Erection

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A penis flaccid (left) and erect (right)

An erection (pronounced ee-REK-shən) of a body part such as a man's penis, a woman's clitoris or a nipple refers to it becoming larger and harder.

The term erection is most often used to refer to an erection of the penis. It is widely believed that a man's penis needs to be erect in order for him to take part in sexual intercourse and penetrate his partner's vagina and to ejaculate semen, but all are possible without an erection. For an erection to take place, a man must be sexually aroused (made sexually excited) or stimulated. This can happen if he is touched sexually, or even if he is not touched – for example, if he sees a naked person or thinks about having sex with someone else. Tissues in the penis called the corpus spongiosum penis and corpora cavernosa penis fill with blood, causing the penis to become longer, thicker, harder and to stand upright. A man's erection usually stops if he is no longer sexually aroused, or after he has had an orgasm and has ejaculated.

Overview[change | change source]

Erect penises have appeared in erotic (sexually exciting) art for a very long time. Pictures of men with erections appear on ancient objects and in paintings. In the past, the erect penis was also a symbol or sign of health and fertility (the ability to give life). Ancient Egyptians, Greeks and Romans believed in gods that had erect penises. Today, erect penises do not often appear in artworks or movies because many people think that showing a man's penis when it is erect is obscene (not decent). Men with larger penises are often thought to be more handsome, manly and powerful. A lot of people also believe that men with bigger penises are better at making their partners feel good when they are having sex. However, this is not always true.

Like a man's penis, a woman's clitoris can also become erect. This happens in the same way as an erection of the penis. The clitoris also has a corpus spongiosum and corpus cavernosum, and when a woman is sexually excited these parts of the clitoris fill with blood. This causes the clitoris and other parts of the woman's sex organs to become larger, harder, redder in colour, and very sensitive to being touched. An erection of the clitoris that does not go away after a long time is a medical problem called clitorism.

The nipples of men and women can also become erect. Women's nipples become erect when they are breastfeeding (giving milk to their babies from their breasts). Men and women may also have an erection of their nipples when they are sexually excited, or if they feel cold. Nipples do not have any tissue in them that fills with blood. Instead, the body's nervous system makes muscles in the nipples contract (become shorter), causing them to stand up and become slightly harder.

Blood flows out of the corpus spongiosum and corpora cavernosa penis, and the penis goes back to its normal size. A man who often has problems having or keeping an erection of his penis is said to have erectile dysfunction (ED). On the other hand, an erection that lasts too long is also a dangerous condition called priapism.

Penis[change | change source]

The term erection is most often used to refer to an erection of the penis. A man's penis is usually soft, quite short and hangs down. When the penis is like this, it is said to be flaccid (pronounced FLA-sid). In order for the man to take part in sexual intercourse by putting his penis inside a woman's vagina, his penis needs to become longer, thicker, harder and to stand upright. When this happens, it is said that the penis is erect, or that the man has an erection. The penis needs to be at least mildly erect before the man can have an orgasm and ejaculate semen.

The scientific name for an erection is tumescence (which means "swelling"). Some slang terms for having an erection are getting hard, getting wood and having a hard-on, and an erect penis is informally called a boner, hard-on, stiffy, wood or woody.

How it happens[change | change source]

A drawing showing the inside structure of the penis
This cross-section of a penis (what you would see if a penis was sliced across its middle) shows the two corpora cavernosa penis near the top surface of the penis and the corpus spongiosum penis (which used to be called the corpus cavernosum urethræ) surrounding the urethra near the bottom surface.

The penis is shaped like a banana or sausage. It has a duct or tube called the urethra running right through it. Semen and urine pass along the urethra to get out of the body. Around the whole urethra is tissue called the corpus spongiosum penis (which is Latin for "body of the penis that is like a sponge"). It is near the lower surface of the penis. Also inside the penis near its upper surface are two cylindrical tissues called the corpora cavernosa penis (Latin for "bodies of the penis that are like caves"). (One of these tissues by itself is called a corpus cavernosum.) The corpus spongiosum penis and corpora cavernosa penis are filled with many blood vessels called arteries which carry blood.[1]

When a man is sexually aroused or stimulated (made sexually excited) by touch – for example, if he masturbates or another person touches him in a sexual way – the touching is picked up by nerves in the arteries of the corpus spongiosum penis and corpora cavernosa penis. The nerves then cause a chemical called nitric oxide to be released into the arteries. This makes the arteries dilate (become wider), and they fill up with blood. Thus, the corpus spongiosum penis and corpora cavernosa penis all fill with blood and become larger and harder. This makes the penis grow longer, thicker and harder. The corpora cavernosa penis press against blood vessels called veins that let blood flow out of the penis. Since less blood can flow out of the penis through the veins, more of it stays in the penis, which remains hard. During an erection, a valve stops urine from entering the urethra so that only semen flows along it. This is why it is very difficult for a man to urinate when he is having an erection.

