Thursday, October 29, 2009

Understanding Male Sexuality: Information You Did Not Learn From Your Parents, Your Friends or in Your High School Sex Education Class! (Part I)

This information is intended for those who wish to learn more about male sexuality--particularly information about topics that are considered to be too complicated, controversial or perhaps too embarrassing to discuss. The topics discussed here are loosely based on my responses to several hundred e-mail questions that have dealt with a variety of complicated but interesting issues related to male sexuality.

Basic Plumbing and Electrical
A suitable starting point is to begin with a discussion of how the basic plumbing and electrical system of male sexuality works. The plumbing and electrical system is complex, but very well designed for its purpose. Medical doctors refer to the electrical system consisting of the portions of the brain governing male sexual response and the associated nerve system as the limbic system. This electrical system connected to the plumbing system--a series of arteries and veins that control the inflow and outflow of blood to and from the penis, and also is connected via nerves to assorted glands.

Arousal, Erection and Ejaculation
Men often tend to consider these together, but, in reality they are separate but interrelated events, although ultimately related to each other. Any of these events can occur in the absence of the others

The Arousal Mechanism
Suppose that a man encounters something that excites him sexually. (more about what this might be later on). What happens? First, of course, messages are transmitted to the portion of the brain dedicated to sexual response. The man says to himself "I'm turned on" which is slang for sexual arousal. Many men believe that sexual arousal is always accompanied by an erection, but this is not necessarily the case at this first stage. The experience of being aroused is followed by electrical signals to two tiny glands that lie along the sides of the urethra where the tube that leads from the bladder through the tip of the penis. These two glands, called the Cowper's glands, are located inside the body directly above a point behind the scrotum called the perineum.

These little-recognized glands play a role in the male sexual response. They are
primarily responsible for the production of glistening drops of a clear, slippery fluid sometimes called pre-ejaculate, but known also in slang as "ooze" or "precum". For many men, if not most, the first physical indication of sexual arousal is the formation of a drop or two of this fluid at the tip of the penis, even before erection occurs. Some men believe that when this fluid appears, they are already starting to leak ejaculate but this is not the case. This fluid acts as a lubricant for sperm and semen and lubricates the tip of the penis in sexual intercourse. It's pH level is quite high and it is very slippery. Research suggests that the high pH may help decrease the acidity of the vagina, thereby increasing the chance that the sperm will be able to fertilize the egg. Nature is very creative; it thinks of everything. Nature is at its very best when creating systems to ensure the continuation of the species, and the human system is one of its best and most elaborate efforts. The sexual arousal section of the brain sends signals to the cowper's glands (sometimes called the bulbourethral glands) telling them go into action. This is an automatic result of sexually-exciting stimuli, and thus outside of conscious control: the only way to stop it's production is to avoid the stimulus that is causing the sexual arousal.

These glands are present in many other mammals including the common livestock species. An internet resource dealing with the reproductive system of bulls, for example, indicates that the cowper's gland also secretes a similar clear fluid which is produced (and drips off the end of the bull's penis) during initial sexual arousal! Again, a function of the fluid is to reduce the acidity of the urethra, increasing the chance that sperm will survive.

A number of other things happen during the early stages of sexual arousal. First the man suddenly feels very good, psychologically. During arousal, the brain is flooded with natural chemicals that act similarly to drugs such as cocaine. These natural chemicals, called endorphins, make the man say to himself that whatever is causing the sexual arousal is very enjoyable and should be continued. If the sexual response is the result of observing another person, the man may make an effort to meet the other person involved.

Nature protects itself here and is very cunning. Nature's goal is to continue the species. If this is to occur, it's important that sexually attractive mates elicit a response that maximizes the chance that the two people involved will become better acquainted and perhaps eventually engage in sexual intercourse. (In case you were wondering, the arousal mechanism works identically for gay males, but the object of the sexual attraction here, is, of course, another male.)

Most men will produce pre-ejaculate when anything found to be sexually exciting occurs, perhaps even reading a sexually explicit story or watching a sexually explicit movie. The reason erotic books and videos sell well is because it often elicits this response in men along with feelings of psychological well-being, whether or not they have erections ultimately result in orgasm. There is no limit to the length of time that a man can be aroused, and throughout the man can continue to produce drops of pre-ejaculate. Pre- ejaculate may, of occasion, contain some sperm, and a woman can become pregnant even if actual orgasm and ejaculation does not take place. That is rare, although there are cases of this happening.

