Anatomy of Male Sex Organ
The male reproductive system is mostly located outside of the body. These external organs include the penis, scrotum, and testicles. Internal organs include the vas deferens, prostate, and urethra. The male reproductive system is responsible for sexual function, as well as urination. (Figure 1)
The penis is the external organ that has three parts:
The root: This is the part of the penis that attaches to the wall of your abdomen.
The body or shaft: Shaped like a tube or cylinder, the body of the penis is made up of three internal chambers. Inside these chambers, there’s a special, sponge-like erectile tissue that contains thousands of large spaces that fill with blood when you’re sexually aroused. As the penis fills with blood, it becomes rigid and erect, which allows for penetration during sex. The skin of the penis is loose and elastic, allowing for changes in penis size during an erection.
The glans: This is the cone-shaped end of the penis. The glans, which is also called the head of the penis, is covered with a loose layer of skin called the foreskin. This skin is sometimes removed in a procedure called circumcision.
The opening of the urethra — the tube that transports both semen and urine out of the body — is located at the tip of the glans penis. The penis also contains many sensitive nerve endings.
The scrotum is the loose pouch-like sac of skin that hangs behind the penis. It holds the testicles (also called testes), as well as many nerves and blood vessels. The scrotum protects your testes, as well as provides a sort of climate control system. For normal sperm development, the testes must be at a temperature slightly cooler than the body temperature. Special muscles in the wall of the scrotum allow it to contract (tighten) and relax, moving the testicles closer to the body for warmth and protection or farther away from the body to cool the temperature.
The testes are oval organs about the size of very large olives that lie in the scrotum, secured at either end by a structure called the spermatic cord. Most men have two testes. The testes are responsible for making testosterone, the primary male sex hormone, and for producing sperm. Within the testes are coiled masses of tubes called seminiferous tubules.
The epididymis is a long, coiled tube that rests on the backside of each testicle. It carries and stores sperm cells that are created in the testes. It’s also the job of the epididymis to bring the sperm to maturity — the sperm that emerge from the testes are immature and incapable of fertilization. During sexual arousal, contractions force the sperm into the vas deferens.
The internal male reproductive organs include:
Vas deferens: The vas deferens is a long, muscular tube that travels from the epididymis into the pelvic cavity, to just behind the bladder. The vas deferens transports mature sperm to the urethra in preparation for ejaculation.
Ejaculatory ducts: These ducts are formed by the fusion of the vas deferens and the seminal vesicles. The ejaculatory ducts empty into the urethra.
Urethra: The urethra is the tube that carries urine from the bladder to the outside of your body. In males, it has the additional function of expelling (ejaculating) semen when you reach orgasm. When the penis is erect during sex, the flow of urine is blocked from the urethra, allowing only semen to be ejaculated at orgasm.
Seminal vesicles: The seminal vesicles are sac-like pouches that attach to the vas deferens near the base of the bladder. The seminal vesicles make a sugar-rich fluid (fructose) that provides sperm with a source of energy and helps with the sperm’s ability to move (motility). The fluid of the seminal vesicles makes up most of the volume of your ejaculatory fluid, or ejaculate.
Prostate gland: The prostate gland is a walnut-sized structure that’s located below the urinary bladder in front of the rectum. The prostate gland contributes additional fluid to the ejaculate. Prostate fluids also help to nourish the sperm. The urethra, which carries the ejaculate to be expelled during orgasm, runs through the centre of the prostate gland.
Bulbourethral glands: The bulbourethral glands, or Cowper’s glands, are pea-sized structures located on the sides of the urethra, just below the prostate gland. These glands produce a clear, slippery fluid that empties directly into the urethra. This fluid serves to lubricate the urethra and neutralize any acidity that may be present due to residual drops of urine in the urethra.
