Ah, the lovely Journal of Medical Hypotheses. I went to it last week for a post on ear wax, and what should be the article right before it, but a post on erectile dysfunction. I think this journal’s impact factor is underrated. It certainly makes an impact on ME.
Anyway, as I’m sure you are all aware from the multitude of commercials out there for Viagra, Levitra, Cialis, and other such drugs that are making companies a LOT of money, erectile dysfunction (ED) is a bit of a problem in modern society. Is it a big problem? From the commercials, you’d think half the world had it, but there is no evidence that rates have been increasing. In this case, we’re just living, and loving, longer. And when you live long, apparently loving long is not as easy as it once was.
Don’t worry folks, we have a pill for that:

But the author of this article things that we may not need a pill after all. Using the philosophy of “if you don’t use it, you lose it”, he implies that those men who are snoozing might be losing…their erections.
ResearchBlogging.org Ma, Y. “Regular and frequent sexual intercourse for elderly men could preserve erectile function” Medical Hypotheses, 2009.
PS: I am not responsible for any reaction you may have to the pictures below the fold. They are all medically relevant, but consider yourself warned.


Of course, it would be nice if men didn’t need pills for this sort of thing. If there was…well, a more natural solution to the issue. It’d certainly save them (and the insurance companies that cover this sort of thing) a boatload of money. But how does erectile dysfunction work, and how does this researcher think it can be solved?
ED is a problem maintaining an erection long enough to complete sexual intercourse. This can happen in all men from time to time (bad sex or a bad day can happen to anyone), but in some men, particularly older men, it’s a recurring problem. But in order to understand exactly how erectile dysfunction occurs, you first need to understand how an erection itself happens.
The anatomy of an erection
Basically, the inside of a male penis is composed of a tube (the urethra, which carries urine or semen depending on demand), a whole lot of nerve endings, and two large, open sponge structures that run along its length. These spongy structures are the corpus cavernosa (the “cave body”). During a state of physical arousal, the corpus cavernosa fill with blood, causing them to become rigid. Since they run the whole length of the penis, the penis then becomes rigid, and there you go.
But of course, for an erection to be maintained, the blood needs to STAY in the penis. So arousal keeps the blood going in, and tightens up the veins going out, to stop the blood from flowing out of the penis. Once the physical stimulation passes, the veins dilate, blood flows out, and everything returns to normal.

So what goes wrong?
There are lots of things that can cause persistent erectile dysfunction, though we now know that they aren’t ALL psychological. Sure, psychological and psychiatric issues, such as anxiety (performance or otherwise), depression, stress, and other problems may play a role. But there are many other problems which can contribute to ED, particularly things like hypertension and cardiac problems, and the medicines that go with them. Not only that, there are other causes, such as nerve damage, surgeries, or just…age. But here’s what basically happens.
In many cases of ED, the problem is not with blood flow getting IN to the penis. Rather, the problem is that it’s getting back out. The veins controlling the blood outflow of the penis stiffen, and aren’t able to contract like they used to, and so blood trickles out of the penis, and the penis can’t stay erect. Drugs like Viagra try to combat this problem by working as vasodilators, opening up the blood vessels going in and maximizing the amount of blood that gets into the penis.
But of course, you wouldn’t need to use these drugs if there was something you could do to keep those veins coming out of the penis toned up and strong, so they can close off and keep the erection up to snuff. Obviously a vasoconstrictor of some type would be able to help this, but that’s really not a good idea if you’re older and have some natural decreases in blood vessel plasticity. So this author proposes something natural. The great remedy that helps so many things: exercise.
Well, if you call sex exercise of the penis, then yes, exercise.
Of course, sex is a kind of exercise, if done athletically enough. Exercise of any kind, even light to moderate, can help boost cardiac function. And of course, if you don’t use it, your veins may not retain as much plasticity. Having frequent sex might help retain the plasticity in your blood vessels, allowing the blood vessels in to open fully the ones going out to constrict fully.
And then, of course, there’s the possibly psychological issues with ED. Sex might be able to help with that, too. Men who have frequent sex have higher circulating levels of testosterone, which may in turn increase sex drive and performance. And of course it could also help your confidence a little.
Personally, I don’t think this hypothesis would work for everyone. Many people have cardiac problems related to more than just age, and no amount of just sex is going to help the ED associated with these problems. Many psychiatric problems are severe, and a little extra testosterone wouldn’t overcome them.
On the other hand, what could it hurt? A little more sex might make everyone a little more relaxed, and relaxation is good for everyone’s blood pressure. I say it’s worth a try! But you might want to discuss it with your partner first, or you might find that your efforts to fight ED come up against a upsurge in headaches.
Ahmadian, S., & Fakhree, M. (2009). Earwax (cerumen) might be formulated into a safe and biodegradable insect repellent Medical Hypotheses, 72 (3), 370-371 DOI: 10.1016/j.mehy.2008.09.036