A man can also become sexually aroused without being touched, for example, if he sees a naked person or thinks about having sex with someone. In this case, his brain sends messages through his spinal cord (which is inside his vertebral column or backbone) to his penis and makes an erection happen.[1] The brain can also stop an erection from happening, even if the man is being touched sexually.

After a man has had an orgasm and has ejaculated, his erection usually ends. How long this takes depends on the length and thickness of his penis.[2] A man can also stop having an erection without having an orgasm and ejaculating, if he is no longer sexually aroused. Nerves in his body cause the arteries in the penis to constrict (become narrower). This forces blood out of the corpus spongiosum penis and corpora cavernosa penis. As they go back to their normal size, they do not press so much on the veins leading out of the penis. This lets blood flow faster out of the corpus spongiosum penis and corpora cavernosa penis.[1] The scientific term for this process is detumescence.


Shape and size[change | change source]

The angle that an erect penis makes varies from one man to another. If it is imagined that a man is standing upright and there is a horizontal line stretching out from the base of his penis, most men's erect penises point upwards from the line at a certain angle (as shown in the photograph on the left). However, it is common and normal for an erect penis to point nearly vertically upwards, nearly vertically downwards, or even horizontally forward. The angle depends on how long a man's suspensory ligament is. The suspensory ligament is a band of tough, stringy tissue that joins a man's penis to the front of his pelvis.

Few men's penises are completely straight when they are erect. It is common for an erect penis to have a slight curve in it. The curve can be up or down, or to the left or right. A curve of up to 30° is considered normal, and medical treatment is usually not needed unless the angle of curvature is more than 45°. A curved penis does not usually cause a man any problems when he is having sex. However, if the curvature of a penis changes, this could be caused by an illness called Peyronie's disease (see below).

A survey of 300 men over the age of 18 carried out between 11 March and 17 March 2001 in Cancún, Mexico, found that among those men the average erect human penis was about 14.928 centimetres (5.877 inches) long, and that most of them had an erect penis length of between 14 and 16 centimetres (5.5 and 6.3 inches). The typical girth or circumference (the length around the outside of the penis) was about 12.63 centimetres (4.972 inches), and most erect penises had a girth of between 12 and 13 centimetres (4.7 and 5.1 inches).[3][4] As this survey was only done in one city, its findings may not apply to men from other countries.

The size of an erect penis generally does not change after puberty, the time when a boy becomes sexually mature. Some people have surgery to make their penises larger.[5] However, a study that came out in 2006 found that only 35% of men who had gone for such surgery were happy with the results.[5][6]

Unexpected erections[change | change source]

An erection of the penis can also happen by itself when a man is asleep, often when he is dreaming. The scientific term for this is nocturnal penile tumescence (which means "swelling of the penis at night"). It is also common for a man to wake up after a night's sleep to find that he has an erection. This is often caused by his bladder being full of urine, which presses on the tissues in the penis. Such an erection is sometimes informally called a morning glory or morning wood.

Unexpected erections are involuntary and are normal. Such erections can be embarrassing if they happen in public.[7] Erections can occur unexpectedly at any time of day.

Health problems[change | change source]

Difficulty having an erection[change | change source]

Erectile dysfunction
Classification and external resources
ICD-10 F52.2, N48.4
ICD-9 302.72, 607.84
DiseasesDB 21555
eMedicine med/3023
MeSH D007172

A man who often has problems having or keeping an erection of his penis is said to have erectile dysfunction. Erectile dysfunction is also known as ED, impotence or male impotence.[8] The study of erectile dysfunction comes within andrology, the field of science dealing with men's health.[9]

ED is not uncommon. For example, about 10% of all men in the United Kingdom will have ED happening to them regularly at some time in their lives.[10] It can be due to both physiological and psychological reasons. Physiological reasons are those dealing with how the body works. Psychological reasons are those involving human behaviour and how people think.

