Category Archives: Sexual Health

Ejaculation vs. Orgasm…what’s the difference?

Ejaculation vs. Orgasm…what’s the difference?

Sexual Health, ,

When it comes to talking about sex, our culture struggles with understanding terminology and definitions. Using words and meaning is necessary for clear communication. If we are not able to communicate clearly, we are not able to explain accurately what is going on with our bodies. If we are not using the words correctly the doctor can often end up focusing on the wrong problem. There are two words that I find people often use incorrectly: ejaculation and orgasm.

Ejaculation and orgasm are not the same things at all. They are two vastly different bodily functions that happen to occur usually around the same time. Both ejaculation and orgasm can have function problems. If we are not clear in describing the issue, the doctor is going to be unable to help us. The general public is not alone in this confusion. I am often amazed when I’m talking to urologists that even they confuse these two events.

Ejaculation is the pulsing contraction of pelvic/penile muscles to expel semen. Ejaculations can include one or many muscular contractions that can last anywhere from a couple seconds to 30 seconds or more. It is normal for the semen to dribble out and it is also normal for the semen to shoot several feet! Everyone is different.  For some men, no semen will come out. That does not mean that there was no ejaculation – it is simply called a “dry ejaculation.” The ejaculation process is controlled by a lower spinal cord nodule that acts as a miniature brain controlling sexual response.

An Orgasm is the euphoric feeling that occurs with the climax. Very often, an orgasm can contribute to muscle spasms, vocal sounds, and other body movements. But these movements do not aid in the expulsion of semen. An orgasm is caused by a sudden release of brain chemicals. These euphoric sensations can be described as a big, small, genital-focused, whole body, and can even seem to emanate from various areas of the body. Orgasms can last anywhere from a few seconds to 15-20 seconds for some men – the average for most men is 5-10 seconds.

Most men think they experience these two events simultaneously. The truth is they do occur near each other but for some men, they feel an orgasm right before the ejaculate and other men begin to ejaculate and then feel the orgasm. Both of these are perfectly normal. The pulsating contractions of ejaculation are pleasurable, but they are not really part of the orgasm any more than the pleasurable stimulation on the penis is part of the orgasm.

Interestingly enough, some men learn to separate ejaculation from an orgasm. Some men can learn to have multiple orgasms and never ejaculate until they choose to do so. This takes a lot of practice, but it can be done. Some men learn to have whole-body orgasms from anal/prostate stimulation. These orgasms do not have an accompanying ejaculation – in fact, these orgasms have nothing to do with the penis at all! There are anecdotal stories of men who have experienced spinal cord injuries who cannot feel their penis but can give themselves an orgasm from stimulating other parts of their body such as armpits or neck. Some men can give themselves orgasm from nipple stimulation. Some men can ejaculate/orgasm without touching their penis at all!

Both orgasms and ejaculation can have problems. If that happens to you, please be sure to be aware of what exactly is going wrong. Are you having trouble with ejaculation (such as timing, pain, or semen) or are you having problems with orgasm (loss of euphoria, diminished sensation, loss of orgasm)? Make sure to consult with a sexologist in Delhi.

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What Guys Need to Know About Masturbation

What Guys Need to Know About Masturbation

Sexual Health,

Masturbation is natural and healthy. Over 94% of men masturbate.

It feels good. It can reduce stress and tension by releasing endorphins, oxytocin, and dopamine, and it can even help you sleep.

It helps young men to explore their bodies, and learn what they like and don’t like.

But most men know very little about masturbation, so we’re going to cut through the myths and misinformation, and answer some practical questions.

Does Masturbation Cause Erectile Dysfunction?

This is a common belief, but extensive studies have shown that masturbation has no effect on a man’s ability to achieve and maintain an erection. The International Society for Sexual Medicine says, “The notion that masturbation causes erectile dysfunction (ED) is a myth.”

However, some studies show that there could be a potential link between watching too much porn and erectile dysfunction.

Are There Health Benefits from Masturbation?

In addition to reducing stress, masturbation may actually have a measurable effect on reducing your risk of prostate cancer. Studies have found that men who ejaculate at least 5 times per week have a significantly lower risk than men who ejaculate less frequently (2 or fewer times per week), although researchers don’t understand why.

