflammatory disease causing abnormal bending or twisting of the penis, and sometimes also hinder the filling of blood into the erectile bodies, sometimes gives problems for the erections.

• Circumcision causing the penile skin to be too tight, or causing extensive inelastic scars.

• Side effects of medicines, such as medications taken for high blood pressure or depression.

• Zinc deficiency.

• Heart disease.

• Diabetes causing injury to the nerves and blood vessels to the penis.

. High blood pressure (hypertension).

. Liver or kidney disease.

• Alcohol or drug abuse impairing psychological and neural functions.

PSYCHOLOGICAL CAUSES OF ERECTION PROBLEMS

Psychological causes can interfere with the erection process by distracting a man from stimuli that normally would give him sexual arousal. Psychological issues account for about 40% of erection problems. Erection problems in men under age 50 are most likely to be caused by psychological factors. Psychological causes of erection problems include:

• Anxiety for not being able to perform sexually as well as the partner demands.

• Prolonged emotional upset, such as worrying, anxiety or anger due to a man's economical, professional or social situation.

• Relationship problems, for example when the woman has different preferences of sexual practice than the man.

• A man who looses sexual desire for his partner may develop erection problems.

• Recently widowed men can get erection problems.

• Some men have difficulty having sexual intercourse with their partner after she has given birth because he does not like the changes that the birth process has caused to the woman's body.

CAUSATIVE TREATMENT

When a specific organic and psychological condition causes problems for the erections, this problem should be treated with appropriate methods that will vary according to the actual disease.

If the cause is heart disease or atherosclerosis, lifestyle changes and training adapted to the medical situation can often improve the general health situation and improve the erectile abilities.

If the cause of the erection problems is a problematic penile shape, for example curved or twisted penis by Peyronie's disease, using a mechanical penis reaction device for some time may help.

On the marked you can also find herbal products to treat injured or diseased blood vessels in the genital area. These products typically contain herbal elements that experience has proven to stimulate tissue repair in blood vessels.

POSSIBLE FUNCTIONAL TREATMENT

It is not always possible to cure the condition causing erectile problems. Still the problems can be overcome by medication that stimulates the vessels leading blood to the penis to relax and the vessels draining the penis to constrict. These drugs typically achieve this task by stimulating the release of nitrogen oxide in the genital area.

Viagra and Cialis are the best known pharmacological treatment for erection problems. In spite of what people often think, these drugs do not increase the sexual drive. If the sexual excitement is there, Viagra can help to achieve erection, if the drive and excitement lack in the first place, Viagra will not help.

There are also herbal products on the market that stimulate the erection mechanism. Erection oils give an instant erection response, but the response only last 2-3 hours. Erection or potency pills take a longer time to give effect, but the effect lasts for many hours. The herbal product will often contain components that increase the sexual excitement in addition to improving the pure erection mechanism.

If it is not possible at all to achieve erection with any treatment, surgical implants can help to make the penis stiff and raised up enough to perform an intercourse. One type of implant is partly rigid bodies that make the penis permanently partially erected. Another type of implant is inflatable bodies that can make the penis fully erected when the need rises.