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Hello all, It has been awhile since I have posted. I am 59, with ED progressively getting worse. Last year, I had a mild heart attack and before that I had 2 cardiac stents put in. I am slowly dealing with and accepting ED. The interesting thing is about once a month or so, I wake up, I have firm "morning wood". Is that common? I know I used to get this a few times a week. And it seems very random as to when it happens.

Absent the heart attack and stents, your story is similar to mine.

How long does the morning wood last?

Have they been getting less rigid over time (months/years)

Generally I have to urinate quickly so maybe 5 to 10 minutes after I wake up. It is ironic that it is a nuisance.
And the frequency definately has gone down, but the hardness seems to be the same.

The presence of nocturnal erections and morning erections suggests that your plumbing may be intact. (tending to rule out venous leakage and pointing to some other cause, like psychogenic - but this is a tenuous tending and VERY far from conclusive, or even hard evidence). Sometimes a man's position/posture will affect an erection (standing, sitting, on his side, etc.) and this is also pretty vague evidence that must be taken into account by a clinician who can take a full history and physical examination.

If your plumbing is truly intact, oral medications may be the way to go (though heart conditions need to be taken into account before oral meds are used).

I am no sort of medical professional, so my thoughts are pure speculation. Consulting a urologist specializing in male sexual function/dysfunction is, I think, appropriate.

I am a recent recipient of Titan Inflatable Prothesis.
I was not capable of erections for intercourse without injecting tri-mix. But I did get nocturnal erections, which didn't last long after waking up. During my workup with my urologist I had a penile ultrasound, they scanned my penis then injected meds for erection and then scanned again.
The results were that I had great blood flow and no venous leakage. Surgeon explained it was nerve damage from diabetes and high blood pressure. The nerves weren't emitting the "chemical" to cause a sexual erection, and this is also why the oral meds wouldn't work for me. Because they still relied on this chemical. He also explained that the nocturnal erections were a different physiological process then for sexual erections. So that was why even with my nerve damage I could still have nocturnal erections. You have to remember the definition of ED refers to the inability to achieve/maintain erection for satisfactory sexual relations.
Too often they will tell you that if you can get nocturnal erections then it's all in your head. This is not necessarily true.

implant1959 wrote:I am a recent recipient of Titan Inflatable Prothesis.

Surgeon explained it was nerve damage from diabetes and high blood pressure. The nerves weren't emitting the "chemical" to cause a sexual erection, and this is also why the oral meds wouldn't work for me. Because they still relied on this chemical. He also explained that the nocturnal erections were a different physiological process then for sexual erections. So that was why even with my nerve damage I could still have nocturnal erections.

Really? This doesn't make sense. You need the nerve-transmitted chemical to get an erection when you are awake, but don't when you are asleep?

Anyone else heard this? I'm very interested in the physiology of erections and would like to learn more. I am 30 months post-RP and striving for the "holy grail" -- a spontaneous, intercourse-quality erection without injecting or taking pills. I still believe it is possible for me.

ftwabeck3533 wrote:

implant1959 wrote:I am a recent recipient of Titan Inflatable Prothesis.

Surgeon explained it was nerve damage from diabetes and high blood pressure. The nerves weren't emitting the "chemical" to cause a sexual erection, and this is also why the oral meds wouldn't work for me. Because they still relied on this chemical. He also explained that the nocturnal erections were a different physiological process then for sexual erections. So that was why even with my nerve damage I could still have nocturnal erections.

Really? This doesn't make sense. You need the nerve-transmitted chemical to get an erection when you are awake, but don't when you are asleep?

Anyone else heard this? I'm very interested in the physiology of erections and would like to learn more. I am 30 months post-RP and striving for the "holy grail" -- a spontaneous, intercourse-quality erection without injecting or taking pills. I still believe it is possible for me.

Here are some various things I found online.

“While there’s no shortage of evidence for the existence of morning and nocturnal erections, nobody knows the exact reasons for morning erections.”