Physiology of Erection
The penis is made of spongy tissue, two corpora cavernosa, and one corpora spongiosum. These are sponge-like structures that have rich blood vessel supplies. When there is stimulation, the blood vessels become wider, blood flow increases, and the spongy tissue is soaked with blood and it making the flaccid penis larger and erect, and hard. The blood in spongy tissue compresses the veins in the penile tissue and doesn’t allow blood to leave the penile tissue maintaining an erection. (figure 2)
Physiology of Ejaculation
Sperms are produced in the testis and travel through a tube called vas deferens to the urethra. There are two glands namely prostate and seminal vesicles that produce semen, the watery content that mixes with sperms in the urethra. It forms the ejaculate which then comes out of the opening, the process called ejaculation. The rhythmic contraction of bulbocavernosus and ischiocavernosus muscles around the base of the penis helps in the forced expulsion of semen out of the urethra. But do you know what controls this activity of erection and ejaculation? (figure 3)
Mind is the Master, Organ a Player
It is the mind that controls the activity of the male sex organ. The mind is the most powerful sex organ. The sex organ is just a soldier, the master is the mind. Whenever there is an erotic stimulus either in the form of visual images or video, sensual touch, erotic smell, or audio, a particular part of the brain is stimulated that sends a signal across neurons that are further transmitted through the spinal cord to the erectile nerves in the penis resulting in erection and ejaculatory process (figure 4).
Brain is the most powerful sexual organ
This is mediated by the medial preoptic and paraventricular nucleus near the hypothalamus in the brain that releases the brain chemical, neurotransmitter dopamine. It spreads the electrical impulse down the spinal cord where there are nerves at different levels that subserve different functions. The parasympathetic nerve fibers (S1-S4) travel to the penis and mediate erection. These nerves by causing dilation of blood vessels in penile tissue cause the pooling of blood in the penis causing engorgement and hence an erection. The sympathetic nerve fibers ( T12-L2) travel to the penis and participate in the ejaculatory mechanism. Sympathetic nerves also function in increasing heart rate, and blood pressure and that is why man feels increased heartbeat during orgasm and ejaculation. There are pudendal and genitofemoral nerves that carry sensations from the penis and adjacent regions(e.g. thighs) to the brain. That is why even stroking the stimulus in a sensual way can stimulate the male organ. (Figure 5) Advanced scans like functional MRI of the brain have revealed that a particular brain part like the dorsal anterior cingulate gyrus is activated during sexual stimulation. These studies clearly prove that the brain is the most powerful sex organ and controller of all sexual acts. If one can master the brain, one can easily regulate sexual activities. (figure 6)
Chemicals control the action of the mind
The brain has neurons. Neurons are like electrical wires. These neurons are connected with each other through connections called synapses. Electric current flows in electric wire and this electric current is nothing but the flow of electrons. Similarly, the signal from one neuron to another in the brain is passed through chemicals called neurotransmitters. The most important neurotransmitter in the brain for the sexual pathway is dopamine. (Figure 7)As already said, when there is a stimulus (tactile, visual, olfactory), the paraventricular nucleus and preoptic neurons are activated that release dopamine. Dopamine travels and attaches to receptors on the nerves of the spinal cord to activate the sympathetic and parasympathetic nervous systems. Receptors are like antennas that sense and capture dopamine for further transmission of brain signal downwards. Once there is a transmission of signal downwards, it mediates physiological processes of erection and ejaculation. This is the mechanism of how erotic stimulus from outside is translated into the physiological process of erection and ejaculation. If there is excessive stimulation, receptors are activated maximally resulting in very strong and fast transmission of signal downwards. If receptors are reduced in number, the signal is not passed effectively resulting in faulty physiological processes of erection and ejaculation. (Figure 8 )
Dopamine is that’s why called pleasure or reward hormone and it mediates many actions like lovemaking, sex, gambling, drug pleasure, etc. (figure 9)
Dopamine – The Pleasure Hormone
