Treatments for Early Ejaculatory Dilemmas
During sexual intercourse, millions of sperm are deposited into the vagina. They travel through the cervix and uterus to the fallopian tubes. Sperm can live within a woman's body for up to three days. Each sperm contain three distinct parts, the head, mid-piece, and tail. Each of these parts has a distinct purpose. The head of the sperm is composed of the nucleus (containing the chromosomes), an acrosome cap (containing enzymes crucial in fertilization), and an outer membrane. The mid-piece contains energy-producing mitochondria, and the tail is the mechanism for movement. Despite the ingenious design, fewer than 1 percent of the sperm released in an ejaculation ever make it to the egg. Factors inhibiting the success of sperm include abnormal formation and premature death from exposure to acidic vaginal secretions. Sperm can also be blocked by excess mucus covering the cervix, or they may travel to the fallopian tube that does not contain the egg. Fortunately, only one sperm is...
Movement of sperm cells from the cauda of the epididymis to the reproductive tract of the female during mating or collection of semen for artificial insemination involves an integrated sequence of events. The penis is erected, sperm and secretions from the accessory glands are moved into the ejaculatory duct, and ejaculation moves semen to the exterior of the penis. The duration of ejaculation ejaculation varies with species from a fraction of a second for bulls and rams, to several minutes for boars (Table 2). Stallions, rams, and bulls produce 5 to 10 billion sperm per day and daily sperm production of boars is about 16 billion sperm.
Pressure applied to the end of the penis is the most common collection technique for swine and poultry. The primary stimulus for mounting behavior in boars is an object that resembles an immobile sow, and the primary stimulus for ejaculation is pressure on the end of the penis. Therefore, most boars can be trained to mount a bench called a collection dummy, or dummy sow. After mounting, boars will begin to thrust forward until the penis protrudes from the sheath. Manual pressure is applied by grasping the tip of the penis with a gloved hand. The pressure on the tip of the penis mimics cervical contractions during natural mating and results in full extension of the penis and ejaculation. In male birds, the cloaca is the exit for the reproductive system and contains small nipple-like projections called papillae. Collection of semen is achieved by massaging the papillae. The area surrounding the vent is massaged while simultaneously stroking the back. These actions stimulate a spinal...
The bladder neck or internal urinary sphincter is automatic and unlike the external urinary sphincter are not under voluntary control (Fig. 19.2). For normal voiding, both these sphincters must relax. If the external sphincter is damaged it is possible to remain continent with the internal sphincter alone. The operation of transurethral resection of the prostate (TURP) removes the prostatic adenoma obstructing the prostate urethra, and it is common for the bladder neck and the internal sphincter to be resected as well. This leads to retrograde ejaculation following TURP
Several studies carried out on animals indicate the possibility of long-term memorisation of odours acquired during infancy. Infantile olfactory memory has been examined particularly in relation to the orientation of social and sexual preferences. In domestic dogs, maternal odour is retained by puppies, and even after two years of total separation, they remain capable of recognising their mother's odour (Hepper 1994). This 'olfactory imprinting' process has been analysed more thoroughly in rodents. Young female mice raised in the absence of adult males do not display, as adults, a normal attraction for male mice (Mainardi 1963). This effect is due to an olfactory mechanism female mice whose mothers were odorised with Parma violet odour throughout the nursing period, when sexually mature, manifest a preference for males with this odour compared with test males. On the other hand, females raised in a normal environment prefer non-odorised males (Mainardi et al. 1965). This early effect...
Usually, sympathetic and parasympathetic divisions act separately and at times cooperatively. Sweat glands and blood vessels in the limbs have only sympathetic innervation the pupil and bladder are dominated by parasympathetic fibers. Certain disparate domains see both divisions working together in never-ending modulation (with neurohormonal assistance) of cardiac rhythmicity and intermittent assistance in male sexual function (erection is mediated mainly by parasympathetic fibers but ejaculation by sympathetic
Shown to have antidepressant and anti-anxiety properties in both animal models and in patients. With regard to its side effects, the frequency of nausea and ejaculatory dysfunction after escitalopram is approximately the same as that of the racemate. From the results of the published clinical studies, it would appear that the tolerability of escitalopram is slightly better than the racemate and the time of onset of the clinical response may be slightly faster but this needs confirmation. In general, the adverse effects were mild and transient with a low patient withdrawal rate. Early clinical trials suggest that escitalopram is as effective as citalopram in the treatment of depression and anxiety disorders.