These are some common physiological reasons for ED:

  • Problems with the brain and nerves – diseases affecting the brain, spinal cord and nerves, such as Alzheimer's disease, clinical depression, diabetes mellitus, multiple sclerosis, panic disorders, Parkinson's disease, schizophrenia and stroke.[11][12]
  • Circulatory problems – diseases that affect the way blood circulates (moves around) the body, such as hypertension (high blood pressure) and blood vessels becoming blocked. Such diseases can lead to less blood flowing into the penis. Smoking can lead to ED as it causes arteries to become narrower.[13] Research shows that the number of men who have ED among those who smoke is about 85% higher compared to men who do not.[14]
  • Hormonal problems – diseases affecting the testicles or pituitary gland such as a tumor in the pituitary gland. (A tumor, also spelled tumour, is a bunch of cells growing out of control that can sometimes lead to cancer.) This can cause hypogonadism, which means that there are low levels of testosterone in the body. Testosterone is a hormone (chemical made by the body) that is important in libido (wanting to have sex).
  • Problems with the corpora cavernosa penis – for example, Peyronie's disease (pronounced PAY-rə-neez). When a man with this disease has an erection, his penis is very curved. The curvature is caused by scar tissue growing inside the penis. Peyronie's disease can make having an erection painful and lead to ED.[15]
  • Problems caused by medical treatment and surgery – the nerves and blood vessels involved in erection can be damaged by some types of medical treatment such as using radiation to kill cancer cells; and surgery of the bladder, colon (large intestine), prostate or rectum. For instance, if men have prostate and bladder cancer surgery they are more likely to suffer from ED because nerves and other tissue around tumors usually need to be taken out together with the tumors.[16] Some drugs (medicines) may also cause ED. One such drug is lithium, which is made of chemicals called lithium salts. Lithium is given to people who suffer from bipolar disorder, a kind of mental illness. People who have bipolar disorder suffer from mood swings – they sometimes feel very happy and friendly, then become angry or very sad. Lithium helps to reduce the number of mood swings. However, it also seems to lower the amount of nitric oxide in the blood vessels of the corpora cavernosa.[17]
  • Lifestyle and growing older – ED is more common in people who take too much alcohol and illegal drugs, people who are obese (fat in an unhealthy way), and older people.

ED can also happen for psychological reasons. For example, a man can find it difficult to have an erection:[12][18]

  • if thinking about having sex with someone makes him feel anxious or nervous, because he is worried that his sexual partner will think he is not sexy or not good at sexual intercourse;
  • if there are problems in his relationship with his partner, such as having arguments, no longer being in love, or facing a divorce;
  • if he is feeling a lot of stress due to his job, or big changes in his life like the death of someone close to him; or
  • if he is not sure about his gender identity (though he is a man he may feel like a woman) or his sexual identity – whether he is heterosexual (straight) or homosexual (gay).

Having erections is seen by many people as a very important part of being a man. Therefore, a man who has ED often feels that he is not manly enough and not successful in life. This can lead to him feeling ashamed and not as good as other men.[19] The matter is made worse because men often do not like talking about their personal problems with other people, so they keep their unhappy feelings to themselves. However, talking to a doctor or psychiatrist (a doctor who knows a lot about mental problems) is helpful, as he or she may be able to suggest ways of dealing with the problem.

How ED may be treated depends on the cause. If it is caused by a disease, sometimes treating the disease will reduce the problem. For example, if a man is unable to have erections because his body does not make enough testosterone, he can be given pills to take which help his body to do so. If the blood vessels or nerves in the corpora cavernosa penis are damaged, a full cure may not be possible. However, there are some temporary treatments that allow a man to have an erection for long enough to have sex:

