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PubMed1987

The psychophysiological nature of premature ejaculation.

The hypothesis that premature ejaculators (PEs) are less able than non-premature ejaculators (NPEs) to evaluate accurately their level of physiologically determined sexual arousal was tested. Twenty-six men (13 PEs and 13 NPEs) viewed a variety of videotaped vignettes, some of which were excerpts from sexually explicit films. Concurrent subjective (self-report) and objective (plethysmograph) ratings of sexual arousal were taken. Data revealed that both the PEs and NPEs were equally accurate in assessing their level of physiological sexual arousal. These results and those from a sexual history questionnaire were used to evaluate several hypotheses regarding the nature and etiology of premature ejaculation.

Adult↗
PubMed1998

Treatment of premature ejaculation with sertralin.

To evaluate the efficacy of oral sertralin in the treatment of premature ejaculation, out of 22 patients with premature ejaculation 16 received oral sertralin, 50 mg a day for at least 2 weeks. Four patients were lost to follow-up. Two patients interrupted treatment due to side effects of sertralin. Out of 16 patients who completed at least a two-week period of treatment 14 (87.5%) responded clinically. Clinical response was achieved in the first week of treatment in 11 of 16 responders (68.75%). We conclude that low dose oral sertralin may be useful with a reasonable side effect rate in the treatment of patients suffering from premature ejaculation.

1-Naphthylamine↗
PubMed2006

Retarded ejaculation.

Retarded ejaculation (RE) has a relatively low prevalence (<3%), yet this condition results in considerable distress, anxiety, and lack of sexual confidence for those suffering from it. Furthermore, men with partners often experience impairment of both the sexual and nonsexual aspects of their relationships, with such negative effects compounded when procreation is a consideration. The definition of RE is ambiguous, due to the variability and paucity of data regarding normal coital ejaculatory latency. RE is influenced by both biogenic and psychogenic components, which may vary over time both between and within individuals. While specific pathophysiology can often be identified, further elucidation of the biogenic components of this dysfunction will require greater understanding of the physiological mechanisms underlying ejaculation. Yet, the most useful strategies for understanding RE will integrate rather than isolate the various biogenic and psychogenic aspects of this dysfunction. Evidence based evaluation and treatment protocols for this disorder are lower than for other sexual dysfunctions, but reports suggest better treatment efficacy when the etiology is predominantly psychogenic. As with erectile dysfunction (ED) and premature ejaculation (PE), if safe and efficacious oral pharmaceuticals are eventually developed for this condition, the treatment algorithm is likely to undergo significant alteration. Even then, however, the most effective treatments are likely to result from a combination treatment that integrates sex coaching with pharmacotherapy.

Ejaculation↗
PubMed1992

Chronic clonidine treatment and its termination: effects on penile erection and ejaculation in the dog.

The effects of chronic administration (4 weeks) of the alpha-2 adrenoceptor agonist clonidine (CL) and its termination on penile erection and ejaculation were investigated in male dogs. Penile erection and ejaculation were elicited by manual penile stimulation (for 5 min). CL (10 micrograms/kg/hr, s.c.) was delivered via osmotic minipump (Alza, 2ML-4). 3 or 7 days after the minipump implantation, CL caused a significant decrease in the amount of ejaculate produced by the genital stimulation without affecting the erectile potency. Ejaculatory ability returned to pretreatment levels despite continued CL administration, becoming evident in tests 14 days after initiation of treatment. Further, chronic CL (23 days) antagonized the inhibitory effects of acute administration of CL (0.05 mg/kg, i.p.). These data indicate tolerance to continued delivery of low doses as well as to acute administration of a higher dose. In the acute drug experiments, the ejaculatory inhibition elicited by CL (0.05 mg/kg, i.p.) was completely antagonized by pretreatment with yohimbine (0.05 and 0.10 mg/kg, i.p.), an alpha-2 adrenoceptor antagonist, but not with naloxone (1.0 mg/kg, i.p.), an opioid receptor antagonist. Furthermore, DG-5128 (1.0 and 2.0 mg/kg, i.p.), a selective alpha-2 adrenoceptor antagonist that poorly penetrates the blood-brain barrier, failed to antagonize the CL-induced ejaculatory inhibition. This study suggests that functional alterations in the central alpha-2 adrenoceptor mechanism may be related to the changes in the ejaculatory capacity during chronic treatment with CL.

Adrenergic alpha-Antagonists↗
PubMed1985

Time-contingent change in infanticide and parental behavior induced by ejaculation in male mice.

