Erectile Function is the complex, integrated neurovascular and hormonal process that results in the engorgement and rigidity of the penile corpus cavernosum, which is necessary for successful sexual intercourse. This function represents a precise integration of central nervous system signals, peripheral nerve impulses, and localized vascular dynamics, all modulated by circulating sex hormones, primarily testosterone. Optimal erectile function is a critical clinical biomarker of overall vascular health, endothelial integrity, and systemic endocrine balance in men.
Origin
The term is derived from the Latin erigere, meaning ‘to set up’ or ‘to raise,’ describing the physical state. The clinical and physiological understanding of this function evolved significantly in the late 20th century with the discovery of the molecular pathways involved in penile blood flow regulation, shifting the focus from purely psychological causes to identifiable physiological mechanisms. This foundational work led to the development of targeted pharmacological therapies.
Mechanism
The process begins with psychogenic or tactile stimulation, leading to the release of nitric oxide (NO) from non-adrenergic, non-cholinergic (NANC) neurons and endothelial cells in the penile tissue. Nitric oxide activates the enzyme guanylate cyclase, which increases the intracellular concentration of cyclic guanosine monophosphate (cGMP). This second messenger causes smooth muscle relaxation in the corporal arteries and sinusoids, allowing for rapid inflow and subsequent trapping of arterial blood, thereby creating the necessary rigidity against the tunica albuginea.
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