  • Medicines – Medicines in the form of pills that are swallowed such as sildenafil (which is sold as Viagra), tadalafil (Cialis) and vardenafil (Levitra) make the arteries in the corpora cavernosa penis relax, which allows more blood into the penis. There are also other medicines in cream or liquid form that are put into the opening at the tip of the penis, rubbed on the outside of the penis, or injected into the penis using a syringe (a medical tool with a needle at one end that is poked into the body). An example of such a medicine is alprostadil, which also works by making the arteries in the penis become wider.[20]
  • Vacuum pumps – If medicines do not work, a vacuum pump can sometimes help. This device is made up of a plastic cylinder that fits over the penis, which is joined to a pump. The pump can be electrical or worked by hand. When the pump is used, it draws air out of the space around the penis. This causes more blood to flow into the penis, making an erection happen. Once the penis is erect, the device is taken off. To slow down the flow of blood out of the penis, a tight ring is worn around the base of the penis.[21]
  • Surgical implants – If other treatments do not work, a last method may be for the impotent man to go for surgery and have a penile implant put into his penis. Modern implants are made up of cylinders that are put inside the corpora cavernosa penis. The cylinders are connected by tubes to a pump that is put under the skin near the testicles. When the pump is used, it pushes fluid into the cylinders, which become hard and cause an erection. After the man has finished having sex, he can press a valve that allows the fluid to flow out from the cylinders.[22]
  • Counselling – If a man's ED is caused by a psychological problem, counselling can often help. This means talking to a psychiatrist to try and understand what is making the man feel anxious or worried and to find ways of dealing with the matter. Even if the ED is not caused by a mental problem but some disease, talking to a psychiatrist can also be useful if the man is very worried.

Erection lasting too long[change | change source]

If a man's erection lasts for more than four hours even though he is no longer sexually excited, this is a medical problem called priapism (pronounced PRYE-ə-pi-z(ə)m). The condition is named after the Greek god Priapus, whose penis was believed to always be erect (see below). Priapism is painful, and is a medical emergency because the blood stuck in the penis can become thick and form clots. This can damage the blood vessels of the penis and lead to erectile dysfunction (ED). In serious cases the tissues of the penis can die, and the penis may have to be amputated (cut off) so that the tissue death does not spread to the rest of the body.

It is not really known what causes priapism. Men who suffer from priapism sometimes have blood diseases like leukemia (a type of cancer of the blood; in the United Kingdom and some other countries it is spelled leukaemia) or sickle-cell disease (which makes the blood cells crescent-shaped). Problems with the nervous system such as injury to the spinal cord or abnormal growths on it can also lead to priapism. Certain medicines can make priapism happen, including some used to treat ED such as alprostadil. A 2008 study suggests that too much of the chemical adenosine in the body may cause priapism since it makes blood vessels widen which lets more blood flow into the penis.[23]

When a man with priapism is brought to the emergency department of a hospital, a doctor will usually try to remove blood from the corpora cavernosa penis by aspirating it (sucking it out) using a syringe. If this is not enough, a chemical called phenylephrine may be injected into the penis to try and make the blood vessels become narrower. If this also does not work, the doctor will make a shunt (a hole or passage) between the corpora cavernosa penis and corpus spongiosum penis. This allows blood to flow away from the corpora cavernosa penis into the corpus spongiosum penis.[24] For men who have priapism again and again, it has been found that medicines such as sildenafil (Viagra) and tadalafil (Cialis) may help.[25]

Culture[change | change source]

Part of a Greek vase which shows the second man from the left having an erection. The vase, which is in the National Etruscan Museum in Rome, Italy, was from the Etruscan civilization (about 1200–100 B.C.).
A carving of the Ancient Egyptian god Min on the wall of a temple. Min is usually shown having an erect penis.

Symbol of sex and fertility[change | change source]

When an erect penis is shown in art, it is often called a phallus. Erotic (sexually exciting) art has shown phalluses for a very long time. Pictures of men with erections appear on ancient objects and in paintings.

The erect penis was also a symbol or sign of health and fertility (the ability to give life). The Hohle Fels phallus was found in a cave in Germany. It is a piece of stone carved to look like a penis that archaeologists believe is about 28,000 years old.[26] (Archaeologists are scientists who study the past by looking for things that people have left behind.) From the fourth millennium B.C. (4000–3001 B.C.), Ancient Egyptians worshipped Min as the god of reproduction and the maker of all things.[27] Min was shown in statues and on wall carvings as having an erect penis.

The Ancient Greeks believed in a god called Priapus who had a very large penis that was always erect. He was thought to protect livestock (animals kept by humans for food, milk, leather or wool), fruit plants and gardens, and men's sex organs. He was also seen as able to chase away evil, and as a protector of sailors, fishermen and others needing good luck.[28]

A fresco (type of wall painting) of Priapus with a giant erect penis that was found on a wall in the Roman city of Pompeii. Today, Pompeii is in Italy. The fresco, now in the National Archaeological Museum in Naples, is believed to have been painted between 89 B.C. and 79 A.D.