About 50% of sexually-naive male CF-1 mice (Mus musculus) commit infanticide (kill young). But, 80-90% of male mice commit infanticide between 1-4 days after mating. Between 12 and 50 days after mating infanticide is inhibited and most males (80-100%) behave parentally toward young (they build a nest, retrieve and groom the young, and hover over the young to keep them warm). Beginning at 60 days after mating, infanticide is again facilitated and parental behavior is inhibited (70-80% of males commit infanticide). The facilitation and inhibition of infanticide as a function of time after mating is mediated by the act of ejaculating rather than by mounting and intromitting during mating or by cohabiting with a female either before or after mating. The experience of committing infanticide either prior to mating or within the first 4 days after mating does not influence the facilitation of parental behavior that occurs 12 days after mating. But, repeated contact with young after males become parental serves to maintain parental behavior for an extended period of time. The age of the young (newborn-20 days old) utilized as stimulus animals does not influence these time-dependent changes in the behavior of male mice after ejaculation. This phenomenon is unique in that a response (infanticide) to a novel stimulus (young) is facilitated, then inhibited, and then facilitated again as a function of time between an event (ejaculation) and exposure to the novel stimulus.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Biological↗
PubMed1985

Retrograde ejaculation caused by incomplete paralysis of pelvic nerve.

A case of retrograde ejaculation is reported. Initially, it was considered idiopathic, but various examinations revealed subclinical neurogenic bladder with hypotonic detrusor and normal external urethral sphincter. This was due to incomplete paralysis of the pelvic nerve and the normal activity of the pudendal nerve. Normal antegrade ejaculation was obtained by bilateral pudendal nerve block. Some cases of idiopathic retrograde ejaculation are ascribable to neurogenic bladder; and urodynamic examination is essential in the diagnosis of this disease.

Adult↗
PubMed1990

Intracavernous medication for treatment of premature ejaculation.

Sixteen men complained of premature ejaculation during a five-month period between May, 1987, and October, 1987. Eight patients entered this study using intracavernous vasoactive drugs as treatment for their problem. The patients, ages twenty-four through fifty-eight (average 42 years), were all physically healthy and taking no medications. Five patients had normal findings on nocturnal tumescence monitor, while 3 patients did not use the monitor. A mixture of phentolamine mesylate, 1.0 mg/mL, and papaverine hydrochloride, 30 mg/mL, was used. The dosage required was from 0.10 mL to 0.40 mL. All 8 patients responded successfully to this treatment. Three patients stated they were cured and stopped the treatment. The other 5 patients continued using the medication after fourteen months. The drug-induced erection lasted between two and four hours despite ejaculation. There have been no side effects through April, 1988. All patients report satisfaction with the results of this treatment. The study showed that intracavernous medication therapy can be successful in the treatment of premature ejaculation.

Adult↗
PubMed1981

Mechanisms of PCA-induced hypothermia, ejaculation, salivation and irritability in rats.

Injections of p-chloramphetamine (PCA, 5 mg/kg) induced hypothermia, ejaculation, salivation and irritability in male rats kept at an ambient temperature of 20 +/- 1 degree C. PCA-induced hypothermia was attenuated by pretreatment with the 5-hydroxytryptamine (5-HT) uptake blockers Lundbeck 10-171 (Lu 10-171, 10 mg/kg) and chlorimipramine (CMI, 20 mg/kg) and the 5-HT synthesis inhibitor parachlorophenylalanine (PCPA, 150 mg/kg daily for 3 days); it was potentiated by pretreatment with the noradrenaline uptake blocker Lundbeck 5-003 (Lu 5-003, 10 mg/kg) and the catecholamine synthesis inhibitor alpha-methyl-p-tyrosine (AMPT, 50 mg/kg every 3 hr for 9 hr). PCA- induced ejaculation was attenuated by pretreatment with Lu 10-171 and CMI. PCA-induced salivation was attenuated by pretreatment with Lu 10-171 and CMI and potentiated by pretreatment with Lu 5-003. PCA-induced irritability was potentiated by pretreatment with PCPA. These results suggest that both 5-HT and the catecholamines play a role in PCA-induced hypothermia, ejaculation, and salivation.

Aggression↗
PubMed1991

Differential role of serotonin and noradrenaline on anxiety reduction after ejaculation in the rat.