Normally, however, arousal is followed by erection. An erection of the penis occurs as the spongy tissues of the penis are engorged with blood. There is one large primary artery responsible for blood flow into the penis, but several veins that drain the penis of blood. When an erection is not happening, the inflow of blood and the outflow is maintained in balance and the penis remains flaccid. The valves (actually flaps, according to medical experts) that control the flow of blood, however, are opened and closed by nerves that run through the spinal cord to the brain. During erection, blood flows into the penis and holes in the spongy tissue in the penis fill with blood. At the same time, flaps in the veins leading out of the penis enlarge, cutting off the drainage. As a result, the penis fills with blood. As more and more blood flows in than out, the penis enlarges and becomes harder. Finally, veins in the penis are compressed from the increasing pressure from the erection itself. Not only that, the heart rate and blood pressure increase, the pressure of blood into the penis increases, keeping the penis the hardest.
What can go wrong with the plumbing system? Several things. Those with spinal cord injuries are frequently unable to attain an erection because the nerves that control the valves in the veins and arteries have been severed. If these valves cannot be opened and closed an erection is impossible. As a man ages, the valves (flaps) controlling the veins that must be shut off may leak a bit, and not prevent the outflow of blood. And the blood flow into the penis may be restricted.

Also, as a man ages, the main penis artery may fill with sludge, reducing blood inflow. Smoking may contribute to this, as it does to the buildup of sludge in other portions of the circulatory system. Furthermore, alcohol use may decrease the ability of the nervous system to close off the necessary valves. That's why intoxicated men often cannot get and maintain an erection. Bicycle and other injuries to the groin area can be dangerous in that the main artery controlling blood flow to the penis may be squeezed shut, making a firm erection difficult or even impossible.

The size of the erection may be relatively unrelated to the size of the non-erect penis. Typically, those with smaller penises tend to enlarge to a greater degree when erect, so the differences in the size of the erect penis may not be that great. According to the book "Man's Body," the average flaccid penis is about 3 3/4 inches long with most falling between 3 1/4 and 4 1/4 inches, though a few fall outside this range. The average erect penis is 6 1/4 inches, with most between 5 and 7 inches, though a few are smaller and larger.

A somewhat tongue in cheek primary data survey is at How Do you Measure Up?

A Newsweek article (September 16, 1996, p. 73) reported American Geriatric
Society average data on the angle of erection from horizontal of the erect penis
by age. The data are as follows:
Age Angle
2010 degrees up from horizontal
3020 degrees up from horizontal
40 1 degree up from horizontal
50 1 degree down from horizontal
7025 degrees down from horizontal

I wonder how data like these are collected!
An article in Men's Health Magazine (June, 1996) indicates that these data are overly optimistic, and that the average erect penis length now widely accepted by doctors is 5.1 inches. This seems a bit short to me, at least for an average number, but if these data become widely known, most men may be happy to find out that they are "above average." Part of the problem is that scientific data on this is difficult to collect by other parties, and men, if they measure themselves in private, are perhaps sometimes prone to brag a bit. Furthermore, erect penis length varies with the degree of erection.

Past puberty, in the teen years, and perhaps during the twenties, it is possible to get a full erection without any manual stimulation at all. As men age beyond the 20s, this occurs less and less frequently and increasingly some manual manipulation of the penis is needed. As the penis becomes increasingly erect, the nerve endings located there gradually become more and more sensitive to touch. In general, the harder the penis can become, the more pleasant the sensations from the touch. Other physiological changes occur. As the erection grows, the heart and breathing rate increases. During the initial stages of arousal, before erection occurs, the testicles and scrotum feel quite large and soft, and are very sensitive to touch. Gentle pressure on the testicles with the fingertips produces particularly pleasant sensations. As the erection proceeds, the testicles change as well, increasing in size by up to 50% as they also fill with blood. The become harder and are drawn up to the body as the point of ejaculation becomes nearer and nearer.