Behaviors performed by the female that bring the male into closer proximity and maintain his proximity and sexual motivation in order for mating to occur. Finally, receptivity describes the behaviors and postures exhibited by a female that allow successful intromission and intravaginal ejaculation to occur. Production demands and housing systems can interfere with the expression of female reproductive behavior. Studies aimed at learning how physiological and environmental signals are integrated could improve reproductive performance.1-10-1
The G-spot and other recent discoveries about human sexuality. New York Holt, Rinehart, and Winston. Alzate, H., & Hoch, Z. (1986). The G-spot and female ejaculation A current appraisal. Journal of Sex and Marital Therapy, 12, 211-220. Davidson, J. K., Darling, C. A., & Conway-Welch, C. (1989). The role of the Graefenberg spot and female ejaculation in the female orgasmic response An empirical analysis.
What happened Was the victim physically assaulted With what (e.g., gun, bat, or fist) and where Determine the type and location of physical injuries and appropriately evaluate these injuries. Delineate actual or attempted vaginal, anal, or oral penetration. Did ejaculation occur If so, where Was a foreign object used Was a condom used This information will direct the physical examination to areas of potential injury.
PRIAPISM Priapism is a persistent and usually painful engorgement of the paired dorsal corpora cavernosa, resulting in a dorsal penile erection, while the glans penis and the ventral surface remain flaccid. The resultant erection is not necessarily associated with sexual stimulation or desire, and it is not relieved by ejaculation.
Each ejaculation releases 2 to 5 mL of semen, the fluid containing the sperm. Semen normally contains between 20 and 100 million sperm per milliliter. The sperm consists of a 5-p.m head containing the nucleus, a midpiece containing mitochondria, and a 55-p.m-long flagellum, or tail, which can propel the sperm at a speed of 1 to 4 mm min. The seminal vesicles and the prostate gland produce much of the liquid that makes up semen, which includes fructose to provide energy for the sperm, and alkalinity to counter the acidity of the vagina. When the male becomes sexually excited, nerves of the autonomic nervous system produce dilation of arterioles in the penis, causing blood to enter that organ faster than it can leave. This causes the erectile tissue to become engorged, causing an erection. The male then inserts the penis into the female's vagina in the act of copulation, injecting the semen by rhythmic contractions called ejaculations.
Intrauterine insemination is used when a couple's inability to conceive a child is caused by the sperm's inability to reach the egg. Sperm must move through the uterus and enter the fallopian tube before they can fertilize the egg. Anything that prevents the sperm from making this trip will block conception. Coital or ejaculatory disorders can limit the sperm's travels, sperm antibodies in the female reproductive tract can kill the sperm, and sperm may be unable to penetrate the cervical mucus.
The internal male reproductive organs consist of the epididymis, vas deferens, seminal vesicles, prostate gland, ejaculatory ducts, and urethra. (See Figure 3.1.) The vas deferentia consist of two tubes that serve as sperm ducts. The vas deferentia actually look a lot like strands of spaghetti, but they serve as the pipes and plumbing works for sperm. They transport the mature sperm from the epididymis and into the pelvic cavity. Once inside the pelvic cavity, the vas deferentia pass over the bladder and eventually connects with the seminal vesicles to form the ejaculatory ducts. Just prior to ejaculation, the sperm are mixed with the seminal fluid. The seminal fluid is composed of secretions from the seminal vesicles and the prostate gland. Ejaculatory Ducts The ejaculatory ducts are two short tubes that descend through the prostate and into the urethra. They are formed by the union of the vas deferens, the seminal vesicles, and an opening within the prostate. It is here that the...
Neurological dysfunction of the bladder (the neurogenic bladder) is particularly important to recognize. In the early phases, there is failure fully to empty the bladder such that the bladder enlarges, eventually building up back pressure on the ureters and kidneys. Finally, the patient goes into urinary retention which is often painless due the involvement of the sensory pathways. In the male, neurogenic bladder is accompanied by failure of penile erection and ejaculation.
Hormone testosterone), excretory ducts (epididymis, vas deferens, and ejaculatory duct), and accessory structures (prostate, seminal vesicles, bulbourethral glands, and penis). The scrotum, containing two testes, provides for efficient regulation of testicular temperature. Descent of both testes from the abdomen to their proper scrotal location is necessary for maximal fertility. Failure of one or both testes to descend is a common reproductive organ defect in livestock, especially in swine, where the condition is a hereditary defect transmitted by the male and is referred to as cryptorchidism (13).
