A persistent erection that makes sexual intercourse complete and complete is perhaps the dream of many men. Unfortunately, it is not achievable for everyone. Every tenth man aged 21 to 29 complains of erectile dysfunction, every fifth at the age of 30-35, and almost every second at the age of 40-70, according to the World Health Organization.

Huseyin Sadykov, doctor of the highest category, leading urologist-andrologist of the Nova Clinic network of reproduction and genetics centers, spoke about the causes of the disorder, the impact of lifestyle and stress on erection, and modern methods of treatment.


Male arousal, like female arousal, starts from the head, for example, during foreplay, fantasy, watching a video of the corresponding nature, etc. Then parasympathetic nerve impulses send signals to the nerve endings located in the mucosa of the cavernous (cavernous) bodies of the penis and their smooth muscles relax (the cavernous bodies form the trunk of the penis and provide its blood supply). As a result, the bloodstream of the penis expands and fills with blood, while the venous outflow is disturbed. Those. blood comes to the penis, but does not leave immediately if everything is in order with an erection.

Before orgasm occurs, the muscles of the perineum begin to contract, and this provokes additional compression, i.e. at this moment the member is maximally tense.

After orgasm, the erection weakens under the influence of the sympathetic nervous system, which leads to relaxation of the muscles of the cavernous bodies.


There are several types of erectile dysfunction.

“In the psychogenic form, depression, stress, the so-called misfires during intercourse become the cause,” says urologist-andrologist Huseyin Sadykov. – Often, psychological problems are the basis, for example, the fear of failure. This is especially true for young people who are just starting to have sex. Such situations are also possible due to fatigue, etc.

Organic erectile dysfunction can be venogenic or arteriogenic. In the first case, venous leakage occurs, which contributes to the rapid outflow of blood. In the second case – insufficient blood supply to the cavernous bodies.

Physiological causes include hormonal changes, pathologies of the genitourinary tract, cardiovascular diseases, diabetes mellitus, and even overweight.

In the case of severe violations of all of the above forms of erectile dysfunction, a complete lack of erection occurs, the doctor adds.

Any violation is always a reason to see a doctor. It is important to find out why such changes occur and eliminate the causes in a timely manner.


The first mention of erectile dysfunction was noted in the manuscripts of ancient Egypt. Since then, attempts to improve erections have been hampered by the lack of effective drugs.

A breakthrough occurred only at the end of the 20th century, when sildenafil was synthesized, later tadalafil, vardenafil and udenafil appeared. These drugs are called phosphodiesterase type 5 inhibitors and are designed to treat erectile dysfunction directly.

Erectile dysfunction is a precursor to coronary heart disease. In this regard, the use of type 5 PDE inhibitors to improve erection can also be considered as the prevention of myocardial infarction, hypertension, acute cerebrovascular accident.

Venogenic erectile dysfunction, when the penis relaxes prematurely due to rapid blood leakage, is also treated with the above drugs or surgically. In this case, ligation (ligation) of the deep dorsal vein is performed. As a result of the operation, the pathologically high outflow of blood stops, the quality and duration of the erection increases.

Recently, non-pharmacological methods of treatment have also become popular, for example, this is extracorporeal shock wave therapy, which is called deep micromassage. The procedure improves blood circulation, promotes the growth of new capillaries, which, in turn, favorably affects the restoration of erection. In addition, SWT has an anti-inflammatory and anti-edematous effect, reduces pain.

Injection treatment for erectile dysfunction is the introduction of a cacheject into the penis. This is a drug that relaxes the muscles of the corpora cavernosa, increases blood flow and improves microcirculation. The doctor makes the first injections, then, after a detailed briefing, the man can inject himself.

And the last method of treatment, the most radical, is penile prosthetics, if medications and procedures do not help. In this case, surgeons place implants in the area of ​​the cavernous bodies of the penis. Thus, an erection will always be ensured.


The peak of sexual activity occurs at the age of 19, after which the level of testosterone gradually decreases. A healthy lifestyle can support men’s health: active sports, a balanced diet, quitting smoking and alcohol, monitor weight and control chronic diseases.

It will also help to deal with anxiety and stress. Remember, contacting a psychologist is not ashamed, this is normal.