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Nocturnal Erections and Penile Health

Nocturnal Erections and Penile Health

Nocturnal erections

Nocturnal penile tumescence (NPT) is a spontaneous erection of the penis during sleep or when waking up. Several less formal and well-known expressions might be morning hard on, morning wood or descriptions like morning glory all used to describe this natural anatomical process.  Have you ever wondered what causes the phenomenon?

What causes nocturnal erections?

man getting into bedSeveral theories are popular, none entirely proven. One is that spontaneous night time erections may be caused by a full bladder, which is known to cause mild stimulation of a region of the spinal cord containing nerves that control a man’s ability to have so called “reflex” erections.

Some clinical studies suggest testosterone is thought to be at its highest levels in the morning at that this may provide an explanation.  The connection between testosterone levels and nocturnal erections is not very conclusive.

There is evidence that spontaneous erections begin early in the life of males.  Fetal penile erections have been recorded in ultrasound scans so it is difficult to imagine that these types of erections are related in any way to acts of sex, so what physiological role do they play?

Sleep Cycle

REM sleep is associated with spontaneous erections

Most men have 3-5 spontaneous erections during deep sleep.  REM sleep is one of five distinct phases of sleep.  Because sleep cycles repeat, everyone enters REM sleep several times a night.  This is when dreaming is most common.

REM-related erections have been observed in all mammalian species where they were looked for. No-one knows why REM-related erections occur.  So why do men wake up with an erection?

Man waking up in the morning

Why do men wake up with an erection?

Scientific explanations as to why men get erections in the morning may vary, and the absolute cause may not be exactly known.   However, the way scientist and medical doctors use the presence of nocturnal erections as a diagnostic tool is very clear.

A study in the Urologic Clinics of North America noted that Nocturnal Penile Tumescence (NPT) monitoring remains the best single non-invasive examination to distinguish between whether erectile dysfunction or impotence has a physical cause or psychological cause.

Nocturnal penile tumescence test

Nocturnal penile tumescence tests are used to determine if the cause of impotence is physical, psychological, or both.  By determining if men achieve 3-5 erections during rem sleep a physician maybe able to begin the process of understanding how to treat the underlying conditions that have created ED.

The stamp test is one of the most common and simple ways to test for nocturnal penile tumescence. Types of erectile dysfunction tests can vary depending on your symptoms and the recommendation of your doctor.

The chances are if you do not experience nocturnal erections spontaneously during sleep that there is a physical cause to the impotence or ED you are experiencing.  If this is not diagnosed by your physician it’s time to work with your doctor to determine the cause.

Penile Health and exercise

Penis Health

Routine erections in a 24-hour time period are necessary to keep your penis in shape. Penile rigidity and erections bring oxygen to the penis. Use it or lose it is a common term and applies to penile health.

The penis in its flaccid or non-erect state it does not have adequate blood flow and oxygenation to keep penile tissues healthy. Without blood flow every 24 hours in the form of spontaneous nighttime erections penile atrophy, programmed cell death, and penile shrinkage may occur due to the lack of erections.

In a clinical study published in the Journal of Sexual medicine theories that support penile rehabilitation using a vacuum erection device are presented.

Penile rehabilitation

Time to heal stopwatch

Many physicians who treat prostate cancer focus on minimizing the side effects of erectile dysfunction resulting from treating cancer.  Erectile function, including nocturnal erections, may be lost if nerves are severed during removal of the prostate.

Penile rehabilitation is the process of preventing penile atrophy, programmed cell death and penile shrinkage by using a medical intervention to create erections that “exercise” the penis.

The goal of penile rehabilitation is to maintain and create penile health through artificially induced erections so a man may return to natural erectile function when severed nerves heal.  The effectiveness of penile rehabilitation for maintaining and creating penile health is widely debated.

Vacuum erection devices are considered first-line therapies of erectile dysfunction and preservation (rehabilitation) of erectile function following treatment for prostate cancer. 

An erectile dysfunction pump is considered the treatment of choice for penile health and rehabilitation because multiple erections (5-8) can be created and released in one therapeutic session (during a 10 minute session). 

This process is thought to mimic the creation of multiple nocturnal erections that would normally occur during REM sleep in a 24-hour period without the use of drugs or needles.  Thus, it is a natural way to bring blood flow and oxygenation to penile tissues to prevent penile shrinkage, atrophy, and programmed cell death.

Much research and debate will be needed in the future. Will the practice of penile rehabilitation translate to all men who do not achieve nocturnal erections?

Will similar penile rehabilitation treatment protocols be used for men who are diabetic, suffer from metabolic syndrome, or take medications that eliminate nocturnal penile tumescence? 

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