Long after the Roman Empire ended and many people became Christian, Priapus was still seen as a symbol of health and fertility. A 13th-century book called the Lanercost Chronicle, which is a history of northern England and Scotland, talks about someone putting up a statue of Priapus to try and stop a disease from spreading among cattle.[29]

Some Native Americans in the Southwestern United States believe in a fertility god called Kokopelli who is in charge of childbirth and agriculture (the growing of plants and animals for food and other uses). He also plays tricks and is a symbol for the spirit of music. Kokopelli is sometimes shown as a man playing a flute with a humpback (a back that is bent forwards), things like feathers sticking out from his head, and a very big penis.[30]

Modern views[change | change source]

Today, phalluses do not often appear in artworks or movies (except in pornographic movies which show people having sex with each other). This is because many people think that showing a man's penis when it is erect is obscene (not decent).

Men with larger penises are commonly thought to be more handsome, manly and powerful. In 2006, it was reported that an Internet survey of 52,031 heterosexual (straight) men and women showed that men who thought that their penises were larger than the average size believed they were more good-looking. Of the men, 55% of them were happy with their penis size, but 45% wanted to be larger. Only 0.2% wanted a smaller penis. On the other hand, 85% of women were happy with how big their partner's penis was.[31] Another study that also came out in 2006 in the Netherlands found that out of 251 homosexual (gay) men who were asked, most felt it was better to have a large penis, and those who thought they had one were happy about their bodies.[32] However, just because a man has a large penis does not always mean he is sexier or stronger than other men, even though many people think this.

A lot of people also believe that men with bigger penises are better at making their partners feel good when they are having sex. For heterosexual men, this is because it is thought that when the penis can go further into the vagina, this helps the woman have a better orgasm. Scientists are not sure whether this is true or not. Some research shows that the most sensitive area of the female sex organs includes the vulva, clitoris and the part of the vagina nearest the outside of a woman's body. There are also parts of the clitoris inside the vulva and vagina.[33] Therefore, most men's penises are long enough to make their partners feel good during sex.[34] Also, some studies say it is not how long but how thick a penis is that decides how well it excites a woman sexually.[35]

However, other research seems to say that a long penis that touches and sexually excites the fornix, which is the deepest part of the vagina near the cervix (the opening of the uterus into the vagina), helps a woman to have an orgasm.[36][37] A study from the Netherlands of 375 women came out in 2002. This study said that although 77% of the women felt that the length of a man's penis was not important to them, quite a large number – 21% – felt it was important.[38]

Clitoris[change | change source]

This drawing shows the parts of a woman's clitoris (in dark pink) that are inside her body.
Only a small part of the clitoris (the clitoral glans, or head of the clitoris) can be seen on the outside of a woman's body.

The clitoris (pronounced KLI-tə-ris) is part of a woman's sex organs. It makes a woman's orgasms happen, which gives her very good sexual feelings. Like a man's penis, a woman's clitoris also becomes bigger and harder, moving out and away from the body, when she is sexually excited. However, because the clitoris is much smaller than the penis, and most of the clitoris is inside the woman's body, only part of its entire length can be seen from the outside. Some clitoral erections cannot be seen as well as an erection of the penis.

An erection of the clitoris happens in the same way as an erection of the penis. The clitoris has a corpus cavernosum similar to the penis. However, instead of the corpus spongiosum it has two vestibular bulbs.[39] When a woman is sexually excited, the corpus cavernosum and vestibular bulbs fill with blood. This causes the clitoris and other parts of the woman's sex organs to become larger, harder, and redder in colour. When this happens, they become very sensitive to being touched.

If an erection of the clitoris does not go away after a long time, even though the woman is not being made sexually excited any more, this is a medical problem called clitorism. Like priapism which can affect a man's penis, it is painful.[40] A woman who thinks she may have clitorism should see a doctor.

