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Morning Glory: Why We Wake Up That Way

Posted 3/10/2016 by UHBlog

Do you have questions about erections and other normal physiological events? Ask us.

Morning Glory: Why We Wake Up That Way

You may wonder why you wake up with an erection. It's no cause for alarm – morning erections are totally normal. In fact, you may have more reason for concern if you don’t begin the day pitching a tent.

Considering the alternative, morning erections should be a welcome sight, says internal medicine specialist Roy Buchinsky, MD.

“If you don’t experience morning erections, you may also have problems getting it up when it really matters,” he says. “For guys with erectile dysfunction, a morning erection is proof that there isn’t something physically wrong with them.”

Morning erections – medically known as nocturnal penile tumescence – are normal physiological events. Typically, men have three to five erections while they sleep at night. The morning erection is the last in the series. It is known that morning erections usually happen during REM sleep – the period of sleep characterized by rapid eye movements – but the reason isn’t clear.

“We know that blood flows into the penis during REM sleep, causing it to enlarge,” Dr. Buchinsky says. “There are two theories of why it happens.”

  • One is that a full bladder during sleep pushes urine into the urethra – the outlet tube of the penis – and causes the organ to engorge and take in additional blood.
  • The other theory is that the brain, during REM sleep, reduces the production of chemicals that keep the penis in its normal, flaccid state, which allows it to take in and hold more blood, causing an erection.

“In any case, a morning erection is a good sign that the plumbing is working,” Dr. Buchinsky says. “I’ve never had a patient come in to complain about waking up with a woody.”

Erectile dysfunction, on the other hand, is a common complaint.

“The real problem is when you can’t get an erection – or at least can’t get one when you really need one,” Dr. Buchinsky says. “Erectile dysfunction is either caused by a physical problem or a mental or emotional problem. If you can never achieve an erection, it’s likely that the problem is physical, like an obstruction of blood flow. If you have erections when you wake up, but not during sexual activity, the problem is probably due to stress, anxiety, relationship issues or some other mental or emotional condition.”

Physical issues can result from:

  • Smoking
  • Conditions like diabetes, high blood pressure and high cholesterol
  • Side effects of medication

These physical causes can be treated with lifestyle changes, or by taking medications, such as Cialis or Viagra.

“It may sound funny, but a good diet of fruits and vegetables can actually help give you a good erection,” Dr. Buchinsky says.

Your primary care doctor or a urologist can usually rule out physical problems through various tests. If physical issues are ruled out, patients may be referred to therapy or counseling to investigate possible emotional or mental issues.

“Generally, erectile dysfunction in younger people is more likely to be psychological,” Dr. Buchinsky says. “As you get older, it is increasingly likely to be a physical issue.”

Roy Buchinsky, MD is an internal medicine specialist and the director of wellness at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Buchinsky or any other University Hospitals doctor online.

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