Researchers at the University of Sydney claim that masturbation improves immune functioning by increasing cortisol levels, which can regulate immune functioning in small doses. It also reduces depression by increasing the amount of endorphins in the bloodstream. They add that engaging in self-pleasure can also ‘lower the risk of type-2 diabetes (though this association may also be explained by greater overall health), reduce insomnia through hormonal and tension release, and increase pelvic floor strength through the contractions that happen during orgasm.

Masturbation also promotes blood flow, an important factor in the health of the penis. This is especially important for men who don’t have nighttime or morning erections, which are believed to be the body’s mechanism for ensuring an adequate blood and oxygen supply to the penis.

Are There Risks from Masturbation?

If you masturbate frequently, the penis can become irritated. To prevent this, use a good quality sex lube, or a lotion without scents or additives.

If you masturbate too vigorously, or if you bend or twist the shaft, it’s possible to fracture your penis, by rupturing the corpus cavernosa – the sponge-like chambers in the penis that are responsible for erections. Signs of this include:

  • Extreme pain
  • A noticeable ‘popping’ sound
  • Loss of erection
  • Swelling or bruising of the penis

A fractured penis requires immediate medical attention. Without treatment, a fracture may result in permanent damage.

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COVID Affects Everything—Even Your Sex Life – Talking About Men’s Health™

COVID Affects Everything—Even Your Sex Life – Talking About Men’s Health™

Sexual Health, ,

Dear Healthy Men: I had a nasty case of COVID-19 several months ago. It’s taken a while, but I’m fully recovered—except for one thing: I’ve been having trouble getting and keeping an erection. I know that most men have erection troubles at some point, but I never have before and I’m wondering whether there could be any connection between COVID and sexual difficulties.

A: What a great question. In a word, the answer is Yes. A recent study published in the Journal of Endocrinological Investigation explored that exact question. Professor Emmanuele A. Jannini, M.D., of the University of Rome Tor Vergata and his colleagues found a definite connection between erectile dysfunction (ED) and COVID-19. How does it work? According to Jannini, there are several likely culprits:

  • Overall health issues. Like it or not, ED is a good indicator of our overall health and is often a symptom of an underlying health problem. And since COVID-19 can aggravate (or cause) many health concerns, it’s no wonder that there’s a connection to ED.
  • Psychological issues. In addition to the damage COVID-19 can do to one’s physical health, there are also numerous mental health issues, including depression and anxiety, both of which can cause ED. Men’s Health Network (MHN, menshealthnetwork.org) and the Patient-Centered Outcomes Research Institute (PCORI, pcori.org) recently organized a conference entitled “Behavioral Health Aspects of Depression and Anxiety in the American Male,” which discussed this topic in detail. MHN and PCORI have also put together a series of webinars on the effects of COVID-19 on the mental health of men and boys. You can read more about the conference and the webinar series at either website.
  • Cardio issues. Many people with COVID have developed cardiovascular problems, including dangerous levels of inflammation in the heart and circulatory system. And any problems with blood circulation may result in ED.

To dig deeper into the connection between COVID and ED, I spoke with Dr. Judson Brandeis (brandeismd.com), who’s a urologist and an expert in men’s sexual medicine. He’s concerned that “the COVID-19 pandemic will result in widespread erectile dysfunction.” How? Brandeis explains the big picture this way: “Erectile function is highly dependent on pressurized blood flow, which starts at the heart, pulses through the large arteries, and then flows through the small blood vessels. Conditions like diabetes, high cholesterol, and smoking cause damage to the inner lining of the blood vessels, which causes ED. So does COVID-19.” That’s fairly to understand. But there’s also a more complicated—yet fascinating—explanation.

“The coronavirus hijacks our own cells to create new copies of itself, which then get released throughout our body,” Brandeis says. “However, since our body has never seen this virus before, it hasn’t developed the antibodies that would allow it to mount a targeted defense. As a result, it tries to stamp out the invader by launching a massive, non-specific immune response. The body’s massive response ends up damaging itself—particularly the endothelium, which is the delicate layer of cells that lines our blood vessels.” The bottom line: blood vessels are narrowed and blood flow is restricted, which increases erectile dysfunction.