Clitorises range in size. From a small pea to fingertip-section(s) when still soft. They engorge with blood and become much larger in all dimensions, and firmer when aroused. They can range into even 4-5 inches in some. A penis has a tubular shape while a clitoris has a hood covering and C curvature shape, and yet still tubelike, and rides along the body. The tip can lift upward more when aroused. The tip can also be referred to as the pearl. Sometimes, it can be uncomfortable to the entire clitoris, from its sensitivity, if treated rashly, mistaking erection for pleasure. This is known mentally by the participant if pleasurable or uncomfortable. It can be hard, or midfirm as well, and climb to a shudder, then do a sharp firm up and an outward move right before, and then a tingling jingle inside and to the g-spot on in the other - and this is an orgasm. Orgasms vary in intensity. The body and mind can be relaxed and passionate afterwards to continue with love making or setting itself.

Nipples[change | change source]

A woman's erect nipple

The nipples of men and women can also become erect. Women's nipples become erect when they are breastfeeding (giving milk to their babies from their breasts). Men and women may also have an erection of their nipples when they are sexually excited. This is caused by the release of a hormone called oxytocin in the body. Nipples can also become erect when a person feels cold or sexually excited.

Unlike the penis and clitoris, nipples do not have any tissue in them that fills with blood. Instead, the body's nervous system makes muscles in the nipples contract (become shorter), causing them to stand up and become slightly harder.

Notes[change | change source]