An artificial vagina is a device that imitates the female vagina and provides the appropriate thermal and mechanical stimulation required for ejaculation in horses, sheep, goats, and cattle. Most artificial vaginas have the same basic design, which includes an outer casing, an inner lining, and an insulated pouch that is attached to one end of the outer casing. Water added to the space between the outer casing and inner lining prior to collection is used to regulate the temperature and pressure to which the penis is exposed during collection. During collection from bulls, rams, or bucks, the male is allowed to mount a female or a neutered male. Stallions can be trained to mount a mare or a collection dummy called a phantom. When the male mounts, his sheath is gently deflected to the side and, as he thrusts forward to breed, the artificial vagina is placed over the end of his penis. The male ejaculates into the artificial vagina.
Many primate behaviors might be homologous to human same-sex sexuality. Examples might include the male-male mounting, with anal penetration but no apparent ejaculation, of stump-tailed macaques and squirrel monkeys, or perhaps the simple mounts without penetration so common in langurs, pig-tailed macaques, baboons, orangutans, chimpanzees, and bonobos or the mutual masturbation and fellatio reported among stump-tailed macaques or the genital-genital contacts of female bonobos and male gibbons (Bagemihl, 1999 Werner, 1998). If we classify these behaviors as homologous with human homosexuality, why not include the sniffing and inspecting of another male's anogenital region among stump-tailed macaques, or the displaying of erections among vervet macaques or baboons, or the deposition of urine drops on subordinate males among squirrel monkeys Could the preference of some rhesus monkeys for homosexual partners indicate primate homologs for pathics (Werner, 1998)
Hemospermia, or hematospermia, is a disturbing symptom that produces extreme anxiety in sexually active males. Most seek medical attention after one or two occurrences. Any process that results in trauma or other injury (e.g., tumor with erosion), inflammation, or infection of the male ejaculatory system may result in bloody semen.23 The most common cause of hematospermia is iatrogenic trauma from instrumentation of the urinary tract or radiation therapy. Patients over 40 in particular may have tumors of the prostate or elsewhere in the ejaculatory system. Benign prostatic hypertrophy can cause hematospermia. In patients under 40, common causes are infections and inflammatory conditions, including prostatitis, seminal vesiculitis, urethritis, sexually transmitted diseases, epididymo-orchitis, calculi with inflammation, and tuberculosis. Testicular tumors occur in the younger population. Vascular abnormalities and cysts causing ductal obstruction are less common causes. As with...
The vas deferens, a prominent part of the adnexa of the scrotal contents, is a distinct muscular tube that is easily palpable within the scrotal sac. It extends cephalad in the spermatic cord from the tail of the epididymis (globus minor) traversing the inguinal canal and crossing medially behind the bladder over the ureters to form the ampullae of the vas, where it joins with the seminal vesicles to form the paired ejaculatory ducts in the prostatic urethra.
Of the testes is the production of testosterone and androstenedione. These sex hormones are synthesized in the interstitial or Leydig cells. The seminiferous tubules in the testes are lined with sertoli cells that support germ cells during the production of sperm (spermatogenesis). The weight of the two testes ranges from 6 g for rabbits to 720 g for boars (Table 1). Gonadotropic hormones synthesized in the anterior pituitary gland stimulate growth and maturation of testes resulting in sexual maturation, sperm production, and ejaculation.
Obstruction in other organs is also seen. In the pancreas it leads to an insufficiency of pancreatic enzymes and malabsorption during digestion in the nose and sinuses, it produces chronic sinusitis and in the intestines, in a small minority of newborn infants with CF, it produces an often fatal condition called meconium ileus. Altered secretions also occur in the sweat glands, so that the sweat of CF patients has an abnormally high salt content. In fact, in the early days of medicine, the diagnosis of CF was often made by licking the skin and tasting the sweat One additional mysterious clinical feature of CF occurs only in men with the disorder They are infertile due to blockage or congenital absence of the vas deferens, the tube through which sperm pass prior to ejaculation.
