Dangerous Erections: What Happens When "It" Won't Go Down

Medically reviewed in February 2022

If you’ve seen commercials for erectile dysfunction meds on TV, you’ve probably heard the warnings about four-hour erections. (A detail like that is hard to miss.) A study says that the medical problem the ads are talking about, called “priapism,” is more common than thought. But impotence drugs are rarely the cause.

Priapism is a painful and dangerous condition that happens when blood fills the penis during arousal and fails to drain out. It can cause permanent harm to the organ by preventing oxygen-rich blood from entering. After a while, tissues in the penis actually begin to die due to lack of oxygen.

Researchers at Northwestern University School of Medicine looked at a database of emergency department visits from 2006 to 2009. They estimated that about 10,000 men head to the ER each year for priapism, making the problem about eight times more common than previously thought.

Few men actually have bad reactions to erectile dysfunction drugs, experts say. A much more common cause is sickle cell disease, a blood disorder that affects about 1 in 12 African-Americans, in which red blood cells become deformed. The cells then can get stuck in blood vessels in the penis and block blood flow. The study found that sickle cell disease accounts for about 20 percent of priapism cases.

Another common cause was an injection that sometimes is used to treat erectile dysfunction. In many cases, there’s no clear reason at all.

Whatever the cause, priapism is an emergency that requires medical treatment right away. Remedies can include—try not to get squeamish here—using a needle to remove the stagnant blood and flush out vessels, injecting medications to help the blood drain or surgery to install a shunt in the penis.

Those options may leave you wanting to stay home and hope “it” goes away. But don’t do it! Getting help promptly is the best way to ensure that your manhood stays healthy and continues to work for you.

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