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Endocrine response to masturbation-induced orgasm in healthy men following a 3-week sexual abstinence

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This current study examined the effect of a 3-week period of sexual abstinence on the neuroendocrine response to masturbation-induced orgasm. Hormonal and cardiovascular parameters were examined in ten healthy adult men during sexual arousal and masturbation-induced orgasm. Blood was drawn continuously and cardiovascular parameters were constantly monitored. This procedure was conducted for each participant twice, both before and after a 3-week period of sexual abstinence. Plasma was subsequently analysed for concentrations of adrenaline, noradrenaline, cortisol, prolactin, luteinizing hormone and testosterone concentrations. Orgasm increased blood pressure, heart rate, plasma catecholamines and prolactin. These effects were observed both before and after sexual abstinence. In contrast, although plasma testosterone was unaltered by orgasm, higher testosterone concentrations were observed following the period of abstinence. These data demonstrate that acute abstinence does not change the neuroendocrine response to orgasm but does produce elevated levels of testosterone in males.
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Michael S. Exton áTillmann H. C. Kru
Èger áNorbert
Bursch áPhilip Haake áWolfram Knapp áManfred
Schedlowski áUwe Hartmann
Endocrine response to masturbation-induced orgasm in healthy men
following a 3-week sexual abstinence
Abstract This current study examined the eect of a
3-week period of sexual abstinence on the neuroen-
docrine response to masturbation-induced orgasm.
Hormonal and cardiovascular parameters were exam-
ined in ten healthy adult men during sexual arousal
and masturbation-induced orgasm. Blood was drawn
continuously and cardiovascular parameters were
constantly monitored. This procedure was conducted
for each participant twice, both before and after a
3-week period of sexual abstinence. Plasma was sub-
sequently analysed for concentrations of adrenaline,
noradrenaline, cortisol, prolactin, luteinizing hormone
and testosterone concentrations. Orgasm increased
blood pressure, heart rate, plasma catecholamines and
prolactin. These eects were observed both before and
after sexual abstinence. In contrast, although plasma
testosterone was unaltered by orgasm, higher testos-
terone concentrations were observed following the
period of abstinence. These data demonstrate that
acute abstinence does not change the neuroendocrine
response to orgasm but does produce elevated levels of
testosterone in males.
Key words Abstinence áSexual arousal áOrgasm á
Prolactin áCatecholamines áCortisol á
Testosterone áCardiovascular
Although sexual abstinence is a common behavioral
pattern in humans, there has been little examination of
the psychological and physiological consequences of this
behavior. Nevertheless, limited data have demonstrated
that sexual abstinence may impact on the physiological
regulation of sexual function. Speci®cally, retrospective
studies have shown that features of semen quality are
reduced during long periods of sexual abstinence [5, 22].
In contrast, periods of abstinence between 12 h and
10 days have generally revealed enhanced sperm quality
parameters [9, 26, 28, 33], although this is not consistent
across all measures of sperm quality [28, 33]. Neverthe-
less, acute sexual abstinence is commonly employed prior
to clinical sperm donation to enhance sperm quality.
Despite knowing that acute abstinence aects repro-
ductive function, no data exist that examines the eect
of abstinence on the physiological response to sexual
arousal and orgasm. We have established a method for
examining the neuroendocrine response to masturba-
tion-induced orgasm in men and women [15±17, 24],
based upon a continuous blood sampling technique.
These investigations demonstrated that masturbation-
induced orgasm produced a pronounced increase in
cardiovascular responses and plasma catecholamine
concentrations. Furthermore, sexual arousal was char-
acterised by a large, persistent increase in concentrations
of plasma prolactin. Since hyperprolactinemia is known
to inhibit sexual arousal and function [13, 35], these data
suggest that prolactin may act as a peripheral and/or
central feedback signal in controlling sexual arousal
following orgasm.
Therefore, the purpose of this current study was
to investigate the eect of acute abstinence on the
physiological response to sexual arousal. Speci®cally, we
World J Urol (2001) 19: 377±382 ÓSpringer-Verlag 2001
The ®rst two authors made equal contributions to this work. This
study was partially supported by a grant from the Deutsche Fors-
chungsgemeinschaft (Sche 341/10±1).
M. S. Exton (&)áT. H. C. Kru
Èger áP. Haake
M. Schedlowski
Institut fu
Èr Medizinische Psychologie,
Universita
Ètsklinikum Essen, Hufelandstr. 55,
45122 Essen, Germany
e-mail: michael.exton@uni-essen.de
Tel.: +49-201-723-4282; Fax: +49-201-723-5948
N. Bursch áU. Hartmann
Division of Clinical Psychiatry, Hannover Medical School,
30623 Hannover, Germany
W. Knapp
Division of Nuclear Medicine, Hannover Medical School,
30623 Hannover, Germany
examined the neuroendocrine responses to sexual
arousal and orgasm following separate periods of
regular sexual activity and sexual abstinence in healthy
men by using an established paradigm.
Materials and methods
Participants
Ten healthy male volunteers (mean age of 25.8  0.8 years, range
of 22±29 years) participated in this investigation. Participants were
screened by completing a general medical/health questionnaire and
gave their written consent before being admitted into the study. The
protocol for this study was approved by the Ethics Committee for
Investigations involving human subjects of the Hannover Medical
School, Germany. Individuals taking medication, abusing drugs/
alcohol, or exhibiting endocrinological, psychological or sexual
dysfunction/disorders were excluded from the study. All partici-
pants reported that they had an exclusively heterosexual orientation
and a relaxed attitude toward pornography. Further, all subjects
were currently in a stable relationship and reported having sexual
intercourse approximately 2±3 times per week.
Design and procedure
A repeated measures design was used so each participant viewed a
videotape and masturbated to orgasm on two separate days. Two
dierent videos were shown in a crossover design for the two
sessions. The ®rst session took place at 1630 hours on day 0.
Immediately after that ®rst session (day 0±day 20), the participant
refrained from any type of sexual activity. At 16:30 on day 21 each
subject once again participated in the sexual arousal paradigm. The
procedure of sexual arousal and orgasm both before (day 0) and
after (day 21) were identical, with each session lasting 2 h.
Experiments were conducted in a separate sound-attenuated
room equipped with a clinical bed, a color television and a video
cassette player. All leads, including the blood line, passed through
the wall into the adjacent room where the cardiovascular data and
blood samples were collected, allowing the subject to be completely
isolated throughout the experiment. At the beginning of each
session participants were placed on the bed in front of the video
screen. The cardiovascular monitor was then engaged 30 min prior
to the ®lm and a steady baseline reading was obtained before the
cannula was inserted (20 min before the beginning of the ®lm).
The session was composed of three sequences, each lasting 20 min.
