Hypogonadal men usually have diminished libido and erectile dysfunction, and testosterone replacement therapy in these men increases sexual activity, erotic thoughts, and self-reported nocturnal erections. The polygraphlc assessment of nocturnal penile tumescence NPT provides an objective index of erectile capability and is useful for differentiating psychogenic from organic erectile dysfunction. In this study we evaluated NPT in six hypogonadal adult men during and after termination of androgen therapy. Multinight sleep studies were conducted within 1 week and 7—8 weeks after each man received mg testosterone cypionate, im. The mean serum testosterone level 4—7 days after testosterone injection was
What's to know about erectile dysfunction? Effects of medroxy progesterone acetate on subjective arousal, arousal to erotic stimulation and nocturnal penile tumescence in male sex offenders. Related articles in PubMed Apraxia in children Nocturnal penile tumescence testosterone adults with obstructive sleep apnea syndrome. Steroids 91— Sex Marital Ther. Furuyama, S. It furthers the University's objective of excellence in research, scholarship, and education by epnile worldwide. Wincze, J. Certain medications, such as antidepressantscan make it more difficult for a person to get or maintain an erection.
Henti meg. What causes erections?
While you might be familiar with REM sleep, which is shallow sleep that facilitates dreaming, you might not know that the body goes through physical changes during this time too. Related Nocturnal penile tumescence testosterone. Cabergoline Comparative Study Group. There was a clear improvement of NPT results in patients who had PRL normalization, even when tumesccence levels were not normalized. Presently, male sexual function can be easily studied by measuring nocturnal penile tumescence NPTwhich evaluates the presence or absence of involuntary unconscious erections, Sell amatuer nude pics site occurring during the rapid eye Nocturnal penile tumescence testosterone REM stage of sleep They normally occur around three to five times during sleep. Moreover, age testostwrone erectile dysfunction duration are the most important variables affecting the results after an intracavernous injection test, evaluated by NPT, probably for a venous insufficiency Morning Wood is often the Who discovred hiv erection men get because there are no triggers that deplete our energy. The possibility of a full bladder causing an erection, especially during sleep, is perhaps further supported by the beneficial physiological effect of an erection inhibiting urination, thereby helping to avoid nocturnal enuresis [ citation needed ]. This all ultimately leads to a man experiencing nocturnal penile tumescence.
Nocturnal penile tumescence NPT and erectile response to visual erotic stimuli VES were measured, by means of a Rigiscan device, in nine hypogonadal men, and repeated after 3 months of androgen replacement.
- You see, Morning Wood is often painful.
- Well, the medical term for it is nocturnal penile tumescence.
- This open longitudinal study investigated the prevalence of depressed sexual potency by monitoring erectile dysfunction using nocturnal penile tumescence NPT in 51 consecutive men with hyperprolactinemia 41 macroprolactinomas and 10 microprolactinomas and evaluated potential reversibility of sexual failure after 6 months of treatment with cabergoline.
- From the group of studies below we can conclude :.
- Nocturnal penile tumescence is a spontaneous erection of the penis during sleep or when waking up.
Hypogonadal men usually have diminished libido and erectile dysfunction, and testosterone replacement therapy in these men increases sexual activity, erotic thoughts, and self-reported nocturnal erections. The polygraphlc assessment of nocturnal penile tumescence NPT provides an objective index of erectile capability and is useful for differentiating psychogenic from organic erectile dysfunction. In this study we evaluated NPT in six hypogonadal adult men during and after termination of androgen therapy.
Multinight sleep studies were conducted within 1 week and 7—8 weeks after each man received mg testosterone cypionate, im. The mean serum testosterone level 4—7 days after testosterone injection was No androgen-related changes in the amount or integrity of rapid eye movement sleep were found. Comparison of these results to those in normal men revealed that none of these men met all diagnostic criteria for organic impotence, even 7—8 weeks after discontinuation of testosterone administration.