As previously reported, a reduction in anxiety after ejaculation was observed. In a previous report it was demonstrated that the GABA-benzodiazepine system is involved in the mediation of this reduction in anxiety. The anxiety levels were measured using a defensive burying model. This work was performed to elucidate the serotonin and noradrenaline participation in the mediation of this phenomenon. Two experiments were made. In the first experiment the serotonergic neurotoxin 5,7-dihydroxytryptamine (5,7-DHT, 10 micrograms/10 microliters) was intracerebroventricularly injected. Five days after its administration the behavioral tests were performed. In the second experiment, the noradrenergic neurotoxin N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP4, 50 mg/kg X 2) was IP administered. The neurochemical data reveal a drastic reduction in various brain areas respective monoamine levels after these treatments. The lesion produced by 5,7-DHT was able to reverse the reduction in anxiety in copulating males, but produced no changes in noncopulating animals. This finding supports the idea that the serotonergic system is involved in the reduction of anxiety observed after ejaculation. The results of the DSP4 experiment suggest that there is not a direct participation of the noradrenergic system in the anxiety reduction observed after ejaculation.

5,7-Dihydroxytryptamine↗
PubMed1987

The activating effects of bicarbonate on sperm motility and respiration at ejaculation.

Mature porcine sperm preserved in the cauda epididymis are quiescent. At ejaculation, they are mixed with the seminal vesicle fluid containing HCO3- and are rapidly activated. The role of HCO3- on the sperm activation process at ejaculation was studied in vitro. HCO3- quickly increased the motility, respiration rate and cAMP content of the porcine epididymal sperm. The extent of activation was proportional to the pCO2 in the medium. The activating effect of HCO3- on the motility was observed even in the absence of fructose as well as in the presence of KCN. 8-Bromoadenosine 3',5'-cyclic monophosphate and theophylline showed similar activating effects to that of HCO3-. However, HCO3(-)-free seminal plasma, Ca2+, amino acids, intermediates of the Krebs cycle, substrates of respiration and increases in the intracellular pH, extracellular pH or ionic strength of the medium had no effect. Fructose sustained the active state of the sperm and gradually increased both the motility and respiration rate when the dose of HCO3- was low. The anion channel blocker enhanced the activating effect of HCO3-. These results suggest that, upon ejaculation, HCO3- is a unique activator in vivo which makes the quiescent sperm motile via the HCO3(-)-adenylate cyclase-cAMP system, to which an endogenous HCO3- derived from metabolic CO2 may be related.

Animals↗
PubMed1994

Sexual asphyxiophilia (Koczwarism) in women and the biological phenomenon of female ejaculation.

Life threatening eroticizing behavior, asphyxiophilia (sexual asphyxia) is practiced in women, as in men, in order to heighten sexual excitement and to achieve orgasm, which is in some women accompanied by expulsions of fluid (ejaculation) from the urethra. The relatively easily achieved orgasm induced by the mechanism of asphyxia is hypothesized to be the common reason for repetitive deviant asphyxiophilic behavior. Moreover, in women of the ejaculatory type (female ejaculators), the desire to induce ejaculatory orgasm by asphyxia may also come into play as this kind of orgasm is usually assessed as sensation of greater delight than orgasm without ejaculation.

Asphyxia↗
PubMedDate not supplied

The effect of ejaculation on albumin excretion rate.

Microalbuminuria predicts the development of diabetic nephropathy. Large daily variations in albumin excretion rates are frequently observed. Because seminal fluid contains protein and albumin, we reasoned that sexual activity, ejaculation, or residual urethral semen could contribute to albumin content in urine and thus effect determination of albumin excretion rate. Our study was designed to determine the effect of ejaculation of albumin excretion rate and to ascertain if patients routinely should be advised to refrain from sexual activity during or before the urine collection period. Ten normotensive, nondiabetic men (age 31.0 +/- 2.3 years) collected 24-h urine specimens on three occasions: after 3 days of abstinence from sexual activity, during a 24-h period which included one ejaculatory episode, and on a day following sexual activity. Results for albumin excretion rate were: abstinence day: 4.8 +/- 0.7 micrograms/min; sex day: 6.3 +/- 1.1 microgram/min; post-sex day: 4.9 +/- 1.0 micrograms/min. There was no significant difference between these values when compared directly or after log transformation. There also were no differences in urinary creatinine excretion or clearance. We conclude that in nondiabetic individuals ejaculation does not influence albumin excretion rate.

Adult↗
PubMed2005

Proposals or findings for a new approach about how to define and diagnose premature ejaculation.