“A leading theory is that norepinephrine production slows down during REM sleep (Mitchell, 2010). This is the chemical primarily responsible for keeping the penis relaxed. Basically, the part of the brain that maintains norepinephrine levels gets turned down during REM sleep. This lets the testosterone-related excitatory mechanisms take over, leading to an erection.”

” Sexually induced erections are a combination of erotic and reflex erection activity, whereas the mechanism initiating and maintaining sleep erections is unknown”

“We do not fully understand why morning erections happen – some theories link morning erections to rapid eye movement (REM) sleep. Whilst in this stage of sleep, it is thought that the systems in the body that prevent erections from happening are switched off temporarily. While these systems are switched off, an erection happens. Also, more testosterone is released in the body as you wake up from REM sleep, which can cause erections. Other studies suggest that these morning erections occur in a different way compared to erections in the day that result from erotic thoughts and stimulation.
They are distinct from normal erections – what we do know is that morning erections are quite different to the erections that happen as a result of being aroused. An arousal erection happens in a different way. A person can become aroused from erotic thoughts or stimulation to the penis. This results in the brain telling the rest of the body to send more blood into the penis.""


” the mechanisms that cause a morning erections are actually different to the mechanisms that cause erections which are a result of erotic thoughts and stimulation. Because of this, some men actually find it quite difficult to have sex if they’ve had a morning erection. So, having a morning erection doesn’t necessarily mean that you’re aroused or interested in having sex.”

So I don’t think you can say all erections are created equal, different things are happening in the body and the brain that impact erections

ftwabeck3533 wrote:

implant1959 wrote:I am a recent recipient of Titan Inflatable Prothesis.

Surgeon explained it was nerve damage from diabetes and high blood pressure. The nerves weren't emitting the "chemical" to cause a sexual erection, and this is also why the oral meds wouldn't work for me. Because they still relied on this chemical. He also explained that the nocturnal erections were a different physiological process then for sexual erections. So that was why even with my nerve damage I could still have nocturnal erections.

Really? This doesn't make sense. You need the nerve-transmitted chemical to get an erection when you are awake, but don't when you are asleep?

Anyone else heard this? I'm very interested in the physiology of erections and would like to learn more. I am 30 months post-RP and striving for the "holy grail" -- a spontaneous, intercourse-quality erection without injecting or taking pills. I still believe it is possible for me.

Yes, really.
All my uros told me the same thing, and i too didn't get it at first. I thought that if i can get a nocturnal erection i should also be able to get "normal" ones... but apparently it is indeed two completely different systems. The sexual arousal one is broken in my case, the other is "fine".

Good explanation of why morning wood is different. Never seen that. There are new treatments for nerve damage that are promising.

Hunchback wrote:

ftwabeck3533 wrote:

implant1959 wrote:I am a recent recipient of Titan Inflatable Prothesis.

Surgeon explained it was nerve damage from diabetes and high blood pressure. The nerves weren't emitting the "chemical" to cause a sexual erection, and this is also why the oral meds wouldn't work for me. Because they still relied on this chemical. He also explained that the nocturnal erections were a different physiological process then for sexual erections. So that was why even with my nerve damage I could still have nocturnal erections.

Really? This doesn't make sense. You need the nerve-transmitted chemical to get an erection when you are awake, but don't when you are asleep?

Anyone else heard this? I'm very interested in the physiology of erections and would like to learn more. I am 30 months post-RP and striving for the "holy grail" -- a spontaneous, intercourse-quality erection without injecting or taking pills. I still believe it is possible for me.

Yes, really.
All my uros told me the same thing, and i too didn't get it at first. I thought that if i can get a nocturnal erection i should also be able to get "normal" ones... but apparently it is indeed two completely different systems. The sexual arousal one is broken in my case, the other is "fine".

Will add one more comment, based on personal experience. I have recently began taking my daily 20mg dose of Sildenafil in the middle of the night (if I wake up to pee). My morning wood is much stronger since I started this regimen, the PDE5 does work whether you are asleep or awake.