While men with androgen deficiency may have normal NPT, sleep-related erections increase in response to testosterone administration. Most users should sign in with their email address.
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One ring is placed at the tip of the penis; the other is placed at the base. Bruxism Cyclic alternating pattern Night eating syndrome Nocturia Periodic breathing Nocturnal myoclonus. As you have a full bladder, it can be a frustrating experience. The nerves controlling reflex erections are located in the sacral nerves of the spinal cord which are also stimulated by a full bladder. Forty-one men had a macroprolactinoma, whereas 10 had a microprolactinoma Table 1. Citing articles via Web of Science The NPT test is not used often and is not a routine way to evaluate erectile function.
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In all subjects, a general clinical examination, serum FSH, LH, and testosterone assay, and the NPT test were performed at baseline; only in the patients were all measurements repeated 6 months after cabergoline treatment. For all patients, cabergoline was the first line of therapy. Consistent with previous studies 8 — 11 , treatment was started orally at a dose of 0.
The rigidity activity unit RAU is a time-intensity measurement that represents the area under the rigidity curve during a qualified event. It is calculated by summing the rigidity values for the duration of a qualified event and dividing by 2 multiplied by The tumescence activity unit TAU represents the area under the tumescence curve above the baseline during qualified events, proportional to the percent increase of tumescence over baseline.
It is calculated by summing the tumescence value minus the baseline tumescence and dividing by 4 multiplied by the baseline. Testosterone levels were assessed using Immulite solid-phase chemiluminescent enzyme immunoassay commercial kits. As shown in Table 1 , compared with controls, the patients with either micro- or macroprolactinoma had low testosterone levels with severe alterations of erectile function.
Testosterone deficiency was present in 30 of the macroprolactinomas Symptoms of reduced libido and sexual potency had been referred by 22 macroprolactinomas However, NPT was significantly reduced in the patients compared with controls, and less than three erectile events per night were found in 49 patients All seven controls were older than 50 yr 57—70 yr.
After 6 months of cabergoline treatment, PRL levels were normalized in 38 patients No changes were noted in FSH levels to 3. Testosterone levels normalized in 35 patients, 27 macroprolactinomas and all microprolactinomas, who achieved PRL normalization, but in none of the 13 patients not achieving PRL normalization. There was a clear improvement of NPT results in patients who had PRL normalization, even when testosterone levels were not normalized.
Conversely, in the 13 patients who did not have PRL normalization, only a modest improvement was observed Table 2. According to the currently accepted criteria of three erectile events per night as the normal value, NPT normalized in 23 of 38 patients However, when the results of our control were stratified according to age, because testosterone secretion physiologically declines with aging 24 , both testosterone levels and NPT were in the normal range according to our controls in patients older than 50 yr but not in younger ones, despite achieving normal PRL levels Fig.
In contrast, as expected, patients not achieving PRL normalization still had very low testosterone and NPT values compared with age-matched healthy men. Testosterone levels top and erectile episodes per night by NPT bottom in patients after 6 months of treatment with cabergoline divided into those achieving responsive and those not achieving PRL normalization resistant compared with controls.
Both patients and controls were divided on the basis of age under 25 yr, 25—50 yr, and older than 50 yr to show the age-dependent decline in testosterone levels and qualified erectile episodes per night. The most important finding of this open longitudinal study aimed at evaluating prevalence and reversibility of erectile dysfunction in men with hyperprolactinemia is that there is a relevant difference between the subjective perception of sexual failure and its objective demonstration by measuring nocturnal penile tumescence.
Importantly, there was an age-dependent decline of testosterone levels, as expected 24 , 25 , and also of NPT events that should be considered when facing sexual failure; our patients older than 50 yr indeed achieved testosterone levels and NPT events in a similar range as observed in our healthy controls, whose number of median events per night was only two.