Ask your doctor about ways to protect your endothelium. Several clinical trials are currently exploring the use of nitric oxide (a chemical produced naturally in our body that acts as a vasodilator, relaxing the lining of blood vessels and increasing blood flow). According to Brandeis, the results so far are optimistic. Also, get vaccinated as soon as possible. That will help your body produce the right antibodies and may reduce blood-vessel damage. In the meantime, keep wearing a mask and avoid groups of people.

Image by Arek Socha from Pixabay 

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Why Do Some Men Continue to Look and Feel Young?

Why Do Some Men Continue to Look and Feel Young?

Sexual Health, , ,

The short answer is that there’s a strong correlation between testosterone levels and overall sexual health. Testosterone is  a key hormone that contributes to looking and feeling younger.  More specifically, testosterone plays one of the most important roles in a man’s overall vitality and sexual pleasure. Men’s testosterone levels often peak during adolescence and early adulthood, but over time, they gradually decline. In fact, it has been projected that men 30 years of age and older will experience a 1.6 % decrease in total testosterone levels each year. Low testosterone, or Low T, is a medical condition that occurs when the body is not producing enough testosterone,  causing a variety of symptoms such as, erectile dysfunction, decreased libido, infertility, decreased muscle mass, fat gain, mood changes, unexplained emotions, and fatigue. Depending on who you talk to, “normal” testosterone levels can vary significantly. That’s why it’s so important to  have your levels checked by a provider who specializes in testosterone replacement therapy.

As men age, it is common to see changes in body composition, resulting in loss of muscle and a gain in fat mass, especially visceral and central fat. Evidence-based practice suggests that  when testosterone treatment is given to men ages 24 to 85 years of age, they saw an increase in lean body mass with a total reduction in both central and visceral obesity.  A decrease in visceral fat is important as we now know it is a predisposing factor that leads to metabolic syndrome, diabetes, and cardiovascular disease.

Evidence-based practice has also proven that men with low T who have started testosterone replacement therapy experienced a decrease in fat, decreased total cholesterol levels, increased bone mineral density, improved erectile dysfunction, improvement in cognition, improved mood, and better glycemic control in men with diabetes. Any combination of these factors can ultimately lead to more energy and an increase in activity, resulting in a more youthful appearance and feeling young again!

If you feel like you may have low testosterone, contact us for a consultation.

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You CAN Get Pregnant During Your Period

You CAN Get Pregnant During Your Period

Sexual Health, , ,

A lot of us grow up hearing all sorts of myths about sex, and since many of us don’t get comprehensive sex education, some of these untruths never get corrected. Today, I’m here to change that! Well, I am not going be able to teach you everything you need to know about sex, but I will be busting some myths about period sex.

The misconception exists that you can’t get pregnant if you have intercourse on your period, but this isn’t true. It IS possible to get pregnant during this time of the month. So, if you’re not on birth control and not trying to get pregnant, always make sure to use a condom for intercourse during your period.

However, just because you can get pregnant it doesn’t mean you should avoid sex or intercourse altogether. Some people aren’t into the idea of having sex on your period, and that’s fine! But also know that there’s nothing wrong with having sex during your period–it can actually be really great. Some people find that they have increased libido during their periods, and that orgasms can reduce menstrual cramps. So, if you’re interested, have at it! Just put down a towel first (and maybe make sure your partner doesn’t faint at the sight of blood).

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When It Comes to Your Health, Your Penis May Be the Canary in the Coal Mine – Talking About Men’s Health™

When It Comes to Your Health, Your Penis May Be the Canary in the Coal Mine

Sexual Health, , , ,

Dear Healthy Men: Like a lot of men my age (I’m 44), I have occasional problems in bed. I think it’s happening because I’m stressed about finances and life in general. I’ve been taking medication that helps, but my wife is concerned that it might be a symptom of something more serious and is urging me to get checked out. Could she be right?