The ®rst and last sections of the video tape were composed of
sections of an emotionally neutral documentary ®lm. However, the
middle section consisted of a 20 min pornographic ®lm that
showed dierent couples engaged in foreplay and sexual inter-
course. Blood sampling was initiated at the beginning of the ®lm.
After 10 min of the pornographic video had been watched (antic-
ipatory phase), subjects in the experimental session were required
to masturbate until orgasm. Blood was drawn continuously with
the samples divided into six 10 min intervals [15±17, 24]. Speci®-
cally, the ®rst two samples represented basal values (10, 20 min),
the third sample represented the response to ®lm-induced sexual
arousal (30 min), the fourth demonstrated the response to orgasm
(40 min) and the ®nal two samples showed the recovery phase (50,
60 min).
Apparatus and materials
Subjective sexual arousal
To provide a measurement for sexual arousal, participants com-
pleted a visual analogue scale (VAS) by rating their subjective level
of sexual arousal from `not at all sexually aroused' to `extremely
sexually aroused' [15±17, 24]. Subjective sexual arousal was mea-
sured at three time points±before, during and after the session±for
both controlled and experimental conditions.
Additionally, subjective assessment of the quality of the
orgasm was completed using 5-point Likert scales. These scales
examined the duration, intensity and speed of orgasm in absolute
value and as compared to a typical orgasm. These questions were
administered following both the experimental and controlled
situations.
Cardiovascular measures
The cardiovascular parameters heart rate (HR) and systolic and
diastolic blood pressure (BP) were monitored continuously via a
®nger cu connected to a blood pressure monitor (Critikon Cu &
Dinamap Vital Data Monitor; Critikon Ltd, USA) that was
located in the adjoining room. Cardiovascular activity was
recorded by computer every 30 s, and the HR and BP values were
averaged over 10 min intervals and analysed simultaneously with
the blood samples taken in 10 min interval.
Endocrine measures
For blood sampling, an IV cannula (Vaso®x Braunu
Èle, 18G) was
connected to a 1.25 m heparinized silicon tube (inner B2.0 mm,
Reichelt Chemie, Heidelberg, Germany) by a plastic three-way
stop-cock (Cook, Mo
Ènchengladbach, Germany). The silicon tubing
passed through the wall into the adjacent room and was positioned
through a peristaltic pump (Fresenius, Homburg, Germany). Blood
¯ow was adjusted to 2 ml/min, so that approximately 10 mls of
blood per 5 min were collected (i.e. more than 150 mls per session).
Blood was collected in EDTA tubes (Sarstedt, Nu
Èmbrecht,
Germany), and the collection of each sample was delayed by the
time it took for blood to pass through the dead space in the tube.
Blood was stored on ice until the samples were centrifuged. Plasma
was stored in glass aliquots at )20 °C until it was time for the
hormone assays.
All samples from the one participant were analysed in duplicate
within the same assay for a particular hormone. Plasma prolactin
was evaluated by immunoradiometric assay (IBL, Hamburg,
Germany) and testosterone, LH, cortisol (Diagnostic System
Laboratories, Texas, USA) and catecholamines (IBL, Hamburg,
Germany) were assessed by radioimmunoassay. Inter and intra-
assay variability were 8.0% and 6.2%, respectively, for noradren-
aline; 5.1% and 4.0%, respectively, for adrenaline; 7.1% and 5.0%,
respectively, for prolactin; 7.9% and 5.2%, respectively, for
testosterone; 5.2% and 3.8%, respectively, for LH; and 4.3% and
2.8%, respectively, for cortisol.
Statistical analyses
Data from all subjects were analysed by 2-factor repeated measures
(condition x time) analyses of variance (ANOVA). If not stated
otherwise, only the condition x time interaction eect is reported.
An alevel of 0.05 was used for all ANOVAs. Post hoc simple eects
were evaluated by using paired samples t-tests with Bonferroni a
corrections made for multiple comparisons. Additionally, the
Wilcoxon test was completed for questionnaire data.
Results
Subjective sexual arousal
Participants rated themselves as being signi®cantly
sexually aroused during the erotic ®lm (F(2, 16) 189.51,
P< 0.001; time eect) and greater subjective arousal
378
was observed following abstinence (F(1,8) 9.21,
P0.016; condition eect, Fig. 1a). Moreover, partici-
pants reported a longer duration (before, 2.1  0.3;
after, 3.5 0.3; Z )2.34, P0.019) and greater
intensity (before, 2.5 0.2; after, 3.7 0.3; Z )2.28,
P0.023) of orgasm following abstinence as compared
to the controlled session, whilst abstinence did not alter
the subjective speed to orgasm (before, 3.1 0.2; after,
3.5  0.2; Z )0.71, P> 0.05). Similar results were
revealed when subjects compared the orgasmic charac-
teristics to those of a typical orgasm (duration: before,
1.8  0.2; after, 3.1  0.4; Z )2.26, P0.023;
intensity: before, 2.1 0.2; after, 3.0 0.3; Z )1.73,
P0.080; speed: before, 3.1  0.2, after, 3.8  0.3;
Z)1.35, P> 0.05).
Prolactin, LH and testosterone response
to sexual arousal
Sexual arousal (timepoint: 30 min) and orgasm
(timepoint: 40 min) increased plasma prolactin levels
markedly in participants (F(5, 45) 5.80, P< 0.001;
time eect, Fig. 1b). However, no signi®cant dierence
was observed in this response before and after acute
abstinence (P> 0.05).
Sexual arousal (timepoint: 30 min) and masturba-
tion-induced orgasm (timepoint: 40 min) did not aect
testosterone concentrations either before or after absti-
nence (P> 0.05). However, a signi®cant increase in
basal testosterone levels were observed following the
period of abstinence (F(5, 45) 6.72, P0.029; con-
dition eect, Fig. 1c). A signi®cant dierence between
the conditions was observed at the 20 min baseline pe-
riod, with this dierence remaining throughout the ses-
sion. Increased testosterone was further accompanied by
a small increase in plasma LH following abstinence;
however this change did not reach statistical signi®cance
(P> 0.05; data not shown).
Cardiovascular response to sexual arousal
Sexual arousal (timepoint: 30 min) and orgasm
(timepoint: 40 min) increased heart rate (F(5, 45)
=14.18, P< 0.001; time eect), systolic blood pressure
(F(5, 45) 16.35, P< 0.001; time eect) and diastolic
blood pressure in participants (F(5, 45) 18.11,
P< 0.001; time eect, Fig. 2). However, no signi®cant
dierence was observed in any of these responses before
and after acute abstinence (all P> 0.05).
Sympathoadrenal response to sexual arousal
Sexual arousal (timepoint: 30 min) and orgasm (time-
point: 40 min) increased both adrenaline (F(5,45)
=7.95, P< 0.001; time eect) and noradrenaline
(F(5,45) 10.90, P< 0.001; time eect) in participants
(Fig. 3). However, no signi®cant dierence was observed
in either of these responses before and after acute ab-
stinence (P> 0.05). Sexual arousal and masturbation-
induced orgasm did not aect cortisol concentrations
either before or after abstinence. However, re¯ecting
circadian rhythm, cortisol levels decreased consistently
over time during both sessions (F(5, 45) 4.66,
P0.02; time eect).