In fact, age is a relevant variable for sexual dysfunction. In elderly men, coordination between neural signals directing intermittent LH secretion and those governing sleep-associated penile tumescence are lost Moreover, age and erectile dysfunction duration are the most important variables affecting the results after an intracavernous injection test, evaluated by NPT, probably for a venous insufficiency It is also worth noting that patients younger than 50 yr and achieving normalization of PRL levels did not completely normalize testosterone secretion and NPT according to their age-matched controls.
The full normalization of testosterone levels is crucial to achieve restoration of sexual function as demonstrated by several reports investigating nocturnal erections. In fact, it has been demonstrated that androgen treatments to increase testosterone levels is accompanied by increased sexual interest and activity and spontaneous erections 28 — Therefore, it is likely that 6 months of PRL normalization is a period not long enough to completely restore testosterone secretion and thus sexual function.
According to some authors, severe erectile dysfunction might be considered as a precocious marker of hyperprolactinemia, even if only a few cases were studied As already mentioned, healthy men have erectile activity during the rapid eye movement REM phase of sleep; the number and duration of those erectile episodes are correlated with patient age, and it is common to find four to five episodes per night.
In , Karacan 32 suggested that monitoring NPT could distinguish between organic and psychogenic erectile dysfunction. On this basis, hyperprolactinemia can certainly be considered as an organic cause of reduced response to the NPT test. The NPT test can be an additional measure in the diagnosis of hyperprolactinemia in men because it fails in as high as Besides the clear-cut PRL-inhibitory effect, cabergoline, in analogy with other dopamine agonists 33 , 34 , could improve erectile function also directly at a central level.
This central effect has been better demonstrated by using apomorphine for the treatment of erectile dysfunction The exact involvement of dopamine in the control of sexual motivation and genital arousal in men is still unknown, but experimental data in male rats suggest an implication of dopamine in sexual motivation as well as in copulatory performance Six months of treatment with cabergoline was successful not only in producing a rapid normalization of serum PRL levels but also in restoring and preserving gonadal function in hyperprolactinemic men.
The treatment should be considered as a first choice in hyperprolactinemic hypogonadism, providing a normalizing of gonadotropin pulsatile secretion and consequently testosterone levels in most cases, thus restoring and maintaining during treatment the capability of normal sexual activity in male patients. This study was partially supported by a grant of the Italian Minister of Research and University in Rome no.
Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents. Subjects and Methods. Oxford Academic. Google Scholar. Stefano Zarrilli. Giovanni Vitale. Carolina Di Somma. Francesco Orio. Gaetano Lombardi. Annamaria Colao.
Cite Citation. Permissions Icon Permissions. TABLE 1. Demographic, endocrine, and seminal fluid parameters in patients and controls at study entry.
Open in new tab. Open in new tab Download slide. TABLE 2. Gender differences in the prevalence, clinical features and response to cabergoline in hyperprolactinemia. Search ADS. The term Morning Wood is a bit of a misnomer.
It is only at the crack of dawn when you are rousing that your member may greet you. However, most clinicians now agree that a single erectile event fulfilling the above criteria is adequate to consider an NPT normal. While you might be familiar with REM sleep, which is shallow sleep that facilitates dreaming, you might not know that the body goes through physical changes during this time too.
Morning Wood stops you from waking up during the night, as hormones feverishly put you into a slumber to get to work rebuilding your body. Not to mention it also prevents you from falling out of bed.
Your body is running critical checks throughout your system so that you awake rested and full of life, but thanks to our fascination with the penile form, we often overlook weird side effects such as sleep paralysis or apnea, in favor or our erotic observations. Morning Wood is often the best erection men get because there are no triggers that deplete our energy. The body is able to drive all of its available resources to your shaft without disruption. As your conscious mind is turned off, your body can tune into your full potential without thinking about anything.
