Basic Information
Chinese name: erection
Object: male sex organs
Clinic: Urology, Andrology
The principle of erection
Gold Viagra mghjvg.gadc. The corpus cavernosum is composed of smooth muscle cells and connective tissue to form the trabecular corpus cavernosum. The corpus cavernosum nerve contains two components, sympathetic and parasympathetic. The former comes from the spinal cord T11 to L2, and the latter comes from the spinal cord S2-4, which stimulates the sacral The parasympathetic nerves in the upper part of the penis can swell, and the stimulation of the sympathetic nerves in the chest and waist will weaken the penis. The dorsal penile nerve transmits sensations in the skin of the body and glans penis and in the urethra and corpus cavernosum.
Penile erection is a complex psycho-physiological process, which is essentially a series of neurovascular activities.
The parasympathetic nerve is excited, the smooth muscle cells of the small arteries and vascular sinuses in the corpus cavernosum relax, the vascular sinuses of the corpus cavernosum expand, the arterial blood flow increases, and the corpus cavernosum is congested and swelled. The swollen corpus cavernosum compresses the small veins under the albuginea, closing the venous outflow tract, and the contraction of the pelvic floor muscles can also compress the corpus cavernosum, making it further swell and hard to produce an erection. The sympathetic nerves are excited, the smooth muscle cells of the arterioles and vascular sinuses contract, the pressure in the cavernous body decreases, the veins open, and the penis begins to weaken. Therefore, smooth muscle relaxation, arterial blood flow velocity and venous blood flow resistance are the three elements of penile erection.
When the smooth muscle cells of the arterioles and vascular sinuses in the corpus cavernosum relax, the brain or the penis receive local stimulation, and the impulses are sent from the hypothalamus or the lower center of the sacral medulla, and the nerve impulses are transmitted to the corpus cavernosum. Under the catalysis of nitric oxide synthase (NOS), the synthesis and release of nitric oxide (NO) increases, NO enters into smooth muscle cells, activates guanylate cyclase (GC), and increases cGMP in smooth muscle cells, which activates protease K, acting on calcium ion channels, reduces the intracellular calcium ion concentration and relaxes smooth muscle cells. The cGMP in the smooth muscle of the corpus cavernosum is degraded to GMP by phosphodiesterase 5 (PDE5) and inactive.
In addition to NO, substances related to smooth muscle relaxation and penile erection include acetylcholine, vasoactive intestinal peptide, calcitonin gene-related peptide, PGE2, cAMP, etc.; substances related to smooth muscle contraction and penile weakness include norepinephrine, endothelial protein, PGF2α, etc. [1]
degree of erection
Normal: normal sexual desire, rapid erection response, the duration of erection can disappear after ejaculation or interruption of sexual intercourse, erection hardness can be freely placed in the vagina, sexual pleasure is good, the frequency of sexual intercourse has not changed significantly, and the erectile response to masturbation is normal.
Ⅰ° (mild): The sexual desire is basically normal, the erection response is rapid, the duration of erection is unstable, sometimes unsustainable, and sometimes the hardness of erection cannot be inserted into the vagina (occasionally once or twice is normal, not in this case) ), the sexual pleasure is basically normal, the frequency of sexual intercourse is less than in the past, and the erection response from masturbation is basically normal. For erectile difficulties of this level, it is generally caused by temporary psychological stimulation. As long as the heart knot can be resolved, it can recover on its own. I hope readers can make a rational judgment on this point, so as not to cause unnecessary panic.
Ⅱ° (moderate): Decreased sexual desire, slowed erection response, often unsustainable erection, often insufficient erection hardness to insert into the vagina, diminished sexual pleasure, significantly reduced sexual intercourse frequency, and reluctant erection response to masturbation.
Ⅲ° (severe): The desire for libido disappears, and there is no erection response. Therefore, it is impossible to talk about the continuation of the penis erection. It cannot be inserted into the vagina at all, and there is no sexual pleasure.
Diagnosis of erectile difficulties should be judged by several parameters such as ① the speed and slowness of penile erection response, ② the duration of the penile erection, and ③ the hardness of penile erection. Any difficulties in these aspects can be considered as abnormal penile erection function.
In addition, attention should be paid to understanding whether the occurrence of difficulty in arousal is sudden (most of these are caused by psychological stimulation, belonging to spiritual impotence) or unconsciously and gradually aggravating step means there is an organic problem), so as to facilitate the identification of impotence type. The erectile difficulties of Ⅰ° and Ⅱ° are mainly due to mental impotence, and may also be the early stage of organic impotence lesions. Ⅲ° are more common with organic impotence.
