What Is Venous Leakage?

Venous leakage, (also known as venous leak,) is a cause of erectile dysfunction (ED) in individuals with penises.

When a person gets an erection, the arteries in the penis expand to allow more blood to enter the penis to make it firm. This inflow of blood leads to increased pressure in the penis, which compresses the veins that would normally allow the blood to flow back out, thereby keeping the blood in the organ until ejaculation or the end of sexual activity. This allows the individual to maintain the erection during the entire sexual experience.

However, sometimes, even when a person has adequate blood flow to the penis, the veins do not constrict properly with the rising pressure in the penis, and some of the blood that has flowed into the penis “leaks” back out into the body. This causes the person to lose rigidity or their erection entirely.

Many individuals who experience venous leakage report starting off with satisfactory erections but gradually losing firmness over time. ED that is related to venous leakage is known as venogenic ED or penile venous insufficiency.

The number of people who suffer from venous leakage is unknown, and it can be misdiagnosed in cases where the pressure in the penis never rises adequately to compress the veins (a condition known as arterial insufficiency). Nevertheless, venous leakage is thought to be a common cause of ED.

Some conditions and factors that may increase a person’s risk of experiencing venous leakage are diabetes, vascular disease, neurological disorders, cancer treatments such as radiation therapy, Peyronie’s disease (PD), the use of certain medications, and anxiety. In particular, PD is thought to contribute to venous leakage because the scar tissue that causes the penis to bend may also prevent the veins from clamping down to keep blood in the penis.

Some symptoms of venous leakage include the inability to maintain an erection, erections that gradually soften, and no morning or nocturnal erections, all of which are symptoms of other types of ED as well.

Also like other types of ED, venogenic ED has several potential treatment options, some of which may be more effective for than others, depending on the individual. Possible treatment options for ED caused by venous leakage are oral ED medications, vacuum erection devices, intracavernosal injections, and penile implants. Lifestyle modifications such as getting regular exercise, eating a balanced diet, maintaining a healthy body mass index (BMI), and quitting smoking can also support good erectile functioning.

If you believe that you may be experiencing venous leakage, schedule an appointment with your primary health care provider or a sexual medicine specialist who can help you determine the underlying cause(s) of your ED.

For more information on this topic, please read these publications from the ISSM Journals: The Journal of Sexual Medicine, Sexual Medicine Reviews, and Sexual Medicine Open Access:

Standardization of Vascular Assessment of Erectile Dysfunction

Thinking About Pathomechanisms and Current Treatment of Erectile Dysfunction—“The Stanley Beamish Problem.” Review, Recommendations, and Proposals

References:

International Society for Sexual Medicine. (n.d.). What is venous leakage and how does it cause erectile dysfunction (ED)? Retrieved July 12, 2023, from https://www.issm.info/sexual-health-qa/what-is-venous-leakage-and-how-does-it-cause-erectile-dysfunction-ed

WebMD. Medically Reviewed by Nazia Q Bandukwala, DO. (2021, September 9). Erectile Dysfunction and Vascular Disease. https://www.webmd.com/erectile-dysfunction/vascular-disease-ed