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Can someone shed some light on my question.

there are times when I wake up at night and I have a very hard erection , so much that's its hard to take a piss.
which led me to my question. Why does the blood flow into the penis at night so successfully, but if you have ED
and try to have sex after arousal the blood flow isn't as strong? Seems like , at night the blood flow is wide open
but closed when attempting to have sex. seems to me that If I had a blood flow problem that I would not be able to get a strong erection at night either. Any ideas?
thx

I had ED for 30 years. After all that time I was finally diagnosed with a severe Venous Leak. My symptom for all of those years was only being able to get an erection for sex or masturbation while I was flat on my back and relatively still. It was a massive effort that took time and patience and if I moved much at all I lost the erection immediately. Yet, all he way up until the day I woke up for my implant sugery I got morning wood. I'd wake up with a raging hardon the rivaled what I had as a teenager. So there was an obvious difference for me because I still had the same VL during the night, but somehow it did not cause a problem for me then. I hope you get your issue figured out. Good luck.

hmmmm, interesting.....
any others out there experience this having really strong erections at night but when it comes to sex , its like a semi flat tire lol?

Even tho I've never had raging boners like you say you have, I used to get a decent amount of nocturnal erections. This was confusing me a lot and I talked to two urologists about it eventually. What they both explained is that the systems responsible for the nocturnal and arousal erections are completely different. Not the same nerves and not the same mechanics are in play, so having one doesn't mean mucblh about the other.

What puzzles me tho is what Greg here said. AFAIK if you have venus leak, you shouldn't have any erection because your veins just can't hold the blood in, no matter the system used. And vice versa, if you do have at least nocturnals then you can be sure your Ed is not venus leak related.

In the last couple of years I've only been getting light morning woods every now and then. I know it's a bit related with the amount of sex I am having, but also lately the injections have really declined in effectiveness and I am getting very worried that I've developed VL

In my experience, the issue of a venous leak and body position is more complicated that you might think. Depending on where the leak is, it may be more or less open depending on the pressure put on it by the surrounding tissue. In my case, I get the best erection sitting upright or standing; lying on my back, my erection is worse. Various posts on Franktalk show other men with a venous leak have various results with the erection being better for some standing and for others lying. The change of erection quality with position is one of the symptoms of a venous leak.

Hunchback wrote:
What puzzles me tho is what Greg here said. AFAIK if you have venus leak, you shouldn't have any erection because your veins just can't hold the blood in, no matter the system used. And vice versa, if you do have at least nocturnals then you can be sure your Ed is not venus leak related.

a Venous Leak is generally position dependent. I was able to get erections in some positions, but not others. My problem also was related to movement. When I tried to have sex or masturbate, it required movement to stimulate an erection, but the movement made it difficult to get hard. My nocturnal erections or morning wood took place during sleep when I was still and as long as I was in a position where the leak was not on the low side of my shaft, the VL did not affect them. However, once I woke up and either adjusted my position or tried to use the erection to masturbate or have sex, I lost it quickly from movement.

I see...
Did a decent cock-ring help you with the VL problem?

Hunchback wrote: [...] What they both explained is that the systems responsible for the nocturnal and arousal erections are completely different. Not the same nerves and not the same mechanics are in play, so having one doesn't mean mucblh about the other.
[...]

This is interesting and maybe a bit controversial.

I believe some urologists claim the exact opposite, e.g. they say nocturnal erections are not only very benefitial because they bring blood to the penis, they are also proof that there is no physical cause to ED. I honestly don't know.

I was going to say that when you're asleep, you are completely relaxed and the sympathetic nervous system is shut down, but it's just a theory of mine.

Not necessarily "no physical" cause of ED, more like "no vascular".

I think a venous leak is commonly misdiagnosed. I am the same way and had the same conversation with my urologist. It doesn’t matter where the erection comes from or when it happens. If it occurs then the leak is non existent or insignificant. And if it is position dependent then why can’t i lie in the same position and achieve an erection while awake?

My urologist had the same answers that didn’t make sense. It’s easier to blame it on a venous leak then to admit you don’t know what’s wrong. Doctors have a hand full of tests and a hand full of cures all of which could be taught in a day. Pills>therapist >shots>venous leak diagnosis > implant. If they stick to this model they can see a lot of patients in a day. What they don’t want is a patient with a difficult issue that takes up time. Or a problem they don’t have an answer to.