Sexual activity is the important part of human life. Erectile dysfunction becomes the serious issues that is a widespread and under-reported disorder affecting millions of men. With the aging of our population and age-related comorbid conditions, this problem is only going increase in magnitude.
To understand the assessment and treatment of sexual dysfunction , it is necessary to first review development of an erection.
The Development of an Erection
could happen in 3 circumstances as follows:
1. Psycologinic Erection
is a vascular event initiated by neuronal action and maintained by a complex interplay between the central nervous system and factors. It may occur as a result of genital stimulation or psychic input (fantasy sight ,sound ,or smell ). Stimuli are processed in the hypothalamus, and neural impulses are transmitted to the thoracolumbar and sacral erection centers. The thoracolumbar center provides sympathetic innervations that maintains penile flaccidity .The sacral erection center provides parasympathetic innervations that leads to erection . (Increased parasympathetic activity result in and increased production of nitric oxide and vasoactive polypeptide. This result in an increased production of cyclic guanidine monophosphate : cyclic GMP ,that reduces intracellular calcium, resulting in smooth muscle relaxation and increased blood flow through the pudendal and cavernous arteries .)