Most of us are probably aware that bloodflow is critical to good erectile function. But how, exactly?
How Stuff Works compares penile erections to inflating a balloon. Only instead of air, a penis uses blood. It contains two cigar-shaped chambers (the corpus cavernosum if you’re interested). The tubes can be either erect or flaccid depending on bloodflow, with arteries bringing blood in and veins letting it out.
The erectile process begins when these normally constricted arteries open, in response to the man experiencing an arousing stimulus. For most men, erectile dysfunction can be traced back to a problem with the arteries opening properly, and thus poor bloodflow.
New research shows an even higher degree of complication involved, with erections depending on special fibres a little like the skin of an earthworm.
In essence though: poor bloodflow, poor erectile function. And improve bloodflow, improve erectile function.
PDE-5 Inhibitors Temporarily Improve Bloodflow
This is essentially the principle Viagra and the other PDE-5 inhibitor ED drugs operate on. One of the fundamental players in the erectile process is the relatively simple molecule nitric oxide. Neural signals stimulate the release of nitric oxide which in turn stimulates the release of an enzyme which produces another chemical called cyclic guanosine monophosphate (cGMP). The role of cGMP is essentially to tell smooth muscles such as those that line the penile arteries to relax. And as they relax, bloodflow increases.
There’s another key component to this process though: phosphodiesterase (PDE) is a ubiquitous enzyme that works continually to reduce levels of cGMP as it spikes. And it’s this enzyme that PDE-5 inhibitors, well, inhibit; thus temporarily preventing the “off mechanism” for the cGMP, if you will, and temporarily causing a surge in cGMP and thus bloodflow.
It’s not just PDE-5 inhibitor drugs that work to improve bloodflow however. Other natural substances, such as arginine (causes a spike in nitric oxide production), ginseng and horny goat weed will all work in a similar way to improve bloodflow and therefore erectile function.
When men experience erectile dysfunction, there may be many reasons behind the problem. One of the most common physical factors though, particularly in older men, is insufficient penile arterial dilation.
How Vascular Diseases Affect Bloodflow
There are also specific medical conditions that can worsen bloodflow. Vascular diseases are any that affect blood vessel health, restricting bloodflow and impacting on the health of the heart, brain and kidneys, as well as erections. It is believed that vascular diseases may play some role in between 50-70% of all men affected by erectile dysfunction.
Some common vascular diseases are:
- Hypertension – high blood pressure
- Hypotension – low blood pressure
- Atherosclerosis – hardening and narrowing of arteries, due to build-up of vascular plaque
- Peyronie’s disease – scar tissue in the sheath surrounding the corpus cavernosum
- Coronary artery disease – often referred to simply as heart disease
- Peripheral vascular disease – narrowing of blood vessels in extremities, particularly lower extremities.
Genetics play a significant role in the risk of developing vascular disease. Lifestyle factors such as high cholesterol, obesity and smoking however all contribute to and worsen vascular disease, and erectile dysfunction as a result.
Venous Leaks and Poor Bloodflow
Another physical cause of erectile dysfunction is venous leaks. A venous leak is basically what it sounds like – a leak in veins’ bloodflow, and can occur in many locations, including the penis. This doesn’t mean the veins in your penis have a hole in them though! A venous leak has more to do with the inability of veins to constrict properly and prevent blood flowing back out through them. It can occur as a consequence of vascular disease, particularly diabetes or peyronie’s, or general poor smooth muscle relaxation and control.
It’s not just vascular and muscular problems that can lead to venous leaks however. Certain neurological disease or high levels of anxiety, stress, can also lead to venous leak problems, as these conditions often impede natural smooth muscle relaxation, and therefore adequate bloodflow, and finally healthy erectile function.
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