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The steps leading to an Erection

Sexual stimulation and arousal
Impulses from the brain and penile nerves
Relaxation of smooth muscles in the two spongy spaces (corpora cavernosa) in the penis
As the spaces rapidly fill with blood, the flaccid penis inflates to become stiff and elongated.
Increase in blood flow to the penis
The tunica albuginea membrane surrounding the spongy spaces trap this blood
Flaccid penis inflates to elongate and become rigid
Erection achieved

When the contraction of these smooth muscles leads to an outflow of blood, the erection is lost and the penis returns to its flaccid state.

Erectile Dysfunction

Erectile dysfunction (ED) is the repeated incapability to get or keep an erection firm enough for sexual intercourse. All over America, ED affects between 15 and 30 million men, depending on the various degrees of dysfunction. ED can either mean a total or even partial inability to achieve or maintain an erection. This gives the definition a very wide array of meaning, and makes it difficult to make estimates in terms of cases.

Causes of Erectile Dysfunction

Erectile Dysfunction can occur if any of the events in the sequence leading to an erection are interrupted. The problem may involve mental processes, nerve impulses in the brain, spine and genital area, or responses in smooth muscles, fibrous tissue, veins and arteries in and around the corpora cavernosa of the penis.

The most common causes of ED are damage to nerves, arteries, smooth muscles, and fibrous tissues, often resulting from diseases such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease. These account for about 80% of ED cases. Between 35 and 50% of men with diabetes experience ED.

Certain kinds of sedentary lifestyles, which usually contribute to heart disease and vascular problems, also raise the risk of erectile dysfunction. Smoking, obesity, and lack of exercise have been reported as possible causes of ED. Smoking affects blood flow in the veins and arteries and may cause hormonal abnormalities such as variation in testosterone levels.

Surgery, usually Radical Prostate and Bladder Surgery for Cancer can injure nerves and arteries near the penis, causing ED. Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to ED by damaging nerves, smooth muscles, arteries, and fibrous tissues of the corpora cavernosa of the penis.

In addition, many commonly used medicines like blood pressure drugs, antihistamines, antidepressants, sedatives and even appetite suppressants can produce ED as a side effect.

It is believed that psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause about 20% of ED cases. Men with a physical cause for ED frequently experience psychological reactions to some extent as well, making psychological factors the secondary cause for the problem.

Erectile Dysfunction Diagnosis

The first step conducted by a physician is a comprehensive examination to determine when and how the condition might have developed, other physical and psychological conditions and medications taken, if any. If an evident physical cause is suspected, blood tests are first taken to check hormonal levels and to eliminate probable diseases from the list discussed above.

Additional specialized clinical tests may also be done:

Penile nerve function:
Physical tests are performed to determine sufficient nerve sensation in the penis. In patients who have damaged nerves, other tests are performed to determine the normalcy of touch sensation in the genital area.

Penile nerve function:
Physical tests are performed to determine the sufficiency of nerve sensation in the genital area. In patients who have damaged nerves, other examinations are conducted to establish the level of touch sensation in the penile area.

Ultrasonography:
Duplex ultrasound is used to evaluate the adequacy of arterial circulation in the penis, i.e. blood flow, scarring of erectile tissue, signs of atherosclerosis and venous leak. The test is taken before and after injecting an external medication to check if the blood flow to the penis gets any better.

Nocturnal penile tumescence (NPT):
In general, men have five to six erections during the night, in their sleep, the absence of which may point to some problem with nerve function or arterial circulation in the genital area. Various methods are used to measure changes in rigidity and girth of the penis during nocturnal erections.

Cavernosometry:
Cavernosometry determines the vascular pressure in the penis. A dye is injected into the veins and arteries of the genital area to monitor any possible peculiarity in the arterial circulation in the penis.

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Male enhancement

Title: Male Insecurity and Jealousy
So, you finally got the girl of your dreams. She's fine-looking and sexy. She's definitely a catch! Every time you go out, other guys are checking her out. So, you hold her closer, have a protective arm around her, and cast steely "Don't you mess with my girlfriend" stares at the other guys. You closely watch her every move and feel a pang of jealousy and insecurity, even at times when it is not the least bit warranted. You constantly call her up to check up on her or count the seconds before she answers your call. You've been too paranoid too many times whenever she says she's out with her girl friends or co-workers, or if she's meeting up with a high school sweetheart or an ex-flame. You instantly erupt in jealous rage at the mention of past loves.
You feel trapped by your insecurity and direct your energy to over protectiveness and jealousy instead. So, you try to buy her time and attention by overwhelming her with the prettiest flowers, wonderful gifts, expensive dinners, and luxurious holidays. You want to control and have the upper hand in the relationship. You utilize the possess-and-isolate tactic on her. You always make excuses for her to be always with you, or to be available at your beck and call. Her girl friends are exasperated with you and upset at how possessive you are.
So where does all this insecurity and jealousy spring from? You may have bad experiences before regarding relationships and loyalty, and you ensure that it doesn't ever happen again. In turn, you intensely guarantee that you are the sole object of her desire.
Male insecurity has also been known to directly correlate with a deficiency in the size of the male member. Many men are bothered that they are not big enough or they're not gonna please their ladies with their current size. This probably explains the thriving and often lucrative business that is penis enlargement.
Another reason may be about money or resources. Many guys feel disdain, oftentimes envy, towards other men who are better off than themselves. With more money, you could probably spend lavish gifts for your girl; and with more presents, you think you make yourself highly desirable and attractive.
Men, just like women, also need to be liked. They want to be respected, adored, and esteemed. They want to be feel important and special to someone. They want to be loved and needed.
So, how would you rein in your insecurity and keep your jealousy in check? Take time to do a self-assessment. Improve your looks and learn new things. Go to the gym, join sports club, or enroll in short courses like foreign languages, arts, or even acting. More importantly, is the measure of trust and loyalty that you and your girl have for each other. Don't let your insecurities cloud your judgment and ruin your relationships. Treat her with respect as much as you would want her to do the same for you.

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