Sex and Psychology Podcast Episode 458: How Erections Really Work (And Why They Fail)
Dec 16, 2025
In this engaging discussion, Dr. Elliot Justin, an emergency medicine specialist and the founder of FirmTech, unpacks the mechanics of erections and tackle common misconceptions about erectile dysfunction (ED). He reveals the often-overlooked issue of venous leak and explains why pills shouldn't be the go-to solution. Dr. Justin also highlights the significance of nocturnal erections as indicators of overall health and offers innovative alternatives, such as cock rings, to enhance performance. Tune in for a fascinating dive into men's health!
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Erection Physiology Is Dual-Sided
- Erections require both arterial inflow and venous compression to trap blood; smooth muscle around venules must constrict to prevent venous leak.
- PD-5 drugs increase inflow but don't address the venous side, so they aren't a complete fix for many problems.
ED Often Misdefined In Practice
- Many men are mislabeled as having erectile dysfunction when their erections are adequate but fade faster with age.
- Clinical expectations based on sick patients skew perception about general population erectile health.
Put A Ring On To Maintain Hardness
- Use a constriction ring to keep blood in the penis when erections begin to fade during sexual activity.
- Combine a ring with a PD-5 medication if you want to optimize performance further.