Fig. 1a±c Subjective sexual arousal before, during and after sexual
arousal; plasma prolactin (ng/ml) and testosterone (ng/ml) concen-
trations during baseline (10, 20 min), in response to ®lm-induced
sexual arousal (30 min), following orgasm (40 min), and recovery
after orgasm (50, 60 min). Each subject participated before sexual
abstinence (h) and following 3 weeks of abstinence (j)(Data
displayed as mean SE). Subjective sexual arousal was increased
by masturbation-induced orgasm (a). Furthermore, this response was
enhanced following sexual abstinence. Plasma prolactin concentra-
tions (b) were signi®cantly elevated by sexual arousal and orgasm
both before and after sexual abstinence. In contrast, plasma
testosterone concentrations (c) were unaected by sexual arousal
and orgasm both before and after sexual abstinence. However, plasma
testosterone was signi®cantly elevated after abstinence when com-
pared to basal values (Data displayed as mean SE)
379
Discussion
The current study demonstrated that 3 weeks of sexual
abstinence elevated basal testosterone concentrations
and increased both subjective sexual arousal and sub-
jective interpretation of the quality of the orgasm.
However, despite these subjective reports, acute absti-
nence did not alter the well-characterised cardiovascular
and endocrine responses to orgasm.
Sexual arousal and masturbation-induced orgasm
produced pronounced increases in sympathetic activity,
which were re¯ected by increased heart rate, blood
pressure and plasma catecholamine concentrations.
Furthermore, orgasm produced a pronounced increase in
plasma prolactin concentrations. These results mirrored
previous data obtained by studying masturbation in
both men and women [15, 24], which have been shown
to be orgasm speci®c [16].
We have suggested that prolactin secretion following
orgasm may act as a peripheral and/or central feedback
signal in controlling post-orgasm sexual arousal. This
position is supported by a wealth of data from studies of
animals and humans that demonstrate the marked
inhibitory eect that hyperprolactinemia has on sexual
arousal and behavior [11, 13, 30, 32, 35], as well as a
decrease in inhibition following the normalization of
circulating prolactin [13, 35].
Prolactin may also act as an acute negative controller
of sexual function by inhibiting the function of sexual
Fig. 2a±c Cardiovascular activity during baseline (10, 20 min), in
response to ®lm-induced sexual arousal (30 min), following orgasm
(40 min) and recovery after orgasm (50, 60 min). Each subject
participated before sexual abstinence (h) and following 3 weeks of
abstinence (j) (Data displayed as mean SE). Heart rate (beats/
min; a), systolic blood pressure (mm Hg; b) and diastolic blood
pressure (mm Hg; c) were signi®cantly elevated by sexual arousal
and orgasm before and after sexual abstinence
Fig. 3a±c Plasma adrenaline (pg/ml), noradrenaline (pg/ml), and
cortisol (ng/ml) concentrations during baseline (10, 20 min), in
response to ®lm-induced sexual arousal (30 min), following orgasm
(40 min), and recovery after orgasm (50, 60 min). Each subject
participated before sexual abstinence (h) and following 3 weeks of
abstinence (j) (Data displayed as mean SE). Adrenaline (a)
and noradrenaline (b) concentrations were signi®cantly elevated by
sexual arousal and orgasm both before and after sexual abstinence.
In contract, plasma cortisol concentrations (c) were unaected by
sexual arousal and orgasm both before and after sexual abstinence
380
organs. Although not extensively examined, some data
clearly demonstrate that acute increases in prolactin
inhibit erectile function by hindering the smooth muscle
relaxation of the corpus cavernosum [4]. Alternatively,
acute increases in prolactin may contribute to a sexual-
satiation mechanism following orgasm by means of
feedback to the central nervous system (CNS) structures
that control sexual arousal [10, 21, 29].
Should prolactin act as a negative regulator of sexual
arousal, increased prolactin secretion may be expected
to accompany increased sexual arousal produced by
abstinence. However, the current data show that acute
abstinence does not alter the prolactin response to
masturbation-induced orgasm. Nevertheless, although it
is clear that the prolactin response is orgasm dependent,
the magnitude of the response may be independent of
the quality of the orgasm. Alternatively, the subjective
scores used presently may not provide an accurate
assessment of physiological quality of the orgasm. Thus,
future studies should incorporate a more complete
assessment of orgasm quality, by integrating a more
robust measurement of orgasmic characteristics (e.g.
exact timing of orgasm duration, erectile response).
In contrast to previous data using punctual blood
sampling [8, 34], sexual arousal in the current paradigm
induced elevations in plasma testosterone concentrations
that did not reach statistical signi®cance. However, basal
testosterone levels were elevated throughout the session
following abstinence when compared to values obtained
prior to abstinence. Enhanced testosterone may have
been a physiological response to re-initiate sexual
activity throughout the abstinence period, since
increasing testosterone concentrations have been shown
to stimulate the initiation of coital and other partnered
sexual activity [19, 20]. However, this appears unlikely
because baseline testosterone levels at the beginning of
the video sequence were similar before and after absti-
nence.
On the other hand, the increased testosterone
concentrations may have resulted from enhanced sensi-
tivity to anticipatory cues, since testosterone secretion
increases in anticipation of sexual interaction [18]. Thus,
the increase in testosterone following abstinence may
have resulted from increased anticipation of the erotic
®lm. Although initial basal testosterone values (10 min
timepoint) were not altered by abstinence, the dierence
between conditions that appeared after the start of the
session (20±60 min) support this position.
Such anticipatory or preparatory sex hormone re-
sponses are suggested by several other studies [3, 25, 31]
and seem to re¯ect more general appetitive responses in
the expectation of the potentially rewarding conse-
quences of sexual activity. As appetitive responses are
behaviors that represent a central motivational state for
contact with a goal object [2], increased testosterone
concentrations may represent an enhancement of the
aective properties of the goal object by sexual absti-
nence. Furthermore, a close interaction exists between
steroid hormones and the brain systems involved in
reward. Speci®cally, acute increases in testosterone have
possible neural rewarding qualities [2]; this eect is
potentially mediated by dopaminergic systems [14]. With
regard to our current results, one can speculate that
sexual abstinence has a twofold eect on this interaction
pattern: It may enhance the anticipated rewarding
properties of re-initiated sexual activity and it may lower
the threshold at which testosterone produces rewarding
eects. Both factors may interact to trigger the elevated
testosterone levels observed following abstinence.
