The creation of an erection is an extremely complicated cascade of events that requires many different things to happen. There are numerous chemical transmitters involved in this including epinephrine, norepinephrine, acetylcholine, prostaglandins and nitric oxide. The exact mechanism by which erection occurs is still unclear but we do know that the neural input from the brain is extremely important. Reflex erections, as seen in people with cord damage such as paraplegics, are often poor erections and not sustainable for prolonged periods of intercourse. Erections can change over time, sometimes stronger or weaker than other times. When men are in their teens they often have little control over their erections and obtain erections when not in a sexual situation. For most men this stops in their late teens to early twenties. As men get older, erections may not always be obtained when they want one. Almost every man has the occasional time when their erection is less strong than they would like but sometimes it becomes a problem. In order to increase the size of an erection, there must be an increase in blood flow and, at the same time, the blood has to be prevented from leaving the penis. Nerves must be working normally for a man to get and keep an erection. Nerve damage can result from diabetes, multiple sclerosis, prostate surgery or damage to the spinal cord. How long your erectile dysfunction lasts depends upon what causes it and how quickly your treatment starts to work. The important thing to remember is that erectile dysfunction is treatable in all age groups.
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