PURPOSE: To review and present the proposals or findings for a new approach about how to define and diagnose premature ejaculation (PE). MATERIALS AND METHODS: Using Medline to search for international peer reviewed manuscripts published from 1996 to 2004 about the definition and diagnosis of PE. RESULTS: PE, to date, has not a universally agreed definition and diagnostic criterion. Many definitions are partial, subjective and nonspecific. An ideal definition or diagnostic criterion should consist of intravaginal ejaculatory latency time (IELT), the ability to control over ejaculation, the extent of male sexual satisfaction, the extent of female sexual satisfaction, the frequency of female sexual partner reaching orgasm and the extent of psychological and pathological factors. Therefore, the Chinese Index of Premature Ejaculation (CIPE) seems an ideal tool and criterion used to diagnose PE due to including all the elements above. In the majority of cases, PE is the result of a mix of psychogenic, physiological and organic factors. So, besides some routine tests such as urine routine test, endocrine hormone assay, psychosexual counseling, couple evaluation and physical examination, prostate examination, serum leptin assay, semen magnesium assessment and glans hypersensitivity measurement, are suggested to be performed in the diagnosis of PE. Although elucidated by two clinical trials and further confirmed, serum leptin assay seems a promising and objective marker to diagnose PE because it is related to the serotonergic system whose disorder has been confirmed to contribute to the etiology of PE. CONCLUSION: None of these definitions and diagnoses has been accepted as a universal agreement of PE. CIPE seems an ideal tool and criterion used to diagnose PE and leptin maybe become a promising and objective marker for PE.

Ejaculation↗
PubMed2006

Expression of the HSPA2 gene in ejaculated spermatozoa from adolescents with and without varicocele.

OBJECTIVE: To evaluate mRNA expression of the HSPA2 gene in ejaculated spermatozoa in adolescents with and without varicocele. DESIGN: Controlled prospective study. SETTING: Patients in an academic research environment. PATIENTS: Adolescent patients with clinical diagnosed bilateral varicocele grades II and III, and adolescent patients without varicocele. INTERVENTION: Reverse-transcription-polymerase chain reaction (RT-PCR) analysis of HSPA2 gene expression in adolescents with and without varicocele. MAIN OUTCOME MEASURE: Comparative RT-PCR expression analysis of HSPA2 gene mRNA, compared to the housekeeping beta-actin gene. RESULTS: Sperm from adolescents with varicocele and oligozoospermia had significantly lower levels of HSPA2 gene expression than both adolescents without varicocele (controls) and adolescents with varicocele and normal sperm concentration (P<.05). The latter group had a nonsignificant increase in gene expression compared to the control group. CONCLUSIONS: This is the first report on HSPA2 gene expression in ejaculated spermatozoa from adolescents and its relationship with varicocele pathology. Results demonstrated that HSPA2 expression was down-regulated in adolescents with varicocele and oligozoospermia compared to controls. There was a higher, albeit nonsignificant, gene expression in adolescents with varicocele and normal sperm concentration than in controls. We speculate that expression levels of this gene might be used as a molecular marker for the acquisition of thermal tolerance in ejaculated spermatozoa.

Adolescent↗
PubMed2006

Evidence for an involvement of peripheral serotonin in p-chloroamphetamine-induced ejaculation of rats.

The purpose of the present study was to determine the mechanism of the ejaculatory response induced by the 5-HT-releasing compound p-chloroamphetamine (PCA) in rats. The ejaculatory response was assessed by weighing the coagulated seminal materials accumulated over 1 h. Intraperitoneal injection of PCA (0.5-5.0 mg/kg) produced a dose-related increase in both the incidence of ejaculation and the weight of the accumulated seminal materials. The ejaculatory response induced by PCA (5.0 mg/kg) was abolished by pretreatment with the 5-HT synthesis inhibitor p-chlorophenylalanine, the 5-HT receptor antagonists methysergide and MDL72222, or by the selective 5-HT reuptake inhibitor citalopram, suggesting that the 5-HT-releasing property of PCA mainly involved the expression of ejaculation. Neither the section of the spinal cord at thoracic (T8-9) level nor the lumbosacral spinal 5-HT denervation by intrathecal (i.t.) injection of 5,7-dihydroxytryptamine affected the ejaculatory response induced by PCA. The i.t. injection of PCA (20-160 microg/rat) at lumbosacral spinal level did not exert the systemic PCA-like prominent effect on ejaculation, whereas i.t. injection of lidocain at the same site completely abolished the response to systemic PCA. Additionally, the peripherally administered 5-HT (0.1 and 0.25 mg/kg, i.p.) enhanced the proejaculatory effect at a threshold dose (1.0 mg/kg, i.p.) of PCA. From these observations, it is concluded that the ejaculatory response induced by PCA is mainly a spinally mediated reflex response that is triggered by the release of 5-HT in the peripheral sites.

