Men’s Sexual Health and Erectile Dysfunction

What is Erectile Dysfunction?

Erectile dysfunction (ED), also known as impotence, is a common condition. All men occasionally have difficulty achieving or maintaining an erection, however, ED is a persistent inability to maintain an erection that is firm enough or lasts long enough to complete sexual intercourse. According to the National Institutes of Health, as many as 30 million men in the United States suffer chronic ED, including more than 50 percent of all men ages 40 to 70 and nearly 70 percent of men over age 70. ED can be caused by your lifestyle – whether or not you smoke, drink excessively, or get enough exercise. But it is most often a sign of an underlying health issue that needs treatment, such as diabetes, high cholesterol, obesity, sleep apnea, low testosterone or cardiovascular disease.

ED is no longer an inevitable part of aging and you don’t have to resign yourself to live with it.

Dr. Fenig understands the emotional and physical effects of ED on men, as well as their partners, and offers a personal, caring and confidential approach to improving your sex life, helping thousands of men re-establish their ability to have sexual intercourse.

How an Erection Occurs

Anatomy 1Before exploring your treatment options, Dr. Fenig feels it is important that his patient’s have a basic understanding of the anatomy of the penis and the physiological process that causes an erection. Because an erection requires a precise sequence of events, ED can occur when any of these events are disrupted. This sequence includes nerve impulses in the brain, spinal column, and area around the penis, and the reaction of muscles, fibrous tissues, veins, and arteries in and near the genitals. Erections are connected to the blood flow. 

Here are the five stages involved in the erection process:

STAGE 1:  Initial Filling – As a result of psychological or sexual stimulation, neurotransmitters (hormones) cause smooth muscles to relax, increasing blood flow to the corporal bodies (the penile chambers).

STAGE 2:  Partial Erections (Tumescence) – Penile arteries expand to accommodate the increased blood flow needed to elongate and expand the penis.

STAGE 3:  Full Erection – The increased volume of blood within the penis is prevented from draining, thus expanding the penis to full erection.

STAGE 4:  Rigid Erection – Maximum rigidity is attained.  The glans and spongiosum (tip and body of the penis) enlarge until penile veins are forcefully compressed.   This increases engorgement and maintains maximum penile rigidity.  Emission of semen and ejaculation occur.

STAGE 5:  Return to Flaccidity (Detumescence) – After orgasm and ejaculation, blood flow into the penis is decreased and blood flow out of the penis increases, thus decreasing its length and girth until flaccid.


Sexual Health Inventory for Men (SHIM)

If you have been experiencing erectile dysfunction, Dr. Fenig recommends that you take the Sexual Health Inventory for Men  (SHIM) questionnaire, which is designed to help you and your doctor identify if you are experiencing ED and to what extent. Filling out this questionnaire can help you and Dr. Fenig identify to what degree you are experiencing ED and can aid in the diagnosis and treatment of ED.


With years of training in treating male sexual problems, Dr. Fenig can offer expertise and  insights on possible causes and the latest treatments for ED.