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How would you explain the common method so many men use to combat stress, which is to have sex, if the penis can't function under stress? Now, this makes me wonder, how does performance go with all those who take medications these days that affect noradrenaline? Because the sexual dysfunction is usually attached to the effect on serotonin. I would add that from my own experience as an anxiety sufferer, which does involve cortisol, that it never ever ever affected that part of my anatomy, but depression and prostate surgery certainly have. Therefore stress might be a factor in the complicated nature of human response, but cortisol isn't what controls erections. Now, I'm not a scientist either, I was just interested and found in about five minutes an article from NIH and one from the journal Nature that would appear to contradict your explanation. Cortisol, on the other hand, is thought to originate in the amygdyla.

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It appears that noradrenaline, or norepinephrine, located in the spinal cord, plus nitric acid, are responsible for erections, though probably not necessarily always for the lack of one. This preamble is just to say, I'm not sure cortisol has anything to do with this. You say you're an MD, but an MD isn't a scientist necessarily, most are clinicians who don't really have the theoretical knowledge a research scientist has. Sorry for the long post but I felt the condition needed to be fully explained. You could probably find a doc who does that and ask about penile injection. Botox to the scrotum has become trendy lately to make the testicles hang lower. I don't know if there are many (or any) docs that do botox to the penis. Botox injections are expensive though and need to be repeated every 4-6 months. There has been at least one study using botox injections to the base of the penis which were successful with few side effects. There is also an herb called ashwagandha that can decrease adrenaline release by decreasing cortisol levels. One of these is Flomax that is used to treat weak urine flow caused by enlarged prostate. There are some drugs called alpha blockers that can help.

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How to treat it? Remove all sources of stress. Why it becomes hyperactive in some men is unknown. Also chemical factors such as stimulants (caffeine, nicotine, etc.). Any type of physical (exertion, cold temp) or mental stress (anxiety) can cause it. It's not really necessary today but the response remains. In the past this was beneficial to protect the genitals during combat, getting chased by a tiger or being exposed to frigid temperatures. Sometimes the contraction can be so strong as to shrink the penis to the size of a button. When stimulated the muscle fibers contract. This is composed of connective tissue and muscle fibers that respond to adrenergic stimuli (adrenaline). The penis and scrotum are covered by what's called the Dartos fascia just under the skin. Most doctors have never heard of it because it's not (or didn't used to be) considered a pathologic condition, just a hyperactive normal physiological response. The condion is called 'Hyperactive Penile Retraction Syndrome'. I just came across this thread and it doesn't look like the problem was adequately addressed so I'm bumping it to try and help anyone with this condition. My husband went to the doctor and of course the doctor didn't have any answers. Does anyone else have this problem or know someone who has? I posted this about a year ago and I received 6-7 messages saying that they or their husband/boyfriend has it and they haven't found any answers to it either. but it makes my husband uncomfortable knowing its retracting and has to adjust himself. I don't believe there has ever been any reports on a penis retracting and never coming out. I have googled this and others have told me that this is called 'Penis Panic' which is a disorder saying that it is all in a guys head. When running or exercising, he is constantly having to 'pull' his penis to keep it from retracting. his penis starts to retract into his body. and I have too! Whenever my husband gets nervous, anxious, or his adrenaline starts to pump. let me say that this isn't a problem that is just in my husband's head! I have had 2-3 woman say that they have seen their husbands/boyfriend problem with their own eyes.

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