Acid phosphatase detection in vaginal washings is helpful in cases of azoospermic ejaculations. Acid phosphatase is derived from cytoplasmic sources (erythrocytes, leukocytes, and thrombocytes) or tissue sources (bone, kidney, and liver). Various chemical means are used to differentiate the source of the acid phosphatase. However, a qualitative distinction between seminal and vaginal acid phosphatase cannot be made, because they are identical biochemically and immunologically. The only reliable distinction may be made quantitatively based on the high levels of acid phosphatase in seminal fluid. 11 The acid phosphatase determinations are most helpful when no sperm are found and acid phosphatase levels are markedly elevated, consistent with the presence of semen. -l1
Firm, but not hard, having no signs of abscesses, injuries, orchitis, or any other condition that could affect fertility. The penis and sheath should be examined for posthitis (pizzle rot), ulcerative dermatosis, adhesions, or injury (including shearing trauma). Often, a blood sample is collected during the BSE in order to conduct a serological test for ovine sexually transmitted diseases, i.e., Brucella ovis. Semen samples are collected usually by electro-ejaculation and analyzed microscopically for color, percent live cells, percent motility, and percent abnormal spermatozoa. Upon palpating the scrotum, both testicles should be fully descended into the scrotal sack. At this time, a measurement is taken of the scrotum at the point of the greatest circumference, and available standard guidelines for these dimensions should be utilized. Research has shown that daughters from sires with larger testicle circumferences have higher pregnancy rates than females sired by males with smaller...
A thorough voiding history begins with questions regarding problems holding or initiating the urinary stream, voiding completely with one continuous stream rather than starting and stopping of the stream, a feeling of complete bladder emptying as opposed to incomplete emptying and postvoid residual, and the relative frequency of nocturia. Ultrasonography is a noninvasive, accurate way to determine the postvoid residual. Most men do not void as well or completely empty their bladders when sitting down to urinate, which happens most often during the night. Infrequent ejaculation may lead to secondary prostatic congestion and subsequent spurious symptoms of irritation and outlet obstruction. Unless specific questions are asked about the latter circumstances, these easily treatable causes of obstructive symptoms can be missed.
During ejaculation, sperm are transported from the epididymis to the urethra by contractions of the vas deferens and combine with accessory sex gland secretions. Accessory glands in farm animals include the seminal vesicles (which secrete the most fluid), the prostate, and the Cowper's glands. Seminal fluid provides a vehicle for sperm transport during ejaculation. However, numerous macromolecules are novel to or enriched in seminal fluid and have been ascribed various roles in sperm transport and fertilization.1-6-1
Why some individuals choose to incorporate deviant stimuli into their masturbatory fantasies is also explained using a conditioning hypothesis. One factor is the stimulus value of deviant stimuli, which is continually strengthened through the pairing of these stimuli with ejaculation. According to a conditioning model, nondeviant stimuli or fantasies, at the same time, undergo extinction (a decrement in responding) as a result of their lack of pairing with ejaculation. Another contributing factor is a common belief held by sexual deviants that a normal sex life is not possible. This belief, according to McGuire and colleagues in 1965, may develop from a number of different sources including aversive adult heterosexual experiences, or feelings of physical or sexual inadequacy. These re Sexual deviations may be best understood through a combination of classical and operant conditioning processes, according to O'Donohue and Plaud in 1994, and Plaud and Martini in 1999. Deviant sexual...
The allantois and a portion of the cloaca unite to eventually form the definitive bladder. The allantois that connects the dome of the bladder to the umbilicus eventually becomes atretic and is called the urachus. The obliterated fibrous connection can be seen in adults as the medial umbilical fold. Similar to the omphalome-senteric duct from the gastrointestinal tract, draining umbilical sinuses or a diverticulum-like outpouching of the bladder may be seen.124 A urachal sinus is the most common anomaly, with a urachal cyst next in frequency. A patent urachus is much less commonly encountered.130 The urachus may become the site of dysplasia, leading to the development of carcinoma. The distal mesonephric ducts and the metanephric diverticulum are separately incorporated into the urogenital sinus. The mesonephric ducts become the vas deferens, seminal vesicles, and ejaculatory ducts in the male and minimally contribute to the urethra, while the metanephric ducts become the ureters.124...
The urine is also checked for the presence of sperm. A high concentration of sperm in the urine may indicate retrograde ejaculation. Retrograde ejaculation, where sperm go backward into the bladder instead of moving forward into the penis, is a fairly common condition. If retrograde ejaculation is found, treatment is available.
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