A: Your wife sounds like a smart lady—and she’s definitely right. While there’s no question that erectile dysfunction (ED) can be caused by depression or anxiety, there’s also no question that it can be caused by existing or impending physical problems. These include cardiovascular issues (including high blood pressure and high cholesterol), diabetes, hormone imbalances (including too-high levels of prolactin and/or too-low levels of testosterone), urinary tract problems, spinal cord injury, and some neurological issues.

What most of these conditions have in common is that they effect blood flow throughout the body. And since the arteries in the penis are smaller in diameter than those in the heart, it doesn’t take much to reduce or block blood flow there, which in turn may lead to ED. That’s why it’s more common for men with known coronary artery disease to complain about ED than it is for men with ED to complain about heart problems—but that doesn’t mean that those heart problems don’t exist. In fact, “having ED can predict that a man will probably have heart disease symptoms within five years,” according to the Cleveland Clinic (my.clevelandclinic.org). They add that, overall, “having ED is as much a risk factor for heart disease as a history of smoking or a family history of coronary artery disease.”

Okay, so now you understand the connection between ED and other health issues. But putting aside sex for the moment, do you have erections during the night or first thing in the morning? Most adult males have three to five erections every night, each lasting roughly five to twenty minutes. Judson Brandeis (brandeismd.com), the urologist and men’s sexual medicine expert I quoted here a few weeks ago, says that these nighttime erections (technically referred to as “nocturnal penile tumescence” or NPT; less-technically referred to as “morning glory” or “morning wood”) are the body’s way of providing oxygenated blood to the penis and keeping scar tissue from forming.

NPT can be very helpful in diagnosing or ruling out underlying physical problems. For example, if you have frequent, strong NPTs but suffer from ED when you try to have sex, your medical provider may be able to rule out conditions or diseases that affect blood flow, and may want to investigate psychological causes instead. On the other hand, a decrease in—or total lack of—NPT is a strong indicator that the problem isn’t “just in your head,” and is, instead, physical.

So follow your wife’s advice and schedule a physical exam. Tell the sexologist about your ED (yes, it may make you uncomfortable, but do it anyway) and ask to be screened for high blood pressure, cholesterol, and diabetes. Also be sure to talk about lifestyle issues: both cigarette smoking and alcohol consumption are strongly associated with ED.

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Quarantine and Chill? Dating Life

Quarantine and Chill? Dating Life

Sexual Health,

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There isn’t a single person on the planet whose life hasn’t been affected in some way by the COVID-19 pandemic (and yes I’m sure you’re tired of hearing it!) Our lives have turned utterly upside down and everyone is struggling, whether in large or small ways.

No matter what your demographic, the struggles are real. Let’s take young adults, just trying to live their best lives and date their best dates. Some are forgoing any IRL experiences, and that’s just fine! Others are turning to dating apps like never before, seeking connection, romance and sex. And anyone who’s a frequent flyer on Hinge, Bumble or Tinder knows that this isn’t always the most desirable way to meet someone. Before the pandemic, you had to worry about all kinds of things – everything from the wording on your profile to protection from pregnancy and STDs. Now, you could be seriously risking your health and that of the people with whom you live if you even so much as get within six feet of a potential partner.

A college student I know recently went on a first date with someone she had been cultivating an online relationship with for several months. She said “we both live with our families, so were very cautious. But it was like a date from the 1800s – we just wanted to hug and kiss hello but we had to put up with a socially distant wave. It really sucked.”
If you live alone, then the choice might be a bit easier. On the other hand, you may not want to risk getting physically close with anyone else right now. And that can result in feelings of defeat and loneliness. Only you can decide what’s best and whether fostering close proximity is worth the risk. The bottom line? This is a super tough period of time, no question.

While there are no easy answers, this will be over soon. And you’ll be able to get back out there in earnest. For now, stick with what feels comfortable. Prioritize self-compassion, exercise and sleep; maximize your self-love sessions (buy a new toy lately?); connect with others in whatever way best suits you. This way, you’ll come out of this craziness with the strength, resilience and energy ‘Normal Times’ dating requires!

For questions about your sexual health, contact us for consultation. Our team is happy to help.

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