The erection of the penis, clitoris or a nipple is its enlarged and firm state. It depends on a complex interaction of psychological, neural, vascular and endocrine factors. The ability to maintain the erectile state is key to the reproductive system and many forms of life could not reproduce in a natural way without this ability.

Penile erection

Penile erection usually results from exposure to sexual stimulation from sexual arousal, and can also occur due to a full urinary bladder. In some men, erection can occur spontaneously at any time of day; it is known as nocturnal penile tumescence when occurring during REM sleep.

An erection results in swelling, hardening and enlargement of the penis, enabling sexual intercourse. The scrotum may also become tightened during an erection. Erection is not required for all sexual activities.

Autonomic control

In the presence of mechanical stimulation, erection is initiated by the parasympathetic division of the autonomic nervous system (ANS) with minimal input from the central nervous system. Parasympathetic branches extend from the sacral plexus into the arteries supplying the erectile tissue; upon stimulation, these nerve branches initiate the release of nitric oxide, a vasodilating agent, in the target arteries. The arteries dilate, filling the corpora spongiosum and cavernosa with blood. Erection subsides when parasympathetic stimulation is discontinued; baseline stimulation from the sympathetic division of the ANS causes constriction of the penile arteries, forcing blood out of the erectile tissue. The cerebral cortex can initiate erection in the absence of direct mechanical stimulation (in response to visual, auditory, olfactory, imagined, or tactile stimuli) acting through erectile centers in the lumbar and sacral regions of the spinal cord. The cortex can suppress erection even in the presence of mechanical stimulation, as can other psychological, emotional, and environmental factors. The opposite term is detumescence.

Shape and size

An erect penis can take on a number of different shapes and angles, ranging from a straight tube angled at a 45-90 degree angle, to a curvature to the left or right, up or down. A tightly curved penis, known as Peyronie's disease, is identified by a severe curve in the erect penis. This may cause physical and psychological effects for the affected individual, which could include erectile dysfunction or pain during erection. Treatments include oral medication (such as Vitamin E) or surgery, which is most often reserved as a last resort.