This dopamine is stored in the end part of one neuron in packets called synaptic vesicles. Once there is outside stimulation, there is a signal to release dopamine from these vesicles. Dopamine is released and attaches to the receptor on the next neuron. This process continues until the signal reaches penile nerves and causes dilatation of blood vessels of the penis resulting in penile engorgement. An electron microscope picture of the synapse (the connection between two neurons) with dopamine particles is shown. (figure 10)
Pre-frontal cortex controls dopamine production
But you must have observed that the same type and intensity of stimulation cause different responses in different individuals. Some men get greatly stimulated on even reading soft sensuous material while some men do not get stimulated easily even looking at the half-naked opposite gender. There is a scientific basis behind this astonishing fact! The front part of our brain called the prefrontal cortex controls the production of dopamine from sex centres of the brain viz medial pre-optic and paraventricular nuclei. The prefrontal cortex regulates the functioning of these sex centres by the release of glutamate. More glutamate release means more dopamine release. (figure 11)
So ultimately the remote control is in the hands of the pre-frontal cortex. The prefrontal cortex by regulating the release of glutamate, in turn, controls the release of dopamine which in turn regulates the physiological process of erection and ejaculation. (DOPAMINE REWARD SYSTEM) (figure 12)
Faulty dopamine system & sexual disorders
Now let us understand the faulty system. When there is increased dopamine much more than normal process due to highly erotic stimulation like porn, self-stimulation of sex organs, the receptors get super-sensitized and the physiological process of erection and ejaculation occurs faster than normal usual. When it is repeated again and again, the brain gets conditioned to this and now the brain releases large doses of dopamine very fast, the signal is transmitted very rapidly and the time to complete the process becomes shorter and shorter. Moreover since one can fast forward the porn video to immediately see orgasm and climax for maximum pleasure, the result is that the mind is gradually conditioned that it must ejaculate fast to derive instant pleasure. And before even one could realize it, the ground for premature ejaculation is already set in the brain. But the story doesn’t end here. As receptors are frequently over-stimulated, ultimately there happens a process called receptor desensitization or tolerance or habituation. Receptors no longer work with the same efficiency and despite the release of dopamine, the power signal is not transmitted downwards due to poor receptor function. Poor transmission means the poor physiological process of erection. This is the cause of erectile dysfunction. (Figure 13)
The genesis of Sex Addiction
The brain has a particular way of feedback mechanism. The dopamine reward system gives a signal to the frontal cortex to release glutamine which in turn stimulates the dopamine reward system to release further dopamine repeating the cycle. Repeated sexual behaviours induce upregulation of Delta FosB, a transcription factor that promotes several neuroplastic changes that sensitize the mesolimbic dopamine system. This up-regulation in the same neurons is mediated via dopamine receptors. This process renders the individual hyper-sensitized to stimuli associated with the activity (increased incentive salience). Exposure to related cues then triggers cravings to engage in the behaviour (increased “wanting”), and leads to compulsive use. In comparing sexual reward to substances of abuse, researchers Pitchers et al. concluded that, “ they converge on the same molecular mediators, and likely in the same neurons, to influence the incentive salience and the “wanting” of both types of rewards” A 2016 review by Kraus, Voon and Potenza affirmed that, “Common neurotransmitter systems may contribute to [compulsive sexual behaviour] and substance use disorders, and recent neuroimaging studies highlight similarities relating to craving and attentional biases”. (figure 14, 15)
“Pre-frontal Cortex is the “thinking brain”
The prefrontal cortex is the front part of the brain that serves 5 major functions:
1. The power to understand difficult things and grasp them fast
2. Expression of one’s personality
3. Power to decide effectively
4. Control of thoughts and emotions
5. Social behavior