The enhanced subjective qualities of sexual arousal
and orgasm intensity following sexual abstinence may
also be explained by increased testosterone concentra-
tions. Indeed, elevated levels of testosterone in men are
known to enhance nocturnal erections [12], probably by
acting on peripheral neurons that control copulatory
re¯exes [23]. Additionally, some evidence suggests that
testosterone stimulates the erectile response to experi-
mentally-induced sexual arousal; however, this position
remains equivocal [7]. Nevertheless, increased testoster-
one elevates feelings of sexual arousal and libido [1, 6],
and increases both orgasmic frequency [27] and coital
initiation [20]. Thus, our data suggest that testosterone
may have in¯uenced the subjective assessment of sexual
arousal either by directly modifying genital reactions, or
alternatively, by manipulating the CNS structures that
regulate sexual motivation and arousal.
Summarizing, the current study demonstrated that
masturbation-induced orgasm produces pronounced
elevated cardiovascular responses and plasma concen-
trations of catecholamines and prolactin. Although
these responses were unaltered by acute abstinence from
sexual activity, abstinence increased subjective sexual
arousal and the quality of the orgasm, as well as basal
testosterone concentrations. Thus, although acute
abstinence enhances subjective sexual arousal it has
little impact on the acute neuroendocrine response to
orgasm.
References
1. Anderson RA, Bancroft J, Wu FCW (1992) The eect of
exogenous testosterone on sexuality and mood of normal men.
J Clin Endocrinol Metab 75: 1503±1507
2. Alexander GM, Packard MG, Hines M (1994) Testosterone
has rewarding eective properties in male rats: implications for
the biological basis of sexual motivation. Behav Neurosci 108:
424±428
3. Anonymous (1970) Eects of sexual activity on beard growth
in man. Nature 226: 869±870
4. Aoki H Fujioka T Matsuzaka J Kubo T, Nakamura K,
Yasuda N (1995) Suppression by prolactin of the electrically
induced erectile response through its direct eect on the corpus
cavernosum penis in the dog. J Urol 154: 595±600
5. Auger J, Kunstmann JM, Czyglik F, Jounnet P (1995) Decline
in semen quality among fertile men in Paris during the past
20 years. N Eng J Med 332: 281±285
6. Bagatell CJ, Heiman JR, Rivier JE, Bremner WJ (1994) Eects
of endogenous testosterone and estradiol on sexual behavior in
normal young men. J Clin Endocrinol Metab 78: 711±716
7. Bancroft J, Wu FCW (1983) Changes in erectile responsiveness
during androgen replacement therapy. Arch Sex Behav 12: 59±66
381
8. Becker AJ, U
Èckert S, Stief CG, Truss MC, Machtens S,
Scheller F, Knapp WH, Hartmann U, Jonas U (2000)
Cavernous and systemic testosterone levels in dierent phases
of human penile erection. Urology 56: 125±129
9. Blackwell JM, and Zanefeld LJD (1992) Eect of anstinence on
sperm acrosin, hypoosmotic swelling, and other semen vari-
ables. Fertil Steril 58: 798±802
10. Bole-Feysot C, Gon V, Edery M, Binart N, Kelly PA (1998)
Prolactin (PRL) and its receptor: actions, signal transduction
pathways, and phenotypes observed in PRL receptor knockout
mice. Endocr Rev 19: 225±268
11. Cruz-Casallas PE, Nasello AG, Hucke EETS, Felicio LF
(1999) Dual modulation of male sexual behavior in rats by
central prolactin: relationship with in vivo striatal dopamin-
ergic activity. Psychoneuroendocrinology 24: 681±693
12. Davidson JM, Camargo CA, Smith E (1979) Eects of
androgen on sexual behavior in hypogonadal men. J Clin
Endocrinol Metab 48: 955±958
13. De Rosa M, Colao A, Di Sarno A, Ferone D, Landi ML,
Zarilli S, Paesano L, Merola B, Lombardi G (1998) Cabergo-
line treatment rapidly improves gonadal function in hyper-
prolactinemic males: a comparison with bromocriptine. Eur
J Endocrinol 138: 286±293
14. Everitt BJ (1990) Sexual motivation: a neural and behavioral
analysis of the mechanisms underlying appetitive and copula-
tory responses of male rats. Neurosci Biobehav Rev 14: 217±232
15. Exton MS, Bindert A, Kru
Èger T, Sceller F, Hartmann U,
Schedlowski M (1999) Cardiovascular and endocrine
alterations after masturbation-induced orgasm in women.
Psychosom Med 61: 280±289
16. Exton NG, Truong TC, Exton MS, Wingenfeld SA, Leygraf N,
Saller B, Hartmann U, Schedlowski M (2000) Neuroendocrine
response to ®lm-induced sexual arousal in men and women.
Psychoneuroendocrinology 25: 189±199
17. Exton MS, Kru
Èger THC, Koch M, Paulson E, Knapp W,
Hartmann U, Schedlowski M (2001) Coitus induced orgasm
stimulates prolactin secretion in healthy subjects. Psychoneu-
roendocrinology, 26: 187±194
18. Graham JM, Desjardins C (1980) Classical conditioning: In-
duction of luteinizing hormone and testosterone secretion in
anticipation of sexual activity. Science 210: 1039±1041
19. Halpern CT, Udry JR, and Suchindran C (1997) Testosterone
predicts initiation of coitus in adolescent females. Psychosom
Med 59: 161±171
20. Halpern CT, Udry JR, Suchindran C (1998) Monthly measures
of salivary testosterone predict sexual activity in adolescent
males. Arch Sex Behav 27: 445±464
21. Hull EM, Lorrain DS, Du J, Matuszewich L, Lumley LA,
Putnam SK, Moses J (1999) Hormone-neurotransmitter
interactions in the control of sexual behavior. Behav Brain Res
105: 105±116
22. Jouannet P, Czyglik F, David G, Mayaux MJ, Spira A,
Moscato ML, Schwartz D (1981) Study of a group of 484
fertile men. Part I: distribution of semen characteristics. Int
J Androl 4: 440±449
23. Keast JR (1999) The autonomic nerve supply of male sex
organs ± and important target of circulating androgens. Behav
Brain Res 105: 81±92
24. Kru
Èger T, Exton MS, Pawlak C, von zur Muhlan A, Hartmann
U, Schedlowski M (1998) Neuroendocrine and cardiovascular
response to sexual arousal and orgasm in men. Psychoneu-
roendocrinology 23: 401±411
25. LaFerla J, Anderson D, Schalch D (1978) Psychoendocrine
response to sexual arousal in human males. Psychosom Med
40: 166±172
26. Magnus O, Toolefsrud A, Abyholm T, Purvis K (1991) Eects
of varying the abstinence period in the same individuals on
sperm quality. Arch Androl 26: 199±203
27. Mantzoros CS, Georgiadis EI, Trichopoulos D (1995)
Contribution of dihydrotestosterone to male sexual behaviour.