Animals↗
PubMed2004

Timing between ejaculations changes paternity success.

It is believed that when two male rats copulate with a single female, the last one that ejaculates fathers significantly more pups than the first one. To determine the effects of order and elapsed time between two males copulating with the same female, albino Wistar (W) and pigmented Long-Evans (LE) male rats copulated with a W female. Paternity was confirmed by the pups' pigmentation. Three groups were made according to the elapsed time between the first male's ejaculation and the placement of the female with the second male; T0 (0-min group); T5 (5-min group); and T10 (10-min group). Male order was counterbalanced in each group. The results showed that the second male had the advantage in T0, but the first males had the advantage in T5 and T10. These data indicate that in a two-male situation, the advantage in paternity for a second male occurs only during copulations following the first few minutes of a first male's ejaculation. After 5 min, a second male has no advantage in fathering pups.

Animals↗
PubMed2006

Assessment of chromatin status (SCSA) in epididymal and ejaculated sperm in Iberian red deer, ram and domestic dog.

Abnormal chromatin condensation is not detected using classical techniques for sperm analysis. SCSA has demonstrated its usefulness in sperm chromatin analysis in several species (human, bull, stallion and boar). In this work, we studied sperm samples from red deer, ram and dog to analyze the differentiation of chromatin structure applying SCSA in epididymal and ejaculated spermatozoa. Epididymal samples were obtained from the caput, corpus and cauda by means of cuts, and ejaculated ones were obtained by electroejaculation (deer), artificial vagina (ram) and digital manipulation (dog). SCSA results suggested different critical points in sperm maturation (spermatozoa with loose chromatin to more condensed chromatin) among species: from corpus to cauda in ram and from caput to corpus in deer and dog. Moreover, we also detected differences in ruminants and dog, reflected in the appearance of SCSA plots. Indeed, ram and deer samples rendered two peaks within the sperm main population (sperm with condensed chromatin), whereas only one was detected in dog. Although some differences were observed between cauda and ejaculated samples, SCSA parameters indicated good chromatin condensation, making these samples suitable for germplasm banking. Some species-dependent modifications in the analysis of the results may be necessary to take full advantage of its analytical power.

Animals↗
PubMed2006

Comparison of efficacy of sildenafil-only, sildenafil plus topical EMLA cream, and topical EMLA-cream-only in treatment of premature ejaculation.

OBJECTIVES: To compare the efficacy of sildenafil (Viagra) only, sildenafil plus topical anesthetic cream (EMLA), and topical EMLA-cream-only to that of placebo in treating premature ejaculation. METHODS: A total of 84 patients were enrolled in this study. The duration of premature ejaculation in the patients ranged from 9 to 60 months (mean 32.5 +/- 14.6). Patients were randomized into four groups. Group 1 consisted of 20 patients who took placebo for 2 months. Groups 2 and 3 consisted of 20 and 22 patients, respectively, and they received 50 mg sildenafil 45 minutes before coitus for 2 months. In addition, patients in group 3 applied topical EMLA cream to the glans penis 15 minutes before coitus. The 22 patients in group 4 used topical EMLA-cream-only. After at least eight sexual attempts, the patients' clinical responses were assessed using the patient self-description method. Effectiveness was described as improvement plus cure. RESULTS: The effectiveness was 40% in group 1, 55% in group 2, 86.4% in group 3, and 77.3% in group 4. Of the groups, a significant difference was found in the effectiveness of the treatments (Pearson chi-square= 0.00). No significant difference was found between groups 1 and 2 (P = 0.26). Efficacy was more successful in groups 3 and 4 than in the others (P = 0.00). The difference between groups 3 and 4 was not significant (Pearson chi-square = 0.42). CONCLUSIONS: Sildenafil-only was not superior to placebo or combination treatment. Topical EMLA-cream-only had equal effectiveness to that of sildenafil plus topical EMLA treatment. The use of topical EMLA-cream-only seems to be an effective treatment of premature ejaculation.

Administration, Topical↗