If the prefrontal cortex is damaged or underdeveloped, such persons suffer from a lack of compassion, and sympathy and have no guilt feelings. They will not experience shame even while doing wrong things. They will neither acknowledge their wrong-doings, nor they will have feelings of compassion towards others. Such a person has problems in social interaction and a permanent habit of arbitrary conduct. (Figure 16) Dr Rajita Sinha, Professor of Psychiatry and Neurobiology at Yale University did research on this aspect. The prefrontal cortex is damaged by addictions like smoking, tobacco, alcohol, porn addiction, masturbation addiction, video game addiction, etc. Dopamine is the craving hormone. Serotonin is the anti-depressant hormone. (Figure 17)
Prefrontal Cortex & Sex Addiction
When there is constant overstimulation and release of dopamine, it induces a series of changes even at the level of DNA forming altered protein products that induce neuroplastic changes in various parts of the brain, especially the prefrontal cortex making its function faulty. The result is faulty the prefrontal cortex does not have the ability to think rationally and is overpowered with so many sexual thoughts that result in craving and addiction to bad habits. The person despite being aware of the harmful effects is not able to regulate his addictive behaviour and it becomes a compulsive act. (figure 18)
The final outcome is that the brain is mostly preoccupied with sexual thoughts and cannot concentrate on other tasks like studies, office work, and creative activities. There is poor attention span, poor learning, and poor personality, and skills. (figure 19)
He feels his life is a burden to the extent that he thinks of ending his life. Low levels of serotonin make him depressed, hopeless, helpless, and dejected. (figure 20)
“The Hard-Flaccid” Penis
There is another interesting fact “The Hard Flaccid”. You must have noticed that people who masturbate often have large tortuous veins on their penis. Some also complain of the small size of the penis if they start masturbating from an early age. Whenever there is tough masturbation, during rubbing of the penis firmly with hands or use of other objects, there is tearing of these delicate blood vessels and nerves due to shearing forces and friction. There is local inflammation and when the body tries to heal this injury, there is tortuosity and dilation of veins. But due to incomplete and imperfect repair, the person has permanent damage to these structures. This results in symptoms like penile numbness, cold and/ soft glans, erectile dysfunction, and pain sensation on erection or ejaculation. The result is anxiety/depression and low libido. This is depicted in figures 21 & 22.
Mechanisms of sexual problems
Hope you are clear about this amazing and intriguing physiological process of the function of the male organ and its control by its master the brain. And also all your doubts about how the practice of masturbation and porn addiction leads to sexual problems of erectile dysfunction, premature ejaculation, and addiction.
The mechanisms of sexual problems, hence, are
1. Reward Circuitry over-stimulation
2. Super-normal stimulus, hyper-sensitivity
3. Tolerance, Habituation, DOWN REGULATION, CONDITIONING
4. Local injury to penis vessels, nerves, tissues
Porn has many issues. Firstly, porn shows something which is extraordinary compared to usual sexual acts. Si gives a super-normal stimulus to the brain that results in overstimulation of dopamine circuitry but it also creates a memory of that super-normal stimulation in the brain which then one tries to repeat with a real sex partner. But if the same or high-intensity stimulus is not received, the person is not aroused. In other words, the threshold for an erection is increased with the need for a super maximal stimulus to release the same amount of dopamine for the process of erection to happen. With time, due to the downregulation of receptors, much more dopamine needs to be released. All these are the reasons for erectile dysfunction. Moreover, it is possible to fast forwards or scroll the porn video directly to the act of sexual intercourse since the orgasm or ejaculation is the highest point of excitement. But it carries a very big risk. Now the mind is conditioned to directly visualize and want orgasm/ejaculation fast to facilitate the rapid and maximum release of dopamine that results in premature ejaculation. Now the person can no longer control ejaculation for the desired time and semen is released quickly. This develops a vicious cycle wherein the person watches more and more porn to satisfy the craving for dopamine. The dopamine reward system in turn stimulates the prefrontal cortex for more craving. This is called craving begets more craving; dopamine begets more dopamine. And this is the physiological basis of PORN AND MASTURBATION ADDICTION.
If these habits develop at an early age even before the full development of the male sex organs has happened, it results in poor development of the organ and problems like small size, bent penis, etc.
