There are a whole host of conditions which fall under the category of Erectile Dysfunction (ED). It is a condition which can be complete or partial, where the person is not able to maintain an erect penis till orgasm. There are several causes for it: long standing conditions like diabetes or hypertension, the side effects and, more importantly, the medicines taken to manage these conditions. All these reduce the chances of maintaining an erection.

To understand why, let’s understand how an erection works. A combination of the nervous system, vascular system and tissues control an erection. The penis has within it a whole array of nerves; let’s forget them for now.

The core of the penis, two cylinders running all the way up the length, is full of spongy tissue which fills up and retains blood pumped into the penis during an erection. This spongy tissue (corpuscavernosa) is supported by muscular erectile tissue surrounding it and another type of tissue (Fibrous Tunicae) encircles the cylinders, prevents the blood from leaking back out. Coming back to the nerves, stimulation from the brain triggers the entire sequence of events. Things which can go wrong happen only if the three systems mentioned above are affected.

• Tissue: Calcification is a process in which, over time, calcium gets deposited in certain bodily tissues. This causes the pliability or elasticity of the tissue to be lost. When calcification happens at any part of the anatomy of an erection (paired cavernosal arteries or to the fibrous sheath which blocks off blood in the corpus cavernosa), there are leaks or a reduction in capacity.
• Vascular: There are two main arteries supplying blood to the penis, and one vein, the dorsal vein, takes blood away. If at any stage the amount of blood drops, then the erection is under pressure; the erectile tissue (small muscles which help hold things in place) and the fibrous seal at the base (tunicae) are now put to work. Sometimes leaks in the blood vessels may happen, sometimes low blood pressure may be the norm.
• Nervous: In some cases there may be a disconnect of the nerves themselves, trauma either mental or physical may not be allowing a strong enough signal to pass and sustain to keep the high level of physical demand which arousal and an erection asks from the various systems. This can be determined by testing or counselling.