Our minds are the best at fantasy role-play when we feel at ease, but it can have negative consequences if we think of undesirable things like Margaret Thatcher naked on a cold day, anyone? It has been suggested that sleep-related erections are triggered by the release of nitric oxide by the nitrergic nerve fibers within the cavernous nerves. Androgens regulate this mechanism as well as some other non-nitrergic processes within the corpora cavernosa and within the central nervous system.
By contrast, the erectile response to tactile or visual erotic stimuli in wakefulness predominantly involves an androgen-independent system; although it may, at least to a certain degree, also be influenced by androgen-sensitive mechanisms. Read More: Testosterone necessary for nocturnal erections, but waking erections depend on dopamine. During Nocturnal Penile Tumescence , blood enters the penis, dilates, and constricts to form an erection we can all identify, but the similarities to your conscious erections end there.
The blood flow in Morning Wood flushes excessively through your penis to make ensure there are no blockages or other problems going on with your major systems. This increased blood flood also sends important repair tools to any areas of muscle weakness, and seeks to strengthen and protect your penis.
Kinda neat, huh?
Sergio Diez Alvarez does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment. Morning penile erections affect all males, even males in the womb and male children.
It also has a female counterpart in the less frequently discussed nocturnal clitoral erection. Penile erections occur in response to complex effects of the nervous system and endocrine system the glands that secrete hormones into our system on the blood vessels of the penis. When sexually aroused, a message starts in the brain, sending chemical messages to the nerves that supply the blood vessels of the penis, allowing blood to flow into the penis.
The blood is trapped in the muscles of the penis, which makes the penis expand, resulting in an erection. This same mechanism can occur without the involvement of the brain, in an uncontrolled reflex action that is in the spinal cord. This explains why people with spinal cord damage can still get erections and why you can get erections when not sexually aroused.
They occur when certain areas of the brain are activated. We move from sympathetic fight and flight stimulation to parasympathetic rest and digest stimulation.
This is not found during other parts of the sleep cycle. This shift in balance drives the parasympathetic nerve response that results in the erection. This is spontaneous and does not require being awake. Some men may experience nocturnal penile tumescence during non-REM sleep as well, particularly older men. The reason for this is unclear. The reason men wake up with an erection may be related to the fact we often wake up coming out of REM sleep.
Testosterone, which is at its highest level in the morning, has also been shown to enhance the frequency of nocturnal erections.
Interestingly, testosterone has not been found to greatly impact visual erotic stimuli or fantasy-induced erections. Since there are several sleep cycles per night, men can have as many as five erections per night and these can last up to 20 or 30 minutes. But this is very dependent on sleep quality and so they may not occur daily. Pulses of blood flow in the vagina during REM sleep.
The clitoris engorges and vaginal sensitivity increases along with vaginal fluidity. Scientific studies are undecided as to whether morning erections contribute to penile health.
Increased oxygen in the penis at night may be beneficial for the health of the muscle tissues that make up the penis. Loss of nocturnal erection can be a useful marker of common diseases affecting erectile function. One example is in diabetics where the lack of morning erections may be associated with erectile dysfunction due to poor nerve or blood supply to the penis.
It is thought nocturnal erections can be used as a marker of an anatomical ability to get an erection a sign that the essential body bits are working , as it was thought to be independent of psychological factors that affect erections while awake. Studies have suggested , however, that mental health disorders such as severe depression can affect nocturnal erections. Thus its absence is not necessarily a marker of disease or low testosterone levels. The frequency of morning erections and erection quality has also been shown to increase slightly in men taking medications for erectile dysfunction such as Viagra.
While some men will put their nocturnal erections to good use, many men are not aroused when they have them and tummy sleepers might find them a nuisance. Since good heart health is associated with an ability to have erections, the presence of nocturnal erections is generally accepted to be good news.
Edition: Available editions United Kingdom. Many men are not actually aroused when they wake up erect. Sergio Diez Alvarez , University of Newcastle. What causes erections? What about erections while we sleep? So is all this morning action good news?