Clinically, genital size is a topic of great concern to men. After a man enters puberty, under the action of hormones in the body, testes, genitals, scrotum, prostate, etc. all begin to develop and grow. This process generally lasts until the age of 18, and some can last until the age of 20. After maturity, the average length of the male penis is 5 cm in a soft and relaxed state. It is generally considered that the length of the penis in the resting state is between 4.5 cm and 8.5 cm. cm or so is normal. Male testicles are generally the size of a quail egg, which can be connected to a circle with the index finger and thumb. This circle is about the size of the testicle.
Improve erection
Chinese medicine diet
Wolfberry
Flat in nature and sweet in taste, it has the functions of tonifying the kidney and liver, improving eyesight, strengthening muscles and bones, eliminating low back pain, and prolonging life and longevity after taking it for a long time. Especially for middle-aged and elderly people with kidney deficiency, it is the most suitable food. For example, "Materia Medica Tongxuan" records: "Lycium barbarum, nourishing the kidney and nourishing essence, strong water, strong bones, and thirst, dizziness, back pain and knee pain are all cured." "Ben Cao Jing Shu" also said: "Lycium barbarum, It is an essential medicine for the deficiency of the true yin of the liver and the kidney, and the lack of internal heat.
cowpea
Also known as rice beans, long beans. It is flat in nature, sweet in taste, can invigorate the kidney and invigorate the spleen. It is suitable for people with kidney deficiency except for those with spleen deficiency. It is the most suitable for kidney deficiency, thirst, nocturnal emission, white turbidity, or frequent urination, and women's leucorrhea. "Compendium of Materia Medica" once recorded: "Cowpea regulates the qi in the middle, nourishes the kidney and strengthens the stomach, and generates the essence." "Sichuan Traditional Chinese Medicine" also says that it can "nourishe yin and kidney, strengthen the spleen and stomach, and treat leucorrhea, white turbidity and nocturnal emission due to kidney deficiency." It is flat in nature, sweet in taste, and has the dual effects of tonifying the kidney and strengthening the spleen. For example, "Compendium of Materia Medica" records: "Cowpea nourishes the kidney, strengthens the stomach, and generates the essence. Mrs. Xilulian taught people to invigorate the kidney qi, boil cowpea in hollow every day, and eat it with less salt." Modern "Sichuan Traditional Chinese Medicine" also introduces: "Cowpea nourishes yin. Nourishes the kidney, strengthens the spleen and stomach. Treats leucorrhea, white turbidity and nocturnal emission due to kidney deficiency." It is also suitable for those with kidney deficiency and frequent urination.
He Shou Wu
It has the functions of invigorating the liver and kidney, nourishing essence and blood, and has been used by physicians in all dynasties for people with kidney deficiency. Ming Li Shizhen said: "He Shou Wu, can nourish blood and liver, strengthen essence and kidney, strengthen muscles and bones, black beard and hair. It is a good nourishing medicine, and its power is above the medicines of Rehmannia glutinosa and Asparagus." Huang Gongxiu, a famous doctor in the Qing Dynasty, also said : "He Shouwu, all the books say that nourishing water and nourishing the kidney, black hair lightens the body, and I highly appreciate it." Anyone with kidney deficiency has early gray hair, or weak waist and knees, sore muscles and bones, or men's nocturnal emission, and women who take it with them, eat it. should.
sea cucumber
Warm in nature, salty in taste, although soft in texture, it can invigorate the yang qi of the kidney, and is a product for both kidney yin and kidney yang. For example, it is said in "Materia Medica Congxin": "Sea cucumber tonifies the kidney and nourishes the essence, aphrodisiac treatment of atrophy." Therefore, all people with kidney deficiency should eat it. Sea cucumber is rich in arginine, known as arginine monopoly. Arginine is the main component of male sperm cells, which can improve the conduction of brain and gonad nerve function, slow down gonad aging, and improve erection ability.
way of erection
psychogenic erection
When a man excites the cerebral cortex due to the stimulation of hearing, sight, smell, thinking, and imagination related to sexual content, and it is transmitted through the thoracolumbar erection center of the spinal cord, and acts on the corpus cavernosum, the arteries and blood vessels will expand, and a large amount of blood will flow. It flows into the corpus cavernosum; when the venous blood vessels constrict and the blood flowing out of the corpus cavernosum decreases, the blood is fully retained in the abundant blood vessels and sinusoids in the corpus cavernosum, so that the penis quickly produces a psychological erection. On the contrary, when the arterial vasoconstriction reduces the blood flow into the corpus cavernosum; when the venous blood vessels dilate, the rich blood flow retained in the corpus cavernosum is quickly returned, and the penis recovers its weakness.
reflex erection
When the external genitalia is subjected to local stimulation such as direct touch, walking friction, or internal stimulation of the rectum and bladder, it can cause reflex erection, which stimulates its sexuality by stimulating the lower erection center of the sacral cord in the spinal cord. Realized after excitement.
Penile erection is innate, and male fetuses can get erections in the womb. A little boy may also have a hard erection when he urinates after birth, and sometimes lying there peeing can cause the urine to spray straight into the adult's face like a spring, often bringing unexpected laughter and joy to parents who are changing diapers, but The erection at this time does not have any "sexual" meaning.