BMJ 310: 1289±1291
28. Pellestor F, Girardet A, and Andreo B (1994) Eect of long
abstinence periods on human sperm quality. Int J Fertil
Menopausal Stud 39: 278±282
29. Rehman J, Christ G, Alyskewycz M, Kerr E, Melman A
(2000) Experimental hyperprolactinemia in a rat model: cen-
trally mediated neuroerectile mechanisms. Int J Impot Res 12:
23±32
30. Rosen RC, Lane RM, and Menza M (1999) Eects of SSRIs
on sexual function: a critical review. J Clin Psychopharmacol
19: 67±85
31. Rowland DL, Heiman JR, Gladue BA, Hatch JP, Doering CH,
Weiler SJ (1987) Endocrine, psychological and genital re-
sponse to sexual arousal in men. Psychoneuroendocrinology
12: 149±158
32. Sato F, Aoki H, Nakamura K, Taguchi M, Aoki T, Yasuda N
(1997) Suppressive eects of chronic hyperprolactinemia on
penile erection and yawning following administration of apor-
morphine to pituitary-transplanted rats. J Androl 18: 21±25
33. Sauer MV, Zeer KB, Buster JE, Sokol RZ (1988) Eect of
abstinence on sperm motility in normal men. Am J Obstet
Gynecol 158: 604±607
34. Stole
Âru SG, Ennaji A, Cournot A, Spira A (1993) LH pulsatile
secretion and testosterone blood levels are in¯uenced by sexual
arousal in human males. Psychoneuroendocrinology 18: 205±
218
35. Verhelst J, Abs R, Maiter D, van den Bruel A, Vandeweghe M,
Velkeniers B, Mockel J, Lamberigts G, Petrosiians P,
Coremans P, Mahler C, Stevenaert A, Verlooy J, Raftopolous
C, Beckers A (1999) Carbergoline in the treatment of hyperp-
rolactinemia: a study in 455 patients. J Clin Endocrinol Metab
84: 2518±2522
382
... This hemodynamic pattern can be attributed to neurovascular coupling and serves as an indicator of brain activity, implying that the prefrontal cortex is actively engaged during visual sexual stimulation (VSS) (33). Males have shown increased heart rate and systolic and diastolic blood pressure during orgasm induced by masturbation, reaching peak values during orgasm (12,34). During masturbation, a slow decrease in pulse amplitude (PA) was observed, whereas PA was elevated following an orgasm (35 Among men, there was a modest increase in LH concentration after orgasm and a large increase in FSH plasma levels during the orgasmic period (12). ...
... During masturbation, prolactin levels increase in both sexes, with male prolactin plasma levels peaking during orgasm and maintaining high levels (12,13,34,36). Nevertheless, plasma vasopressin concentrations did not change during orgasm in men (13). ...
... A drop in peak systolic blood ow velocity was detected distally in 12 out of 36 patients (33.3%), while an increase in blood ow was reported in 11 individuals (30.5%). Hemodynamic parameters inside the penile region may exhibit variability and may be in uenced by intrapenile arterial anatomical changes (34). VPA responses during masturbation increased (source could not be found). ...
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Background: Human sexual activity serves both reproductive and pleasurable purposes. Many individuals engage in solitary sexual practices that are often linked to pornography. The psychological and physiological aspects of sexual arousal and masturbation have been explored in the literature, revealing divergent findings, particularly regarding cardiovascular, endocrine, and neurological responses. This study sought to enhance our understanding of these responses in the context of sexual arousal and masturbation in humans. Methods: We conducted a systematic review of clinical trials, cohort, case-control, and cross-sectional studies, and excluded case reports, case series, short communications, conference papers, letters to editors, in vitro research, animal studies, and correspondence. We searched five medical databases (PubMed, Embase, PsycInfo, Web of Science, and Scopus) using specified keywords and extracted data on the baseline population, study details, gender proportions, sexual arousal/masturbation data, study objectives, findings, and endpoints. The analysis was performed using a sex-specific approach. Results: During pornography-induced sexual arousal, blood pressure and heart rate increased in both sexes, although the male heart rate varied. Female vaginal blood volume and male genital blood flow increase with elevated Vaginal Pulse Amplitude (VPA). LH levels increased in men, whereas FSH levels remained stable. Pornography increased FSH levels in men, while PRL concentrations decreased in women, but remained unchanged in men. Vasopressin levels remained unaffected in the men. Female sexual stimulation raises estradiol levels, and cortisol levels decrease only slightly in both sexes. Testosterone and adrenaline levels may also increase during pornography. In terms of brain activity, the right hemisphere shows increased activity in females, while right-handed males exhibit broad stimulation in various brain regions. Masturbation increases the heart rate and blood pressure of men, peaking during orgasm, whereas VPA significantly increases these parameters. Hormone responses varied during the masturbation. Prolactin levels peaked in males during orgasm, vasopressin remained unchanged, and cortisol levels did not change. The testosterone and adrenaline levels may also increase. Female masturbation affects testosterone and progesterone levels, and increases adrenaline levels. Oxytocin changes during male orgasm. Conclusion: Most studies have demonstrated a correlation between sexual arousal induced by pornography or masturbation, and the response levels of different physiological systems. However, our systematic literature search revealed inconsistencies in certain of the observed physiological changes. More experimental studies and analyses are needed to define precise responses during and after masturbation.
... In contrast to humans, where the hormonal profile associated with sexual activities such as masturbation, orgasm, coitus, and ejaculation has been well described, there is little to no high-profile research on the impact of manual semen collection on the hormonal profile in trained dogs. [1]. ...
... This could suggest that the stress response in dogs is associated with increased levels of both hormones. In addition to the role of PRL in the stimulation and maintenance of lactation, this hormone plays an important role in many other physiological processes and in some species, its release was found to accompany ejaculation [1,[6][7][8]. In humans, PRL seems to be responsible for the feedback control of sexual drive and rises after orgasm (both in masturbation and coitus conditions) [1,6,8]. ...
... In addition to the role of PRL in the stimulation and maintenance of lactation, this hormone plays an important role in many other physiological processes and in some species, its release was found to accompany ejaculation [1,[6][7][8]. In humans, PRL seems to be responsible for the feedback control of sexual drive and rises after orgasm (both in masturbation and coitus conditions) [1,6,8]. This hormone is also known as "parental hormone" [9], as it plays crucial role in both maternal and paternal behavior in both human and other mammals [10]. ...
