Let’s Talk About Erections

Many people assume that erectile function is only a male issue. It’s important to know that since the penis and the clitoris are analogous structures. They both contain erectile tissue, therefore either structure can experience an erection, thus any gender can benefit from learning about what goes on to get things up.

An erection requires multiple systems to be working well to both achieve and maintain rigidity for sexual activity. The right hormones need to be produced. There needs to be adequate blood supply. The nerves to the penis/clitoris have to be working well. The pelvic floor muscles need to have enough range of motion, along with strength and endurance. And of course the brain needs to be in the right headspace to allow the process to happen. 

Any impairments within these systems can lead to erectile dysfunction, which may look different for each person. 

For instance, someone may report the ability to obtain an erection, but the strength isn’t adequate or they struggle to maintain the erection. This could be due to a variety of reasons, such as the pelvic floor muscles lack the endurance to maintain the erection or they may have something like a venous leak, where the veins don't constrict enough, causing blood to leak back into the body and soften the erection. Both impairments may be happening, or they may have great pelvic floor endurance, but there is a vascular issue and they are anxious about an upcoming meeting, stressed or struggling with depression. 

There are a multitude of reasons for erectile issues, and often more than one thing can be causing the problem. This is why people often benefit from a multidisciplinary team to work with them on improving their sexual function. 

This team may include a general practitioner, a cardiologist, a urologist, a sexual medicine specialist, a sex therapist or counselor and/or a pelvic floor therapist. Depending on what is causing the issue, the providers would determine an appropriate treatment plan which might include: medications, devices such as a penis pump or ring, exercises to improve pelvic floor coordination, stress management solutions or therapy to address any trauma, anxiety or depression. 

There is no one size fits all approach, so it’s important to consult a provider to determine the best plan for the individual. 

I will end by pointing out that more research suggests that erectile dysfunction can be an early indicator of cardiovascular issues. So, if you are noticing erectile problems, it is in your best interest to speak with a provider. While it may be embarrassing to talk about, erections are a normal physiologic process and providers are trained to help! 

If you are concerned about your sexual function, consider scheduling a 30 minute consultation to discuss what might be going on and determine the next best steps! 

(As always, this post is for educational purposes only and not to be taken as medical advice and is not a medical diagnosis. Please speak with a healthcare provider near you to discuss specific concerns and questions.)