Will we ever be able to produce something capable of making us reach the optimum of one of humankind's most basic needs? Will there always be a side effect?
Since the beginnings of civilization, people have been obsessed about their sexuality. Men and women have always tried to achieve a maximum amount of pleasure in any possible way. For human beings this is obtained through the orgasm. Humans usually attain this is goal through sexual intercourse or masturbation. However, sometimes the psychological and physical conditions of a person can deprive him or her from reaching that goal. Thankfully, science and anatomy have also always interested mankind. This has helped to find solutions for problems dealing with our sexuality, which, as a matter of fact are very common. The most recurrent and drastic of all these dilemmas is that of impotence.
The term "impotence" has traditionally been used to signify the inability of the male to attain and maintain erection of the penis sufficient to permit satisfactory sexual intercourse. However, this use has often led to confusing and uninterpretable results in both clinical and basic science investigations. This, together with its pejorative implications, suggests that the more precise term "erectile dysfunction" be used instead to signify an inability of the male to achieve an erect penis as part of the overall multifaceted process of male sexual function. Erectile dysfunction affects millions of men. Although for some men erectile function may not be the best or most important measure of sexual satisfaction, for many men erectile dysfunction creates mental stress that affects their interactions with family and associates. All these things might be very interesting, but to fully understand erectile dysfunction we must first take a look into the physiology of the male erection.
In its most common form, the male erectile response is initiated by a central nervous system event that integrates psychogenic stimuli (perception, desire, etc.) and controls the sympathetic and parasympathetic innervation of the penis. Parasympathetic input allows an erection by relaxation of trabecular smooth muscle and dilation of the helicine arteries of the penis. This fills the spongy tissue that forms the penis with blood; a process referred to as the corporal veno occlusive mechanism. The erectile tissues must have sufficient stiffness to compress the blood vessels penetrating it so that venous outflow is blocked and sufficient tumescence and rigidity can occur. Constriction of the trabecular smooth muscle and helicine arteries induced by sympathetic innervation makes the penis flaccid, with blood pressure in the cavernosal sinuses of the penis near venous pressure. When the trabecular smooth muscle relaxes and helicine arteries dilate in response to parasympathetic stimulation and decreased sympathetic tone, increased blood flow fills the cavernous spaces, increasing the pressure within these spaces so that the penis becomes erect. As the venules are compressed against the tunica albuginea, penile pressure approaches arterial pressure, causing rigidity. Once this state is achieved, arterial inflow is reduced to a level that matches venous outflow. After the orgasm, during the resolution, the erection is lost rapidly and the man enters a refractory period where rearousal can be quite difficult for a time.
Now that the basic functioning of the male erection has been explained we can go on with the subject of this essay. Because adequate arterial supply is critical for erection, any disorder that impairs blood flow may be implicated in erectile failure. Most of the medical disorders associated with erectile dysfunction appear to affect the arterial system. Some disorders may interfere with the corporal veno occlusive mechanism and result in failure to trap blood within the penis, or produce leakage such that an erection cannot be maintained or is easily lost. Lesions of the somatic nervous pathways may impair reflexogenic erections and may interrupt tactile sensation needed to maintain psychogenic erections. Spinal cord lesions may produce varying degrees of erectile failure depending on the location and completeness of the lesions. Not only do traumatic lesions affect erectile ability, but disorders leading to peripheral neuropathy may also impair neuronal innervation of the penis or of the sensory afferents. The endocrine system itself, particularly the production of androgens, appears to play a role in regulating sexual interest, and may also play a role in erectile