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Sex pheromones are chemical substances secreted into the environment that affect the physiology and behavior of recipients. Females use these compounds during oestrus to attract males, which leads to attempts of mating. This study evaluates the influence of manual semen collection in male dogs, in the presence or absence of a female in estrus, on the blood concentrations of cortisol (CRT), oxytocin (OXT), prolactin (PRL) and testosterone (T), as hormones involved both in the physiology of reproduction and stress. Ten male dogs were used in Experiment 1 to measure the serum and plasma concentrations of the aforementioned hormones in the absence of semen collection. Subsequently in the same animals, the concentrations of these hormones were evaluated before and after semen collection in the presence (Exp. 2) or in absence of a female in estrus (Exp. 3). No significant changes in hormone concentration caused by the semen collection were found, either with, or without the presence of female in estrus. Obtained results suggest that the procedure of manual semen collection in dogs, probably due to its passive character, does not stimulate endocrine glands to secrete hormones, and the process of ejaculation is probably controlled by neural pathway. The lack of effect of semiochemical stimulation to the CRT, PRL, OXT and T level, could be caused by a short contact with female during semen collection. Further studies on involvement of the hormones during the process of natural mating, especially preceded by long courtships, similar to that observed under natural conditions, should shed a light on the physiology of mating and the connection between the endocrine system and semiochemical stimulation in dogs.
... Such claims are largely based on two small studies. The first study, by Exton et al., concluded that men achieved higher testosterone levels during and after sexual arousal in addition to more intense orgasms after a 3-week period of abstinence [20]. However, the study has been criticized for its sample size of only 10 men and the likelihood that the increase in testosterone can be attributed to the anticipation of masturbation and orgasm. ...
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Purposefully reducing the frequency of ejaculation, coined “semen retention”, and the similar practice of “NoFap”, have been popularized on social media. They are frequently accompanied by unsubstantiated claims of health benefits. Their increasing popularity has led to the emergence of online courses claiming to teach these techniques. The goal was to characterize the landscape of courses offering ejaculatory training. A systematic Google search was performed using terms related to ejaculation training to identify training programs. Information regarding instructor credentialing, type and duration of courses, costs, and claims of medical benefits were extracted. Eleven ejaculation training courses were identified with 10 instructors (two courses named the same coach). Costs varied from $5 to $147 per week or a $20 to $199 one-time payment. None of the course instructors claimed standardized credentials in the fields of medicine or mental health. Seven instructors (70%) solely cited their own personal experience as their qualifying credentials. Courses claimed to improve erectile dysfunction, premature ejaculation, porn addiction, sexual performance anxiety, testosterone levels, and/or depression. Ejaculation training programs are costly, readily available online, and provided by instructors with no medical background. Despite no scientific evidence, these courses claim to improve various aspects of men’s health and can be potentially damaging financially, physically, and mentally to participants.
... Physiologic studies have shown increases in sex steroids, cortisol, and endogenous cannabinoids with masturbation (Purvis et al. 1976;Fuss et al. 2017;Isenmann et al. 2021), while abstinence from masturbation increases testosterone in men (Exton et al. 2001). Post-orgasmic prolactin, which may be a neurohormonal index of sexual satiety, increases ∼5× more following intercourse compared with masturbation (Brody and Krüger 2006). ...
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Masturbation is common and generally accepted in Western society as a normal, healthy activity. In contrast, the Catholic Church holds that masturbation is immoral. Noting that the human person is a profound unity of body and spirit, if the Church is correct, masturbation should have negative effects on the human person. If the secular view is correct, masturbation should have conversely positive effects. This paper is divided into three parts. An in-depth literature survey was performed to evaluate the physical, medical, psychological, sociological and spiritual correlates of masturbation. The second part is a theological summary of the Catholic understanding of masturbation. The third part is an approach to therapy. Physically masturbation was found to be less sexually satisfying than intercourse. Medical complications include penile injury and self-asphyxial behavior. Psychologically masturbation was found to be associated with depression, anxiety, immature defenses, hypersexuality, guilt, poor body self-image and stress in the workplace. Sociologically most studies indicate a negative correlation between masturbation and relationship satisfaction, quality, intimacy, relational happiness, emotional satisfaction with the partner, trust, passion, and love. Spiritually masturbation is highly positively correlated with pornography consumption and negatively with religion and religiosity. There is a higher rate of masturbation in homosexuals and bisexuals than in heterosexuals. Theologically, masturbation and pornography directly violate the religious virtue of chastity, undermining one's prayer life and the motivation to develop a spiritual life. Therapeutically, positive psychology, which emphasizes cultivating what it identifies as virtues, including justice, courage, temperance, wisdom (similar to prudence), transcendence (similar to hope) and humanity (similar to charity), can be used to counsel individuals struggling with masturbation. Once the harms are understood, a person can be counseled that this temptation represents a challenge, an opportunity to build self-control, and with self-control the capacity to develop character strengths and major virtues.
... (23) Sexual function is affected not only by testosterone, but also by prolactin, cortisol, progesterone, etc., which are hormones that also affect sexual function. (21)(22)(23) However, many studies have not found a signi cant correlation between testosterone and penis size. (13,24) Perhaps that is why men who have frequent or daily sex do not have huge penises. ...
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Background Behavioral habits and parental rearing during physical and sexual growth of men can influence to their penis size. Aim To assess the erect penis size in adult Kazakh males and study the influence of their physiological events and behavioral habits during their body growth on their penis size. Methods A cross-sectional survey pilot study with the intention-to-treat. The study included 282 adult Kazakh fertility males aged 23-35 years. Interventions: paper-based survey administration; erect penis length and girth measurement. Two-tailed Student’s t-test, Pearson correlation, and multivariate tests of the MANOVA/MANCOVA were used. The Ethics Committee of the National Research oncology center approved the study. Outcomes In Kazakh men a mean age 29.6±4.4 years; body height 171.56±6.64 cm; BMI 24.53±3.40 kg/m²; erect penis length 13.41±1.04 cm and girth 11.62±0.91 cm. Results There was a significant correlation between erect penis length and girth (P<0.0001). The frequency of erection in 54.7% males was 5-6 times a day. The frequency of masturbation or coitus with ejaculation in 42.2% males was two times per month. 40.9% males abstained to masturbation or coitus in one of two cases. The frequency of nocturnal sperm emission was in 39.1% males one time per month. Frequencies of erection, masturbation/coitus, abstinence to masturbation/coitus, and nocturnal emission have a statistically significant effect (P<0.01) on both erect penis length and girth in Kazakh males in their body growth. Conclusions Sexual abstinence to coitus and masturbation during childhood has a positive increasing affect on the penis size in adulthood. The more males in childhood abstains from ejaculation, the larger their penis size in adulthood. A long-lasting extended erection during body growth has a positive effect on penis enlargement.
... Only two small studies have been cited in support of the practice of semen retention. Exton et al. (N = 10) found that men achieved significantly higher basal testosterone levels during and after sexual arousal in addition to more intense orgasms after a 3-week period of abstinence, whereas Jiang et al. (N = 28) found that men who abstained for 1 week had increased testosterone levels by 145.7% from their baseline but then had significantly declining testosterone levels starting day 8 of abstinence [17,18]. Both studies were limited by small sample size and methodological concerns (ex. the impact of anticipatory cues). ...