  1. 1.0 1.1 1.2 Richard L. Drake; Wayne Vogl, Adam W.M. Mitchell (2004). Gray's Anatomy for Students. Philadelphia: Elsevier. ISBN 9780443068201 .
  2. Robie H. Harris (1994). It's Perfectly Normal: Changing Bodies, Growing Up, Sex and Sexual Health. Cambridge, Mass.: Candlewick Press.
  3. "Ansell Research: The penis size survey". Ansell Healthcare. March 2001. http://www.free-condom-stuff.com/education/research.htm. Retrieved 2008-07-17.
  4. Another study done in 1996 involving 80 men found that the average erect penis length was 12.9 centimetre (5.1 inches): H. Wessells; T.F. Lue, J.W. McAninch (September 1996). "Penile Length in the Flaccid and Erect States: Guidelines for Penile Augmentation". Journal of Urology 156 (3): 995–997. http://www.ncbi.nlm.nih.gov/pubmed/8709382. See also J. Chen; A. Gefen, A. Greenstein, H. Matzkin, D. Elad (December 2000). "Predicting Penile Size during Erection". International Journal of Impotence Research 12 (6): 328–333. http://www.ncbi.nlm.nih.gov/pubmed/11416836.
  5. 5.0 5.1 C.Y. Li; O. Kayes, P.D. Kell, N. Christopher, S. Minhas, D.J. Ralph (April 2006). "Penile Suspensory Ligament Division for Penile Augmentation: Indications and Results". European Urology 49 (4): 729–733. http://www.ncbi.nlm.nih.gov/pubmed/16473458.
  6. Miranda Hitti (16 February 2006). "Most men unsatisfied with penis enlargement results". Fox News. http://www.foxnews.com/story/0,2933,185156,00.html.
  7. The "What's Happening to My Body?" Book for Boys Lynda Madaras
  8. Richard Milsten; Julian W. Slowinski (1999). The Sexual Male: Problems And Solutions. New York, N.Y.: W.W. Norton. ISBN 9780393047400 .
  9. Warwick Williams (1989). It's Up to You: Overcoming Erection Problems. Wellingborough, Northamptonshire; New York, N.Y.: Thorsons Pub. Group; distributed by Sterling Pub. Co.. ISBN 9780722519158 .
  10. "Erectile dysfunction". Health Encyclopaedia. NHS Direct, National Health Service. 29 May 2008. http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=210. Retrieved 2008-07-22.
  11. Ralph Poore (13 June 2006). "Erection problems (erectile dysfunction)". Healthwise. http://health.msn.com/centers/mensexualhealth/articlepage.aspx?cp-documentid=100062424. Retrieved 2008-07-18.
  12. 12.0 12.1 Amalia K. Gagarina (8 December 2007). "Causes of erectile dysfunction". Armenian Health Network. http://www.health.am/sex/more/causes_of_erectile_dysfunction/. Retrieved 2008-07-22.
  13. M. Kendirci; S. Nowfar, W.J. Hellstrom (January 2005). "The Impact of Vascular Risk Factors on Erectile Function". Drugs of Today 41 (1): 65–74. http://www.ncbi.nlm.nih.gov/pubmed/15753970.. See also S.G. Korenman (March–April 2004). "Epidemiology of Erectile Dysfunction". Endocrine 23 (2–3): 87–91. http://www.ncbi.nlm.nih.gov/pubmed/15146084. I. Peate (April 2005). "The Effects of Smoking on the Reproductive Health of Men". British Journal of Nursing 14 (7): 362–366. http://www.ncbi.nlm.nih.gov/pubmed/15924009.
  14. David Moyer. "Impotence [chapter 12]". The Tobacco Reference Guide. Tobacco Dependence Program, School of Public Health, University of Medicine and Dentistry of New Jersey. http://www.tobaccoprogram.org/tobaccorefguide/ch12/ch12p1.htm. Retrieved 2008-07-22.
  15. Arthur A. Podosyan (6 December 2007). "Male sexual dysfunction epidemiology". Health.am, Armenian Health Network. http://www.health.am/sex/more/male_sexual_dysfunction_epid/. Retrieved 2008-07-18.
  16. "Erectile Dysfunction: Causes". UrologyChannel. Healthcommunities.com. 10 June 1998. http://www.urologychannel.com/erectiledysfunction/causes.shtml. Retrieved 2008-07-22.
  17. H. Sadeghipour; M. Ghasemi, M. Nobakht, F. Ebrahimi, A.R. Dehpour (January 2007). "Effect of Chronic Lithium Administration on Endothelium-dependent Relaxation of Rat Corpus Cavernosum: The Role of Nitric Oxide and Cyclooxygenase Pathways". BJU International 99 (1): 177–182. http://www.ncbi.nlm.nih.gov/pubmed/17034495. H. Sadeghipour; M. Ghasemi, F. Ebrahimi, A.R. Dehpour (February 2007). "Effect of Lithium on Endothelium-dependent and Neurogenic Relaxation of Rat Corpus Cavernosum: Role of Nitric Oxide Pathway". Nitric Oxide 16 (1): 54–63. http://www.ncbi.nlm.nih.gov/pubmed/16828320.
  18. Mayo Clinic staff (18 January 2008). "Erectile dysfunction". Mayo Clinic. http://www.mayoclinic.com/health/erectile-dysfunction/DS00162/DSECTION=3. Retrieved 2008-07-22.
  19. Emil A. Tanagho; Jack W. McAninch, Donald R. Smith (2008). Smith's General Urology (17th ed. ed.). New York, N.Y.: McGraw-Hill Medical. ISBN 9780071457378 .
  20. "Beyond Viagra". WorldHealth.net. 12 August 2003. http://www.worldhealth.net/news/beyond_viagra. Retrieved 2008-08-02.
  21. Chris Steidle (January 2007). "Treatments for erectile dysfunction". SeekWellness.com. http://www.seekwellness.com/mensexuality/treatment.htm. Retrieved 2008-08-02.
