by Irwin Goldstein
and The Working Group for the Study of Central Mechanisms
in Erectile Dysfunction
wrote.
to erection problems.
rate.
Dynamic Balance
function.
During an erection,
the penis not only receives
penis.)
preserved.
extensive it is.
an erection is possible.
of proerectile neurotransmitters.
J O H N W. K A R A P E L O U
interest in children.
10
gratification.
11
ENGORGEMENT begins
when nerves release
transmitters that diffuse
into the smooth muscle
cells around the arteries in the penis, causing
the normally contracted
cells to relax and blood
to flow in (top). As they
relax, the muscles elongate, pushing against the
veins that drain blood
from the penis. The blood
becomes trapped in sinusoidsthe chambers between muscle cellsand
the penis becomes erect
(bottom).
12
to the penis.
demand, in response to mental imagery or nonsexual cues. In one study, men were instructed to
use their minds to arouse themselves in exchange
for a financial reward. When they were given feedback on their performance via a light display, they
rapidly learned to increase their erectionsin the
absence of direct physical stimulationthrough
the use of imagery and fantasy techniques. To
keep their motivation high, the men earned fi13
y understanding the role of the central nervous system in controlling erection and other
14
pathways.
15
IMPOTENCE increases with age, according to several surveys. In 25 years, given the aging of the worlds population,
it is estimated that the condition may affect more than
330 million men.
opposed to 31 percent.
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dysfunction.
hours.
17
The Authors
Further Information
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