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Social media (SoMe) offers great potential to expand access to health information, but a significant proportion of users consume its content instead of consulting a physician. We sought to quantify the volume and characterize the accuracy of men’s health-related content on TikTok and Instagram. We searched TikTok and Instagram for the terms: testosterone, erectile dysfunction, male infertility, semen retention, Peyronie’s disease, and vasectomy. The top 10 hashtags for each term were used to estimate the total impressions for each term on each platform, and posts were then characterized by creator type, content type, and accuracy (1 to 5 scale). TikTok had 2,312,407,100 impressions and Instagram had 3,107,300 posts across all topics. Semen retention had the most impressions on TikTok (1,216,074,000) and posts on Instagram (1,077,000). Physicians created only a small portion of total TikTok and Instagram posts (10.3% and 12.9%, respectively). Across all topics, the accuracy of content was poor (2.6 ± 1.7), however, physician posts were more accurate than non-physician posts (mean 4.2 ± 1.2 vs 2.3 ± 1.6, p < 0.001, respectively). Men’s health content is popular on TikTok and Instagram but is not accurate. We recommend that physicians actively engage in SoMe to address misinformation.
... In their study, they found that after 3 weeks of abstinence from men, the tes-tosterone levels of these men were significantly increased, and then the subjects were allowed to ejaculate through masturbation. After ejaculation, they found that the subjects' testosterone levels had Therefore, the study concluded that testosterone levels in patients with different marital status are different, and testosterone is also released in large quantities during sexual intercourse [7,8], and married men are usually more regular than unmarried men. Therefore, married men have better prostate cancer outcomes than unmarried men. ...
Article
Objective: To study the effect of different marital status on the prognosis of patients with prostate cancer. Methods: The general data of 169,533 patients with prostate cancer confirmed by biopsy or surgery in SEER database were retrospectively analyzed. The COX univariate analysis was performed first, and the meaningful variables of the univariate analysis were incorporated into the Cox proportional hazards model for multivariate analysis, and the independent factors affecting the prognosis of patients with prostate cancer were obtained. Results: The collected patients accounted for 59% of married patients and 22% of unmarried patients. COX multivariate analysis, the results showed: age (HR: 1.063; P<0.001), tumor differentiation grade (HR: 1.367; P<0.001), marital status: married (HR: 0.648; P<0.001), unmarried (HR: 0.602; P<0.001), bone metastasis (HR: 6.077; P<0.001), brain metastasis (HR: 2.296; P<0.001), liver metastasis (HR: 2.582; P<0.001), lung metastasis (HR: 1.256; P<0.001), distant lymph node metastasis (HR: 1.698; P<0.001), T stage (HR: 1.047; P>0.005), N stage (HR: 0.970; P>0.005), M stage (HR: 0.880; P>0.005) were all factors affecting the prognosis of patients with prostate cancer. The average survival time of married patients was 16.05±10.32 months, and the average survival time of unmarried patients was 15.46±10.37 months. The average survival time of married patients was longer than that of unmarried patients (X2=1173.133; P<0.001), and the difference was statistically significant. Conclusion: Based on big data analysis, marital status has a great influence on postoperative prostate cancer patients, and the survival time of married prostate cancer patients is longer than that of unmarried patients.
Article
This study aimed to determine whether male stress is related to seminal stress biomarkers and pregnancy achievement in women exposed to their partner’s seminal plasma (SP) in the intracytoplasmic sperm injection (ICSI) cycle. In this pilot prospective study, 20 couples undergoing ICSI, as well as 5 fertile sperm donors and 10 saliva donors, were investigated. Women were exposed to their partner’s SP via unprotected sexual intercourse during the ICSI cycle and intravaginal application on the day of ovum pick-up (Day-OPU). Semen samples were collected from male partners by masturbation on the Day-OPU. Saliva and serum samples were collected prior to masturbation. Body fluids were frozen at − 80 °C until assayed. Biomarkers of activity of the sympathetic adrenomedullary axis (salivary alpha-amylase and adrenaline), sympathetic neural axis (noradrenaline and dopamine), hypothalamic–pituitary–adrenal (HPA) system (cortisol), and immune system (C-reactive protein and interleukin (IL)-18) were estimated to examine their association with SP composition and clinical pregnancy achievement. The clinical pregnancy rate was 45.0%. In the unsuccessful ICSI group, blunted levels of salivary and serum cortisol were found compared to the successful ICSI group and the fertile sperm donors. With regard to seminal markers, decreased cortisol level and elevated noradrenaline, noradrenaline/cortisol ratio, and lL-18 levels were strongly associated with ICSI failure (areas under the ROC curves were, 0.813, 0.848, 0.899, and 0.828, respectively). These findings confirm that stress response systems activity affects SP composition, which in turn is associated with ICSI outcomes in women exposed to their partner’s SP during an ICSI cycle.
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La respuesta sexual se encuentra mediada por factores anatomo-hormono-neuro-vasculoendoteliales. Ha sido explicada a través de varios modelos como el tetrafásico (Masters y Johnson, 1966), el trifásico (Kaplan, 1979), y el pentafásico (Bancroft, 1983), entre otros. El orgasmo se ubica como una de estas fases en estos modelos. Éste se define como un conjunto de sensaciones corporales sumamente placenteras y de excitación intensa, que libera tensiones y que produce satisfacción. Existen pocas diferencias entre el orgasmo del varón y de la hembra; desde un punto de vista funcional, el orgasmo del varón está estrechamente relacionado con la eyaculación, mientras que en la hembra no existe una conexión tan obvia y directa. En este estudio se recopilaron las semejanzas y diferencias presentes en el orgasmo del varón y de la hembra, referidas a los fundamentos anatómicos, fisiológicos, neuroendocrinos, neurológicos, psicológicos, socioculturales y espirituales.
