Erection problems are common in adult men, says MedlinePlus. In fact, these erection difficulties are typically temporary and may be due to alcohol, nicotine, stress, anger, fear, or medications such as digoxin or sleeping pills. Typically, men have three to five erections at night. You have a physical erection problem when you do not have these normal nighttime erections. Erectile dysfunction (ED), priapism and premature ejaculations are three specific types of erectile problems that have specific treatments.
Erectile dysfunction (ED), also known as impotence, refers to a condition in which you are unable to maintain an erection long enough to engage in sexual intercourse. According to the Mayo Clinic, you qualify as having ED when you cannot have an erection 25 percent of the time you attempt to have sexual intercourse. Causes of ED include pre-existing health conditions such as heart disease, high blood pressure, diabetes and obesity.
ED treatment includes medications such as sildenafil or alprostadil, penis pumps, surgery, penile implants and therapy, says the Mayo Clinic. Medications like sildenafil are phosphodiesterase inhibitors that promote the activity of nitric oxide in your penis. Nitric oxide is a substance that allows your penile muscles to relax. This subsequently leads to increased penile blood flow and an erection. Alprostadil is available as an injection treatment or as an intraurethral (placed into your urethra) treatment. You will inject the base of your penis with alprostadil and within five to twenty minutes, an erection results. In intraurethral treatment, you will place a alprostadil suppository into the tip of your penis (where the urethra is located). The medication is absorbed and more blood flows into your penis and an erection occurs. A penis pump is placed over your penis and creates a vacuum-type erection. Penile implants are surgically placed on either side of your penis to allow you to have an erection. Surgery can also alleviate any penile blood-blockage issues causing your ED. Lastly, sex therapy and psychological therapy sessions may help you understand your stress and anxiety that may be a contributing factor in your ED.
Priapism refers to a condition in which your erection lasts for four hours or more. According to the Cleveland Clinic, this erection is extremely painful and can even occur without sexual arousal. Sickle cell anemia (a condition of abnormal red blood cells), medications such as Thorazine, trauma, carbon monoxide poisoning, black widow spider bites and marijuana or cocaine use can all cause priapism.
Applying ice to your penis can decrease the swelling. In some cases, your doctor may inject medications called alpha-agonists which help decrease the blood flow to your penis. Your doctor may also aspirate the penis and use a needle to remove blood from it. Surgical procedures are also available. In surgical ligation, your doctor will repair the penile blood vessels that may have ruptured. He may also insert a shunt that allows blood to be diverted away from the penis.
Premature ejaculation occurs when you ejaculate earlier than you would like and your erection only lasts for a short time. This is a common occurrence in some couples, and there are specific treatments or methods to consider. MedlinePlus says that the "stop and start" method or the "squeeze" method may be effective. Both methods involve intermittent sexual stimulation to prolong ejaculation. Antidepressants such as selective-serotonin reuptake inhibitors (SSRIs) may help in delaying ejaculation, and a local anesthetic cream may help in reducing penile stimulation.