Many men think that an erection must ordinarily proceed to an orgasm and ejaculation, but this is not necessarily so. By repeatedly massaging and then stopping the manual stimulation of the penis, a man can go through many erection cycles that do not necessary need to lead directly to orgasm. With each cycle, often the man can learn to take a bit more stimulation without ejaculating. Research indicates that stimulation of the septum, a portion of the brain known to be a part of the limbic system, results in the feeling of an orgasm, but this stimulation produces neither an erection nor ejaculation. These findings support the theory that ejaculation and orgasm, though often linked together, are, indeed, separate events. Interestingly, this research finding also lends credence to the theories of those authors who advocate the view that men can learn to have multiple, closely-spaced, orgasms.

Learning how to achieve an erection just below the level which will lead to ejaculation is an important part of sexual enjoyment. It is important for the man to learn how to read his body's signals that orgasm and ejaculation are near. Psychologists call the point where the man can no longer delay orgasm the "point of inevitability" There are several physical indications. First, the hole in the tip of the penis will become more slit-like. Precum production will stop. Generally if the fluid at the tip of the penis becomes milky, the point of inevitability is already past.

Learning how to lengthen the arousal and erection period while delaying orgasm is an important part of maximizing enjoyment from sex. As the erection proceeds, the physical sensations become increasingly more and more exciting, and the psychological pressure to ejaculate becomes more and more intense. The trick is to lean to keep the stimulation just below the level required for ejaculation while learning to deal with the increasing psychological pressure to ejaculate. Like driving a racing car closer and closer to a wall at ever high speeds, the psychological pleasure becomes more and more intense, the longer the arousal can be maintained without ejaculation, but the greater the enjoyment for the man.

Furthermore, the longer this stage can be maintained, the more powerful and enjoyable the orgasm will be for the man. Thus, developing skills for doing this and dealing with the psychological desire to ejaculate for as long as possible are essential for the full enjoyment of partner (and solo) sex, and this is what requires practice. Women usually require a somewhat longer period of time to become fully aroused, so being able to delay orgasm potentially increases the enjoyment of sex by both partners.

Many women believe that men are happier the more frequently they can have intercourse. This is not really accurate. What men truly enjoy is being aroused with their partner (and as their partner is also aroused) while both remain in an aroused state for a long period of time, delaying orgasm for as long as is comfortable and possible. A continuing theme of the story lines in erotic literature is a situation in which the woman arouses the man and keep him for a long time at a level just below what is needed to achieve an orgasm. It's important in achieving marital happiness for women to learn how to do this for their husbands,

All of the sections of the erect penis are not equally sensitive. Thus, by varying locations being stimulated, the man can perhaps delay orgasm.

Stimulation of the base of the penis, near the body, while pleasant, normally will not be sufficient to achieve orgasm. The underside of the tip of the penis, called the frenulum, is very sensitive to manual stimulation. If this area of the erect penis is stimulated very much, an orgasm (and ejaculation) will occur almost immediately. Thus it is important to not stimulate this region, at least not until late in the sex play.

There is a reason for this. During intercourse, when the man's penis is fully inside the woman's body, the tip of the penis will touch the cervix at the end of the vagina. Unless the man is deep inside the woman, the vagina is simply a hollow tube, and the tip of the penis is not touched. By ensuring that the orgasm takes place almost precisely when the tip of the penis comes in contact with the cervix, the sperm will have the shortest distance to travel to reach the waiting egg. Thus, a man's "reward" for placing the semen in the location that will maximize the chance that the woman gets pregnant (and the species continues) is the pleasant sensations that occur when the tip of the penis touches the cervix. In sex play, the man can reproduce these pleasant feelings outside of intercourse by touching the tip, particularly the underside of the tip, although orgasm and ejaculation will likely follow almost immediately.

Because of the sensitivity and pleasant sensations, the frenulum is often referred to as the "male G spot." A significant portion of the penis, perhaps one- third to one-half of it, lies inside the body. This portion of the penis also responds to manual stimulation. It can be felt and externally massaged at a spot called the perineum area, which is directly behind the base of the scrotum. This is a little-recognized but highly spot on the male body. This spot is sometimes referred to as the "second male G spot" though many men are not even aware that it is a sexually sensitive area of the body In addition to the possibility of externally massaging the interior portion of the erect penis, a bundle of nerves terminate here, and the main artery that is responsible for providing blood for erections runs through this area. That is why bicycle injuries may lead to impotency. Surgeons are becoming increasingly talented in repairing damage to this artery. In addition, inside, but directly above this area lies the cowper's (bulbourethral) glands, and it is likely that external massage of this area will to a certain degree stimulate these glands. The prostate is a little further up, but close by. A have heard varying opinions as to whether it is possible to externally massage the prostate by touching the perineum area, but I believe it is possible. Massaging the prostate, a walnut-size gland responsible for secreting most of the liquid contained in semen can be very pleasant, and some men do this by inserting a gloved finger directly inside the rectum, as the gland is located only about an inch inside.