Figure 23 shows how in premature ejaculation, the time from onset of sexual activity to orgasm and ejaculation is shortened because of conditioning of the brain’s dopamine system. Figure 24 shows how supranormal stimulus gives instant pleasure due to the rapid release of a large amount of dopamine but over time causes the problem of premature ejaculation
Some people complain of the passage of whitish semen discharge along with urine popularly known by the slang term “Dhatu-Rog”. In scientific language, it is called retrograde ejaculation. We can see in figure 25 that semen passes through the urethra. Semen when passes through the urethra during the emission phase of ejaculation, the external urethral sphincter, gate at the end of the bladder is closed preventing backflow of semen in the bladder. But when there are weak pelvic and bladder neck muscles, this gate is not closed properly, and semen backflows into the bladder mixing with urine stored there. And when a person passes urine, there is semen mixed urine.
Science Discovers The Physiological Value Of Continence
Mostly it is blamed that medical literature clearly supports masturbation and porn-watching practices. But it is not true. In the last two decades, especially there is growing awareness about the harmful effects of these two practices even among medical personnel, though evidence started emerging as early as 1957. (Figure 26)
Raymond W Bernard in his book “Science Discovers The Physiological Value Of Continence” elaborated on how brain function is related to seminal loss. Semen contains 90% water and 10% solids. 10% solid has the following constituents:
1. Protein substances like albumin, nucleoproteins, globulins, mucin, nuclein, protease, protamine, alkali albuminate
2. Lipoids which comprise phosphorized fats and lecithin.
4. Minerals like phosphorous, sodium, potassium, calcium, magnesium, iron, sulfur, and chloride.
All these elements are also present and essential for our brain to function and there is a direct correlation between seminal fluid weakness and mental diseases.
It has been demonstrated that repeated semen loss results in poor prefrontal cortex development and its function is impaired. Its role in learning, understanding, thinking, emotional processing, and behaviour has already been discussed. A functional study has revealed that the sex-addicted brain has less blood flow and poor metabolic activity as compared to healthy control.
Brahmacharya: Evidence from medical literature
In a recent study published in the “Military Medicine” journal, it was concluded that men who prefer masturbation with pornography to partnered sex have a significantly increased risk of sexual dysfunction. In another study published in 2020 in a reputed journal “ Archives of Sexual Behaviour”, it was said that abstinence from masturbation is frequently recommended as a strategy to improve one’s sexual self-regulation. There are so many studies like that in the last few years demonstrating the harmful effects of porn, masturbation addiction, and the benefits of abstinence. These important medical facts are mostly unknown to the general population due to lack of direct access to medical literature, difficulty understanding the medical terms and script as well as flooding of web media with unauthenticated and biased information. Wikipedia and Google may be storehouses of information but authenticity and correctness cannot be always certain.
Masturbation & Prostate Cancer
Another important scientific myth is the occurrence of prostate cancer with abstinence and that masturbation is protective. In a recent review which is actually the compilation of almost all studies done on this topic, it was clearly stated that data is insufficient to agree to the abovementioned fact. More research is needed to clarify the issue. It clearly shows that the protective role of masturbation in prostate cancer is much over-hyped and its correctness is questionable.
Treatment: Pills, Sprays and Oils
Since sexual problems have taken a gigantic form, so many pharmaceutical companies took it as a great opportunity to manufacture various pills/sprays/oils claiming to treat various sexual diseases. Most young men are misled about the magical cure pills and sprays and they spend lakhs of money on these products. They claim to cure erectile problems, premature ejaculations, semen in urine, etc but know the reality behind it. Are these products really beneficial? Are they free of side effects? Any problems with long use? These are some of the questions to which every youth is confused about but does not find satisfactory answers.