  22. Chris Steidle (April 2003). "Penile prostheses (implants)". SeekWellness.com. http://www.seekwellness.com/mensexuality/penimpl.htm. Retrieved 2008-08-02.
  23. Tiejuan Mi; Shahrzad Abbasi, Hong Zhang, Karen Uray, Janci L. Chunn, Ling Wei Xia, Jose G. Molina, Norman W. Weisbrodt, Rodney E. Kellems, Michael R. Blackburn, Yang Xia (2008). "Excess adenosine in murine penile erectile tissues contributes to priapism via A2B adenosine receptor signaling". Journal of Clinical Investigation 118 (4): 1491–1501. http://www.jci.org/articles/view/33467. Michael Day (13 March 2008). "Relief in sight for sufferers of constant erections". New Scientist. http://www.newscientist.com/channel/health/dn13461-relief-in-sight-for-sufferers-of-constant-erections.html?feedId=online-news_rss20.
  24. D.K. Montague; J. Jarow, G.A. Broderick & others (October 2003). "American Urological Association Guideline on the Management of Priapism". Journal of Urology 170 (4 Pt 1): 1318–1324. http://www.ncbi.nlm.nih.gov/pubmed/14501756.
  25. A.L. Burnett; T.J. Bivalacqua, H.C. Champion, B. Musicki (May 2006). "Long-term Oral Phosphodiesterase 5 Inhibitor Therapy Alleviates Recurrent Priapism". Urology 67 (5): 1043–1048. http://www.ncbi.nlm.nih.gov/pubmed/16698365. A.L. Burnett; T.J. Bivalacqua, H.C. Champion, B. Musicki (November 2006). "Feasibility of the Use of Phosphodiesterase Type 5 Inhibitors in a Pharmacologic Prevention Program for Recurrent Priapism". Journal of Sexual Medicine 3 (6): 1077–1084. http://www.ncbi.nlm.nih.gov/pubmed/17100941.
  26. Jonathan Amos (25 July 2005). "Ancient phallus unearthed in cave". BBC News. http://news.bbc.co.uk/1/hi/sci/tech/4713323.stm.
  27. F. Bechtel (1907). "Ammon". The Catholic Encyclopedia I. New York, N.Y.: Robert Appleton Company. Retrieved on 4 August 2008. 
  28. "Priapus". The Encyclopædia Britannica (11th ed.). (1910–1911). Ed. Hugh Chisholm. Cambridge: Cambridge University Press. 
  29. Yves Bonnefoy (1992). Roman and European Mythologies. Chicago, Ill.: University of Chicago Press. pp. 139–142. ISBN 9780226064550 .
  30. "Kokopelli – Trickster god". Chrystalinks: Ellie Crystal's Metaphysical and Science Website. http://www.crystalinks.com/kokopelli.html. Retrieved 2008-08-04.
  31. Janet Lever; David A. Frederick, Letitia Anne Peplau (July 2006). "Does Size Matter? Men's and Women's Views on Penis Size Across the Lifespan". Psychology of Men & Masculinity 7 (3): 129–143. http://psycnet.apa.org/index.cfm?fa=main.doiLanding&uid=2006-09081-001.
  32. "Size does matter". Mail & Guardian. 20 February 2006. http://www.mg.co.za/article/2006-02-20-size-does-matter.
  33. Sharon Mascall (11 June 2006). "Time for rethink on the clitoris". BBC News. http://news.bbc.co.uk/1/hi/health/5013866.stm.
  34. Louanne Cole Weston (27 May 2002). "Does penis size really matter?". WebMD. http://www.webmd.com/content/Article/42/1685_53202.htm. Retrieved 2008-08-06.
  35. Russell Eisenman (8 June 2001). "Penis Size: Female Perceptions of Sexual Satisfaction". BMC Women's Health 1 (1). http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=33342. Jill Neimark (November–December 1994; online version reviewed 30 August 2004). "The Beefcaking of America: Everyone Knows Women who have Body Image Issues. The Secret: Men have Them Too". Psychology Today. http://psychologytoday.com/articles/pto-19941101-000021.html. Michael Pertschuk; Alice Trisdorfer (November–December 1994, online version reviewed 7 September 2005). "Men's Bodies –The Survey". Psychology Today. http://psychologytoday.com/articles/pto-19941101-000022.html.
  36. "The female orgasm during intercourse". WebMD. 1999. http://www.webmd.com/content/article/44/1689_50048.htm?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348. Retrieved 2008-08-06.
  37. Kevin Pezzi (2004). "Questions and answers about sexual anatomy: What is the cul-de-sac? Is it the ultimate pleasure spot?". Sexualtips.net. http://www.sexualtips.net/sexual_anatomy_questions.htm. Retrieved 2008-08-06.
  38. A.B. Francken; M.B. van de Wiel, M.F. van Driel, W.C. Weijmar Schultz (November 2002). "What Importance do Women Attribute to the Size of the Penis?". European Urology 42 (5): 426–431. http://www.ncbi.nlm.nih.gov/pubmed/12429149.
  39. "The clitoris contains corpora cavernosa as its erectile tissue. ... Instead of a corpus spongiosum, the female has two vestibular bulbs, which lie along the sides of the vestibule, and also expand as the glans clitoris to cap the distal ends of the corpora cavernosa": "Dissector answers – Perineum & external genitalia". University of Michigan Medical School. 2000. http://anatomy.med.umich.edu/reproductive_system/perineum_ans.html. Retrieved 2008-08-17..
  40. Rosie Mestel (3 July 1993). "A Painful Problem for Men and Women". New Scientist (1880): 5. http://www.newscientist.com/article/mg13918800.600-a-painful-problem-for-men-and-women-.html.