Orgasm and Ejaculation
With practice, a man can learn a degree of control over the point when he proceeds to orgasm and ejaculation. Some men believe that male orgasm invariably results in ejaculation, but this is not entirely true. Some men have learned techniques for having multiple orgasms without ejaculating. Many of these techniques involving squeezing of the urethra such that the semen is not allowed to leave the body. To me, this sounds potentially painful and perhaps even dangerous.

As indicated earlier, as the point of orgasm approaches, pre-ejaculate production will normally stop, and the hole in the tip of the penis becomes slit-like. The testicles become hard and are drawn up near the body in preparation. Breathing becomes heavier, and there may be involuntary contractions of major muscles (convulsions) throughout the body.

Finally, the psychological and physical pressure to ejaculate is released in a series of muscular contractions, usually about 8 major contractions spaced a second or so apart, followed perhaps by several smaller ones that can last 45 seconds or so. In essence, a pump has swung into action. Technically an orgasm is similar to a sneeze in that it involves a series of involuntary muscle contractions in response to an "irritation," though, of course, it is usually a good deal more fun. Semen consist of a mixture of sperm from the testicles and primarily fluid from the seminal vesicles and prostate gland, but also contains smaller amounts of other fluids secreted from glands along the urethra. Often the sperm is not very well mixed with the other liquids making the semen appear to have patches of cloudy and clear areas, and has about the same consistency as liquid dish washing detergent. (Somehow, I think of that every time I start my dishwasher!) Semen is usually creamy white in color.

Once the orgasm is complete, the valves which maintained the erection are opened, and the penis is drained of blood so that within a space of a few minutes it has returned to its flaccid state.

He Dribbles! He Shoots!
Generally the more frequently a man has an ejaculation, the less force that ejaculation will have. This results in a shorter shooting distance. Most of the differences, however, appear to be both genetic and age-related. Some men are able to shoot longer distances than other men, and younger men tend to have greater force of ejaculation then older men. The book "Man's Body" indicates that after prolonged abstinence - more than three days - a man may be able to shoot 3 feet or more, but the average is 7 to 10 inches with more frequent ejaculation. If one is able to ejaculate two to three hours after his previous ejaculation, the semen just dribbles out. The ability to shoot long distances not only declines generally with age, but probably varies somewhat according to the hardness of the erection, too. There is also a wide variation in semen production, also according to the book "Man's Body", ranging from 0.2 ml to 6.6 ml.This same book notes that 3.5 ml is average after a few days without ejaculation--about a teaspoonful--while 13 ml has been recorded after prolonged abstinence. So this must be judged in relationship to the frequency of ejaculation.There is undoubtedly normal genetic variation as well. Interestingly, most of he fluid--60 percent on average, comes from glands called the seminal vesicles, whereas 38 % comes from the prostate, with the remainder from glands such as the cowper's. The prostate contribution is responsible for the characteristic odor. The fluid from the seminal vescicles is high in fructose, a type of natually-occuring sugar, which provides primary nourishment for the sperm in their travels.

Frequency of Ejaculation
According to a number of studies, Many post- pubescent young men report daily ejaculation, if not more frequently than that. This frequency gradually declines for most males to 2-3 time per week which is typical of men in their forties. But there is still considerable variation among adult men of a given age. The same Newsweek article cited earlier reports the following data on "average" frequency of orgasm per year by age. These data appear 'conservative' to me, but perhaps that is good if nearly all men, like the children in the mythical

Minnesota town, are "above average." Anyway, here is the data :
Age Frequency
20 104 orgasms per year
30 121 orgasms per year
40 84 orgasms per year
50 52 orgasms per year
60 35 orgasms per year
70 22 orgasms per year

I wonder how many 20-year old men are content to "survive" on an average of fewer than 3 orgasms per week! Most older men should feel pretty good about their frequency of orgasm, based on these data!

