What is Necessary for Erections to Occur Under Normal Conditions?

by Alex Shteynshlyuger MD

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5211.

How Do Erections Occur?

Under normal conditions, men require visual, mental or tactile (touch) stimuli for an erection to occur.  What you see, what you think about and what you feel when you touch someone are the reasons you’re able to achieve an erection.

Signals from your eyes, brain, and skin activate a neural pathway that causes small molecules called neurotransmitters, including nitric oxide, to be released from the blood vessel walls of the penis. The release of nitric oxide (NO) in turn causes blood vessels to dilate. Increased blood flow to the penis leads to engorgement or enlargement and hardening of the penis, what we call a ‘hard erection.’

What Causes Erection Problems or ED in Men?

thinking_sex_shutterstock_71881087Most common cause of erectile dysfunction (ED) is a failure of blood vessels to dilate.  This is usually caused by peripheral vascular disease or microvascular disease as a result of hypertension or cholesterol plaque build-up in blood vessels.

Failure of neural pathways can also occur but less commonly.  This can happen in patients with neurological disease (MS, spinal cord injury, peripheral nerve injury after prostate surgery, diabetes, depression, etc).  Anxiety and stress can cause a similar problem leading to ED which is very common in younger men.

Read about risk factors for ED and prevention of erectile dysfunction.

What is Necessary to Get Hard Erections

For a man to obtain a hard erection, a few things are required.  First, one must have stimulation of some sort to provoke an erection. This can be a visual sight, a mental image or a touch of the genitals or even skin touch by a partner.

The blood vessels need to be wide enough and to be able to widen to allow increased blood flow to the penis.  If the blood vessels are clogged or diseased and cannot expand to allow more blood to flow to the penis the erection will not occur.  In addition, the ‘shell’ of the penis needs to be strong enough to prevent blood from leaving the penis faster than it comes. When the penis ‘shell’ is not working well, men have what is called a ‘venous leak”.

What You Need to Know:

  1. Good Workouts Lead to Better Sex
  2. How is impotence Diagnosed?
  3. High Blood Pressure is a Cause of Erection Problems
  4. Low Libido and Sexual Interest

Learn More About:

  1. Second Opinion Urologist for ED in NYC
  2. Top 5 Causes of ED
  3. Prevention of Erectile Dysfunction
  4. New Treatment for Erectile Dysfunction without Medications
  5. Testosterone and Sex
  6. Medications for ED

Dr. Alex Shteynshlyuger is a board-certified urologist, who specializes in all aspects of care for sexual problems in men including ED, premature ejaculation and other sexual concerns.  He has successfully treated hundreds of men with sexual problems including ED and poor libido. We see patients from all parts of New York City (Manhattan, Brooklyn, Queens, Bronx, Staten Island), Long Island, Westchester and New Jersey as well as other parts in the USA, Canada, South America and the Caribbean and other international patients. We also offer emergency care for men with urological problems.

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5211.


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