What Causes an Erection?


An erection begins when the penile smooth muscle relaxes enabling blood to fill the corpus cavernosum, two cylindrical “caverns” of spongy tissue running within the penis. Stage two of the erection process occurs with this infilling of the corpus cavernosum.  The inflow of blood expands the spongy tissue, which begins to pinch off the emissary veins of the penis, decreasing outflow and – voila! – The erection begins to build. Continue reading this article to find out what the top erection killers are and how to avoid them.


Why Can’t I Maintain an Erection? Top Erection Killers


It is estimated that some degree of Erectile Dysfunction (ED) affects half of all men over the age of 40 and that 150 million men worldwide suffer from ED. There are many reasons a man might not be able to maintain a healthy erection, many of which play into our daily habits and lifestyle choices. If you are having trouble getting or maintaining an erection, consider testing for ED, as an imbalance of hormones could be the root of the problem. Many things that have the potential to hurt our general and sexual health are culturally acceptable so they simply never cross our minds.

  1. Low Testosterone: Testosterone plays a critical role in our sexual health and can be directly linked to libido. Not only do lower levels of testosterone equal lower sex drive, but also it can lead to Venous Leakage. This condition is characterized by the inability to “pinch off” emissary veins that carry blood away from the penis. This results in blood leaking out of the corpus cavernosum as quickly as it can be filled, making a lasting erection impossible to maintain. If you are having erectile difficulties a simple Testosterone Test is a great first step on the road to treatment.
  2. Loss of Morning Erections: Morning erections, or the lack thereof, can be a good way to begin troubleshooting if you have psychological erectile dysfunction. The idea is that if you can achieve an erection by any means, nighttime or otherwise, then your issue is probably more mental than physical. Morning erections oxygenate erectile tissue and fight off penile fibrosis, keeping the penis elastic and healthy.
  3. High Blood Pressure: High blood pressure often results in hardening arteries, constricting blood vessels, and damage to the thin membrane that lines our hearts and veins. This restricts the amount of blood your body can readily provide to your penis when it is “go time.” Not only can high blood pressure kill an erection, but can lead to a host of other, much more immediate, medical complications including heart attack and stroke.
  4. Any Cardiovascular Risk Factor: Almost anything hard on the heart and cardiovascular system is going to lead to erectile dysfunction. The reason is simple: erectile dysfunction is strongly related to endothelial dysfunction where the delicate lining of your arteries becomes damaged and does not output nitric oxide as it should. This is the primary reason that lifestyle is so critical: exercise, weight management, and diet all powerfully affect how your body carries blood and oxygen to your organs.
  5. Cholesterol Management: High cholesterol has been linked to erectile dysfunction due to its direct correlation with elevated LDL or “bad cholesterol.” LDL carries cholesterol to the arteries which, when oxidized, damages artery walls. Not to be confused with HDL, which helps the body get rid of excess cholesterol, high levels of LDL can wreak havoc on your heart, cardiovascular system, and in turn your erectile health.
  6. Bike Seats: Many standard bike seats can damage the pudenda nerve that is connected to the penis. If you have done a lot of bike riding recently and have erectile dysfunction, this is something to consider. The solution can be as simple as changing out your bike seat.
  7. Bisphenol-A and Phthalates: Our modern environment is filled with toxins that have been proven to damage the reproductive and sexual functions of animals, and as primates, men are no exception. Bisphenol-A and Phthalate are chemical compounds used in the production of polycarbonate plastics that litter our world today. These chemicals are filled with endocrine disruptors and xenoestrogens that, over time, can severely impact one’s hormonal and sexual health.
  8. Prolactin: Prolactin is a hormone that stimulates breast development and milk production in women; it serves no known normal function in men. However, High Prolactin can decrease testosterone, lower libido, and cause sexual dysfunction. This is because High Prolactin suppresses the secretion of gonadotropin-releasing hormone, which stimulates the production of testosterone in men and estrogen in women.
  9. Estradiol (E2): Estradiol is the primary form of estrogen during our reproductive years. In men receiving Testosterone Replacement Therapy (TRT), the body can sense increasing levels of testosterone, and aromatizes 0.4% of it to estradiol to compensate. Very high and low E2 in relation to testosterone levels can sabotage TRT results, leading to diminished libido. Testing for ED will give you a good idea of what hormones you have an excess or lack of.
  10. Excess Weight: Being overweight can lead to a plethora of health complications including heart disease, high blood pressure, diabetes, and many more. Excess weight has also been proven to lower testosterone, increase estrogen, raise inflammation and boost insulin levels. In conjunction with one another, all these things can wreak havoc on your sex life.
  11. Smoking: Not just cigarette smoke, but any sort of burning inhalant is bound to damage your lungs and cardiovascular system. Smoke can also cause arteries to constrict and narrow, allowing less blood flow to the penis.
  12. Medications: Many, many medications will kill erections. Some lower testosterone. Some raise prolactin. Some have a sedating effect by raising serotonin levels. Some alter dopamine functions. The bottom line is that if you are on medication and having erectile difficulties, this is one of the first places that you should look.
  13. Depression: Depression is an acutely debilitating condition, not just mentally, but physically as well. Depression causes stress to the body, which, in turn, lowers testosterone. Depression also correlates with heart disease, as depressed individuals are less likely to be consistently physically active. Depression also elevates cortisol levels, which destroy neurons in the brain. All of these factors can lead to erectile dysfunction, which can often worsen depression. This bidirectional relationship reinforces the need to take care of one’s mind as well as body.
  14. Recreational Drugs: Many men do not realize that even something as relatively benign as marijuana use can affect their sex life. However, it has been proven to lower testosterone and damages the body’s cardiovascular system. Harder drugs, such as cocaine, heroin, ecstasy, or prescription painkillers can have even more detrimental effects. They greatly increase one’s risk of developing heart disease, cause plaque buildup on artery walls, and severely reduce ejaculatory volume. In short, drugs age the body faster than normal; and that includes the penis. Drugs destroy gonad function, lower testosterone levels, and can lead to heart failure, so think long and hard before indulging in your favorite recreational substances.


Does More Testosterone Equal a Better Sex Life?


As we’ve discussed, testosterone plays a critical role in stimulating sex drive and developing and maintaining erections. Low levels of testosterone have been directly linked to health conditions and dulled libido. However, this is not indicative of a simple “more is more” relationship between T and sexual health. Testosterone is a hormone that must be balanced properly, as an influx of it signals your body to increase the production of estradiol and prolactin. Make sure to closely monitor your T levels with a testosterone test. To achieve ideal results, it is important to keep testosterone levels between 500 and 1000 ng/dL., while ensuring your levels of estradiol and prolactin do not proportionately increase. It is not uncommon for certain prescription medications to interfere with TRT as well. Many antidepressants, blood pressure medications, and cholesterol-lowering agents have been known to dampen sex drive, even with the use of testosterone replacement. Finally (and most importantly) make sure you are attracted to the person you are intimate with. Lack of attraction to our sexual partners can be the biggest hurdle in achieving a strong erection. All the testosterone and lifestyle changes in the world won’t result in an erection if you simply don’t want to have sex with someone. Porn addiction has also been linked to ED, as it desensitizes us to nudity and intercourse. While there are many physical contributors to ED, there are unquestionably psychological elements as well. So before testing for erectile dysfunction make sure that you are taking care of your body and mind, while properly balancing the hormones your body needs for sexual activity.