Up or Down?
Endless discussions have been taking place on the internet newsgroups with respect to the "best" position to wear the penis--that is, pointing either up or down. Obviously, it would be difficult if not impossible to wear the penis in an up position while wearing loose-fitting boxer shorts, but closer fitting briefs allow that as a possibility. Each side in the discussions has its advocates. (There are even a few men who prefer a position "to one side or another". These men appear to have distinct preferences for either pointing right or pointing left, but not both.) The underside of the penis,that is, the outer side when pointed up, is generally more sensitive to the touch. For some men, the sensation of cloth across the underside of the penis is sufficient to sustain a slight erection and the penis produces a larger "bulge" which might be "inadvertently" touched in the up position.
Many people wonder why male ballet dancers as a group appear to be so amply endowed. Part of the answer is that the penis is positioned in an "up" position.

It is also not widely known that male ballet dancers wear a garment called a "dance belt" which is similar to an athletic supporter but holds the penis in the up position. Some of these belts are padded on the front so that some of the bulge is not actually penis! A "down" penis would ruin "the line" for male ballet dancers. Hence the popularity of the up position.

I recently received a letter from a former ballet dancer who claims that he, as well as the other dancers he knew, wore their penises in a "down" position. He argued that the dance belt does not force the dancer to wear the penis in the up position. So the discussion and disagreement on this topic continues.

A Curved Penis?
I've received a lot of letters asking questions about whether or not a penis that curves up, down or to one side or the other is "normal." That depends. There is considerable variation in this that is considered quite normal. Remember, the penis consists primarily of spongy tissue that fills with blood when erect. Since a delicate system of valves (actually flaps) controls the amount of blood contained within a penis, only slight differences in relative pressures on each side could result in a degree of curvature.

Joel Block's book,(pp. 207-8; see reference list) however, describes a more serious problem, called Peyronie's disease, in which the penis becomes so curved that it interferes or even prevents intercourse. According to Block's book, the penis may be bent into a J-shape. The exact cause is unknown, but is thought to be due to a buildup of scar tissue.Vitamin therapy has been used with success in some cases, but surgery may be required. If you suspect Peyronie's disease, it's a good idea to check with a doctor. There is an internet reference from the National Institutes of Health on Peyronies disease with detailed information about underlying causes and treatment.

Lesions on the Penis
I have also received questions regarding the presence of warts, pimples sores etc. on the penis or elsewhere in the genital area. I am not an MD, and could not diagnose these via e-mail even if I were. Any of these should be checked by a doctor. This is particularly true if you have been sexually active with a partner. These kinds of symptoms could be consistent not only with Herpes, but other, more serious Sexually Transmitted Diseases (STDs) as well. Self-treatment is not recommended. The STDs are cunning in that lesions often heal on their own, and yet the infection continues (as well as the possibility that the disease could be transmitted to a partner). This is nothing to fool around with, no matter how embarrassing you think a visit to the doctor might be.

Blood in Semen
I have received questions regarding the significance of the appearance of blood in semen, particularly whether or not this is a symptom that should be checked by a medical doctor. The internet references I have checked on this topic with respect to possible causes are not necessarily consistent. The consensus is that blood which appears anywhere it should not ordinarily be should be checked by a medical specialist, including blood appearing in the semen. The internet references indicate that the common causes of this symptom include certain kinds of infections of the prostate or perhaps elsewhere in the urinary tract. Another possible cause is slight tears in the blood vessels or walls lining the urethra, which is the tube that carries urine and semen. This symptom could be a result of more serious causes as well, so it should be checked out by a medical doctor.

Sexual Tension and Sexual Feelings
A lot of men are very "orgasm-centered" in their sexual lives. By that, I mean, a focus on orgasm and ejaculation becomes important to the point where many men do not fully notice the sexually-related sensations prior to orgasm. As a result, many men do not fully appreciate or even experience these sensations. Men may find these statement surprising, believing that orgasm and ejaculation is what "sex is all about."

An analogy may be drawn to differences in behavior among people who travel. Some people are very focused on getting to their destination, believing that whatever favorable experiences are to be had will be found at the destination. These people often do everything possible to make travel to the destination as unimportant as possible. If they drive, they drive over the speed limit, stopping only for lunch breaks at drive-through windows, so that they can get back on the road as quickly as possible, and not "waste time." These people tend to fly rather than drive, if possible, because it's faster.

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