The penis is an unusual piece of engineering in that it is the only part of the male anatomy that is hydraulically actuated.
There is actually very little muscle associated with an erection. This has the handy effect of allowing the penis to grow firm enough for intercourse when needed and then to return to a flexible form far less likely to be damaged while chasing a wildebeast across the plain, or, leaning over a desk while day trading.
This feat is accomplished through the control of blood flow in and out of some specialized sponge-like tissues in the penis called the corpus cavernosum. When the penis is erect, these tissues are engorged with blood like a fully inflated balloon. The control over this process begins in the brain.
Three expandable cylindrical formations actually lie along the length of the penis holding blood during erection. The two corpora cavernosa lie along the penis shaft, from the pubic bones to the head of the penis, where they join.There is one smaller such region (the corpus spongiosum) along the bottom of the penis, which contains the urethra.
These formations are made of a sponge-like tissue containing irregular blood-filled spaces lined by endothelium and separated by connective tissue septa. .
When a man becomes sexually stimulated either through physical contact or other sensory stimuli, a signal is sent from the brain to endothelial cells in the penis to release nitric oxide (NO).
The NO release causes a rise in cyclic guanosine monophosphate (cGMP), which in turn causes the smooth muscles of the penis to relax and allow a dramatic rise in blood flow. This process is limited by a specific phosphodiesterase (PDE5) enzyme that breaks down cGMP and recycles it.
At the same time, the pressure of the now-filled corpus cavernosum compresses the veins that normally drain the blood from the penis so that the penis will remain engorged as long as the release of NO continues.
If stimulation is discontinued, the release of NO will taper off and levels of cGMP will follow with the contraction of smooth muscles and a reduction in intercavernousal pressure (ICP). The penis will return to its flaccid state through venous drainage. Ironically, this means that an erect penis is actually a relaxed penis.
If we want to enhance the erectile response, we can look to influence the system at a couple of points.
- The first is to increase the amount of nitric oxide or cGMP produced in response to stimulation.
- The second is to impede the breakdown of cGMP by inhibiting the production of PDE5 and a third is to enhance the control signals from the brain itself.
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