Figure 27 shows how the various pills and sprays act on the human body. Sprays are used locally on the penis. They contain anaesthetic agents like lidocaine which act on penile sensory nerves and numb the penile tissue. As a result, the touch over the organ is not felt. This decreased tactile stimulation does not excite the brain to release dopamine quickly. As a result, the time to ejaculate is increased. But regular use results in some damage to the nerves locally that interferes with erection and also when the spray is not used subsequently, the person has even faster ejaculation due to the rebound phenomenon. Another common pill is VIAGRA or Sildenafil which is marketed for erectile problems. Sildenafil by increasing the levels of Nitric Oxide causes longer and more dilation of penile arteries resulting in longer erections. But again its regular use makes a person habitual and there are difficult erections without it. Moreover, a person commonly experiences side effects of headache, nausea, and palpitations with its use because it causes a fall in blood pressure. There are cases where the person has got a heart attack due to this pill. Another pill marketed for premature ejaculation is dapoxetine. It prevents the reuptake of serotonin and hence increases its levels. Increased serotonin levels prolong ejaculation time but again prolonged use alters the normal physiological process of the body besides other side effects.
These pills are mostly bridges to treat severe problems and they provide only temporary relief. They have side effects on BP, heart, stomach, liver, and kidney. Their long use causes super-sensitivity of receptors. As soon as they are withdrawn, there is a relapse of symptoms with greater force. They do not offer long-term or permanent treatment. That is why doctors also stress behavioural modification/brain conditioning.
The “NOFAP” Challenge
Abstinence definitely has beneficial effects on the recovery of sexual problems and sex addiction. There are nofap challenges popular among men affected by these problems. They follow abstinence for a particular time period and experience the physical, mental, emotional, and social benefits but a major concern is high relapse rates. (Figure 28) That is they again fall prey to addiction after a time period and could not suppress the urges or cravings anymore. This is easily understood by this complex scientific diagram demonstrating how the cycle of addiction works. Triggers like boredom, loneliness, anger, stress, fighting with loved ones, criticism, etc are the driving forces that create the urge to release dopamine. In these times, the mind wants some relaxation and happiness. And the easiest way the mind is already used to acquire happiness is by the release of dopamine; dopamine is the pleasure hormone. So the mind is easily tempted to again do masturbation and watch porn to quickly release dopamine and satisfy its hunger for happiness and pleasure. So there is a compulsive behaviour for these activities and then as an after-effect, there is shame or guilt of wrong-doing. This wound of shame over the mind creates emotions of unworthiness or hatred to self which again triggers the need for more dopamine. This becomes a vicious cycle. (Figure 29)
Brain Rewire is the most effective treatment
Unless the brain is re-conditioned or re-wired to escape this vicious cycle, the problem is not going to get better. Unless one learns to shift deriving pleasure from lower-level sexual behaviours to higher-level spiritual pleasure, it is almost impossible to come out of this addiction. Especially in today’s times when there is so much stressful and negative atmosphere around, only the power of spiritual pleasure can override powerful sexual desires and addictions. This is recognized by researchers across the globe. Dr Herbert Benson, Associate Professor of Medicine, Harvard Medical School and founder of Benson-Henry Institute of Mind-body medicine has worked extensively on Brain Relaxation Response. (Figure 30) Dr Benson’s research extends from the laboratory to the clinic and to Asian field expeditions. His work serves as a bridge between medicine and religion, East and West, mind and body, and belief and science. The techniques studied were the Transcendental Meditation technique, Progressive Relaxation (PR), concentration meditation, Sanskrit mantra meditation, and placebo techniques. The Transcendental Meditation program provides mind-body relaxation that naturally optimizes psychophysiology, thus removing the need for artificial attempts through drugs. The techniques of yoga, meditation, and mindfulness increase levels of serotonin in the brain and balance out the levels of dopamine that are being used for addiction treatment and relapse prevention. (Figure 31) Serotonin is an anti-depressant hormone released from the dorsal raphe nucleus in the brain. You can find a lot of studies on this topic in recent scientific literature. Indian traditional spiritual healing is based on the same principle. It’s high time now that we acquire correct information, understand it in its right perspective and apply it in our lives so we come out of this problem to lead a happy, healthy and blissful life. Not only that but we must educate our fellow men and save them from these self-destructive behaviours.
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