Erectile dysfunction (ED) is a common condition that affects many men, particularly as they age. In fact, approximately 50% of men over the age of 50 and up to 86% of men over 80 experience some form of ED. While the condition can feel frustrating and discouraging, understanding how an erection works—and what can interfere with the process—is an important first step toward effective treatment.
As a vascular surgeon who specializes in ED, I work with patients every day who are searching for answers. This article will help break down the basics in a way that’s simple, relatable, and medically accurate.
How Does an Erection Occur?
An erection begins with sexual arousal, which triggers a complex interaction between your nervous system, hormones, and blood vessels. The key to a successful erection lies in healthy blood flow and proper blood retention within the penis.
Here’s a basic analogy: think of the penis like a tire that needs to be inflated.
Step 1: Blood Inflow (Like Air Filling a Tire)
When arousal occurs, the brain signals arteries in the penis to relax and open, allowing blood to rush into the erectile tissue. This is similar to pumping air into a tire—the penis expands and becomes firm.
Step 2: Blood Retention (Sealing the Tire)
To maintain the erection, veins that usually drain blood from the penis constrict, keeping the blood inside. This is like sealing the valve on a tire to keep the air in. As long as the blood stays in the erectile tissue, the erection is sustained.
What Can Disrupt This Process?
When the system is working well, the result is a firm and lasting erection. But disruptions in either blood inflow or blood retention can lead to ED.
Penile Arterial Disease (Blocked Arteries)
If arteries supplying blood to the penis are narrowed or blocked, blood flow is insufficient. This is like trying to inflate a tire with a clogged or broken pump—you may get some air in, but not enough to fully inflate it. This condition is common in men with diabetes, high blood pressure, or a history of smoking.
Penile Venous Leak (Inadequate Blood Retention)
Even if blood flow into the penis is adequate, some men can’t maintain an erection because the veins don’t properly trap the blood. This is like a tire with a slow leak—no matter how much air you pump in, it won’t stay inflated for long. Venous leak is a frequently overlooked cause of ED.
Understanding the Root Cause of ED
ED is not just about performance—it’s often a sign of an underlying vascular issue. Understanding this helps shift the focus from symptom management to treating the true cause. At the Vascular Institute for Erectile Dysfunction, we use advanced imaging and diagnostics to determine whether your ED is due to arterial insufficiency, venous leak, or both.
With this knowledge, we can create a personalized treatment plan that may include minimally invasive procedures to restore healthy blood flow or correct venous insufficiency.
Take the First Step Toward Recovery
If you’re struggling with ED, don’t wait to seek help. The earlier we understand the cause, the sooner we can begin targeted, effective treatment.
Schedule a consultation today and let’s take the first step—together.
— Dr. Khalil Masabni
