The cycle of human sexual response is of four important phases – excitement, plateau, orgasm, and resolution. The excitement state caused by some stimuli, and causes the physiological changes to take place. The parasympathetic response is activated and makes everything hyper-dilated in the reproductive system. The sexual response phases in males are erection, emission, and ejaculation. The Plateau phase has different secretions from the male and female reproductive systems. Certain ejaculation and contractions take place. Orgasm in males is called ejaculation, which is a sympathetic response. It is generated for the release of semen. In females certain uterine and vaginal contraction takes place. The resolution phase is after the entire sexual response cycle. The female does not have the resolution phase.
The sexual response in the male is controlled by the autonomic nervous system which includes spinal reflexes. There are three phases involved in sexual response and they are erection, emission, and ejaculation. The erection phase is regulated by the parasympathetic nervous system whereas the emission and ejaculation are regulated by the sympathetic nervous system. Mechanical stimulation to the receptors in the penis leads to increased activity in the brain. They act on the inner neuron of the spinal cord. The spinal cord increases activity in parasympathetic neurons to the penis. When parasympathetic activity increases, sympathetic activity decrease. Parasympathetic neurons can relax the arterioles. The smooth muscles of arterioles supply blood to the erectile tissue of the penis. It causes vasodilatation of arterioles that supply blood to the erectile tissue. The blood flow increases in the erectile tissue and therefore blood pressure and volume increase which leads to an erection. The blood volume is increased and the blood pressure compresses veins in erectile tissue. When veins are compressed, blood is accumulated in the tissue. There is less blood leaving the erectile tissue and this starts a positive feedback loop that causes an erection. The emission phase is when the neural activities shift from parasympathetic control to sympathetic control when erection continues in response to stimuli (mechanical stimuli). The sympathetic nervous system causes contraction of the epididymis, vas deference, and ejaculatory duct. It means the movement of sperm is taking place. Sperm leaves the seminiferous tubule and travels to the urethra. Secretions from the seminal vesical and prostate gland take place. The same movement takes place into the urethra using the sympathetic nervous system. Emission is followed by ejaculation. Smooth muscles in the urethra and skeletal muscle present at the base of the penis contract. The urethral sphincter is closed so that urine and semen do not get mixed. Semen moves from the urethra to the outside of the body.
The blood pressure is a simple elevation of systolic and diastolic pressure or it could be a significant elevation. The significant elevation in blood pressure triggers the renin-angiotensin mechanism to cause the blood vessel to relax and also contract. The vessels of terminal arterioles and capillaries become stiff. The normal blood pressure is 120/80 mmHg (millimeters of mercury). People with hypertension have higher blood pressure. High blood pressure affects the erectile mechanism. In erectile dysfunction especially in a B.P. (blood pressure) patient, the terminal arterioles do not relax. The helicine arteriolar is present in the penis and it does not relax. The tissue does not get oxygen when the arteriole does not relax. The nitric oxide, which is a primary mediator of the erection mechanism, does not get released. Some of the people with hypertension are more prone to erectile dysfunction. Hypertension is controlled in some people with one drug or some people with two or three drugs. The people who require two or three drugs have a higher risk of erectile dysfunction than those with a single drug. The drug to treat erectile dysfunction leads to an increase in the blood flow to the erectile tissue.
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