Any stimulation of the genitals themselves can cause reflex erections, which are regulated by the pudendal nerve and the sacral erection center. These two kinds of psychological and physiological stimuli can act independently, but also can influence each other and be involved in sexual activities together.
For example, when the spinal cord injury occurs above the thoracolumbar region, the patient can only have an erection under the condition of physical stimulation of the genitals, and the ability to have a psychological erection disappears. When motor neuron damage occurs below the level of the thoracolumbar region, stimulation of the genitals cannot cause erection, and 24 to 57% of patients still experience psychological erection, that is, psychological stimulation can be transmitted through the thoracolumbar pathway. When spinal cord injury occurs in the lumbar 2 to sacral 1, both psychological and reflex erections exist, but the two cannot be coordinated, and it is impossible to achieve ejaculation orgasm through genital stimulation.
nocturnal erection
In addition to psychological erection and reflex erection, normal men also have a type of nocturnal erection. Men's sleep is always in the alternation of REM sleep and slow eye movement sleep, and they also experience erection—weakness—re-erecting— ─The physiological process of re-weakness, which is medically called nocturnal erection of the penis, is a normal physiological process for healthy men. Generally speaking, men will have 4 to 6 erections every night, 20 to 40 minutes each time, and a total erection of up to two and a half hours. This is because the brain always inhibits the occurrence of sexual reactions during the day, otherwise men will inevitably encounter embarrassing situations from time to time, but after falling asleep, this inhibitory function of the brain disappears, and the penis will spontaneously have an erection response, which is completely normal. no need to worry.
The time, frequency, and hardness of nocturnal erections decrease with age, and are strongest during puberty to around the age of 20. Whether it is psychological or reflex erection, the penis quickly returns to normal after the external stimulus is removed. Nocturnal erections are no exception. After a period of erection, the penis will definitely weaken automatically, because if the blood stays in the cavernous body for a long time, the blood will be hypoxic and accumulate a large amount of metabolic waste, which is not good for the tissue, and necrosis will occur in severe cases.
There is a disease of priapism like this. The patient shows that the penis is swollen, hard, painful, and blue-gray for more than 4 to 6 hours. This is an emergency in urology, and it is necessary to go to the hospital for emergency treatment as soon as possible. Therefore, the penis is not erected all night, but must be stretched and flaccid.
Early morning erection is a clinically meaningful physiological phenomenon. Some doctors have specially studied this phenomenon and found that during the period of illness, the early morning erection will weaken or disappear; and after the body recovers, the early morning erection will also resume. Therefore, the phenomenon of early morning erection can be used as a reference indicator of male health status. The presence or absence of early morning erection can also be used as a reference indicator for judging male sexual function status.
erectile dysfunction
There are two common disorders associated with erections:
One is impotence disease: that is, men can not achieve or not enough to maintain an erection to complete sexual intercourse, most of which are spiritual, but also organic.
The other is priapism: refers to the erection of the penis in the absence of sexual desire and non-coital sex, and can produce pain after erection, often organic.
Erectile dysfunction can affect sexual intercourse, and can cause nocturnal emission, premature ejaculation, non-ejaculation, retrograde ejaculation and painful ejaculation. It is the most common disease of male sexual dysfunction.
erection time
1. Develop good living habits:
Frequent smoking and drinking are the so-called hobbies of most men, but male friends simply don't know that this small hobby will also affect their sex life. Regular smoking and drinking will cause a lot of harmful substances such as alcohol and nicotine in the body, which will affect sperm, testicles and peripheral blood vessels of reproductive organs. The erection time is not long. Therefore, if a man wants to prolong the erection time, he must develop good habits and quit smoking and drinking.
2. Relieve the psychological burden:
In the face of fierce social competition, men will inevitably have some psychological burdens, such as fatigue, tension, anxiety and so on. There may also be problems in the relationship between husband and wife, causing physical and mental harm to men. Therefore, if a man wants to prolong the erection time, he must relieve the psychological burden and have a good and peaceful state of mind.
3. Good physique:
If a man suffers from certain diseases, it will also affect erection. Therefore, if a male friend suffers from a disease, it should be treated as soon as possible. If there is no disease, you should also exercise regularly, and insist on fitness to benefit your sex life. Those who participated in sports were 40% more likely to be excited and 25% more likely to achieve orgasm compared with those before sports. After exercise, the human body will release a pleasant hormone. At the same time, exercise can enhance the blood supply capacity of the heart to the sexual organs. The more blood supply, the longer the erection time.
4. Regular sex life:
Stick to a normal sex life. This stimulates the production of male and female hormones to maintain a balance in the body, improves local blood circulation due to the increased blood flow to the sex organs, and keeps the sex organs elastic, thus delaying atrophy and prolonging the erection time of men.