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This study evaluated the effects of chronic treatment with cabergoline (CAB), a new, potent and long-lasting ergoline-derived dopamine agonist, on seminal fluid parameters and sexual and gonadal function in hyperprolactinemic males in comparison with the effect of bromocriptine (BRC) treatment. Seventeen males with macroprolactinoma were treated with CAB at a dose of 0.5-1.5 mg/week (n = 7), or BRC at a dose of 5-15 mg/day (n = 10) for 6 months. Baseline prolactin (PRL) was 925.7 +/- 522.6 microg/l in the CAB-treated group and 1059.4 +/- 297.6 microg/l in the BRC-treated group. All the patients suffered from libido impairment, ten from reduced sexual potency, and six had infertility. In five patients provocative bilateral galactorrhea was found. Seminal fluid analysis, functional seminal tests and penis rigidity and tumescence, measured by nocturnal penile tumescence (NPT) using Rigiscan equipment, were assessed before and after 1, 3 and 6 months of CAB or BRC treatment. Hormone profiles were assessed before and after 15, 30, 60, 90 and 180 days of both treatments. Before treatment, all patients had a low sperm count with oligoasthenospermia, reduced motility and rapid progression with an abnormal morphology and decreased viability, and a low number of erections. After 1 month, serum PRL levels were significantly reduced in both groups of patients (20.6 +/- 6.6 microg/l during CAB and 256.3 +/- 115.1 microg/l during BRC treatment) and were normalized after 6 months in all patients (CAB: 7.9 +/- 2.2 microg/l; BRC: 16.7 +/- 1.8 microg/l). After 6 months, a significant increase of number, total motility, rapid progression and normal morphology was recorded in patients treated with both CAB and BRC. An increase in the number of erections during the first 3 months of both treatments was noted by NPT. However, the improvements in seminal fluid parameters and sexual function were more evident and rapid in patients treated with CAB. The number of erections was normalized after 6 months of treatment in all patients submitted to CAB treatment, and in all patients but one treated by BRC. In addition, a significant increase of serum testosterone (from 3.7 +/- 0.3 to 5.3 +/- 0.2 microg/l) and dihydrotestosterone (from 0.4 +/- 0.1 to 1.1 +/- 0.1 nmol/l) was recorded. At the beginning of treatment, mild side-effects were recorded in two patients after CAB and mild-to-moderate side-effects in five patients after BRC administration. The treatment with CAB normalized PRL levels, improving gonadal and sexual function and fertility in males with prolactinoma, earlier than did BRC treatment, providing good tolerability and excellent patient compliance to medical treatment.
Article
Sexual problems are highly prevalent in both men and women and are affected by, among other factors, mood state, interpersonal functioning, and psychotropic medications.The incidence of antidepressant-induced sexual dysfunction is difficult to estimate because of the potentially confounding effects of the illness itself, social and interpersonal comorbidities, medication effects, and design and assessment problems in most studies. Estimates of sexual dysfunction vary from a small percentage to more than 80%. This article reviews current evidence regarding sexual side effects of selective serotonin reuptake inhibitors (SSRIs). Among the sexual side effects most commonly associated with SSRIs are delayed ejaculation and absent or delayed orgasm. Sexual desire (libido) and arousal difficulties are also frequently reported, although the specific association of these disorders to SSRI use has not been consistently shown. The effects of SSRIs on sexual functioning seem strongly dose-related and may vary among the group according to serotonin and dopamine reuptake mechanisms, induction of prolactin release, anticholinergic effects, inhibition of nitric oxide synthetase, and propensity for accumulation over time. A variety of strategies have been reported in the management of SSRI-induced sexual dysfunction, including waiting for tolerance to develop, dosage reduction, drug holidays, substitution of another antidepressant drug, and various augmentation strategies with 5-hydroxytryptamine-2 (5-HT2), 5-HT3, and [small alpha, Greek]2 adrenergic receptor antagonists, 5-HT1A and dopamine receptor agonists, and phosphodiesterase (PDE5) enzyme inhibitors. Sexual side effects of SSRIs should not be viewed as entirely negative; some studies have shown improved control of premature ejaculation in men. The impacts of sexual side effects of SSRIs on treatment compliance and on patients' quality of life are important clinical considerations. (J Clin Psychopharmacol 1999;19:67-85)
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DURING the past two years I have had to spend periods of several weeks on a remote island in comparative isolation. In these conditions I noticed that my beard growth diminished, but the day before I was due to leave the island it increased again, to reach unusually high rates during the first day or two on the mainland. Intrigued by these initial observations, I have carried out a more detailed study and have come to the conclusion that the stimulus for increased beard growth is related to the resumption of sexual activity.
Article
Erections in response to erotic films and fantasies were measured in eight hypogonadal men, with and without androgen replacement, and eight age-matched controls. Erections to films in the hypogonadal men did not differ from those of the controls and were not affected by androgen replacement. Erections to fantasy were significantly smaller and slower to develop in the hypogonadal men and did show significant improvement during androgen replacement. These preliminary results suggest that erections to certain types of stimuli are relatively independent of androgens, whereas the response to fantasy may be androgen dependent. The implications of these findings are discussed.
Article
The psychoneuroendocrine responses to sexual arousal have not been clearly established in humans. However, we have demonstrated previously that masturbation-induced orgasm stimulates cardiovascular activity and induces increases in catecholamines and prolactin in blood of both males and females. We presently investigated the role of orgasm in producing these effects. Therefore, in this study parallel analysis of prolactin, adrenaline, noradrenaline, and cortisol concentrations, together with cardiovascular variables of systolic/diastolic blood pressure and heart rate were undertaken during film-induced sexual arousal in nine healthy adult men and nine healthy adult women. Blood was drawn continuously via an indwelling cannula and connected tubing system passed through a mini-pump. In parallel, the cardiovascular parameters were recorded continuously via a computerised finger-cuff sensor. Subjective sexual arousal increased significantly in both men and women during the erotic film, with sexual arousal eliciting an increase in blood pressure in both males and females, and plasma noradrenaline in females only. In contrast, adrenaline, cortisol and prolactin levels were unaffected by sexual arousal. These data further consolidate the role of sympathetic activation in sexual arousal processes. Furthermore, they demonstrate that increases in plasma prolactin during sexual stimulation are orgasm-dependent, suggesting that prolactin may regulate a negative-feedback sexual-satiation mechanism.
Article
Data regarding the neuroendocrine response pattern to sexual arousal and orgasm in man are inconsistent. In this study, ten healthy male volunteers were continuously monitored for their cardiovascular and neuroendocrine response to sexual arousal and orgasm. Blood was continuously drawn before, during and after masturbation-induced orgasm and analyzed for plasma concentrations of adrenaline, noradrenaline, cortisol, luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, growth hormone (GH), β-endorphin and testosterone. Orgasm induced transient increases in heart rate, blood pressure and noradrenaline plasma levels. Prolactin plasma levels increased during orgasm and remained elevated 30 min after orgasm. In contrast, none of the other endocrine variables were significantly affected by sexual arousal and orgasm. © 1998 Elsevier Science Ltd. All rights reserved.
Article
The stimuli from a receptive female and/or copulation itself leads to the release of dopamine (DA) in at least three integrative hubs. The nigrostriatal system promotes somatomotor activity; the mesolimbic system subserves numerous types of motivation; and the medial preoptic area (MPOA) focuses the motivation onto specifically sexual targets, increases copulatory rate and efficiency, and coordinates genital reflexes. The previous (but not necessarily concurrent) presence of testosterone is permissive for DA release in the MPOA, both during basal conditions and in response to a female. One means by which testosterone may increase DA release is by upregulating nitric oxide synthase, which produces nitric oxide, which in turn increases DA release. Hormonal priming in females may also increase DA release in the MPOA, and copulatory activity may further increase DA levels in females. One of the intracellular effects of stimulation of DA D1 receptors in the MPOA of male rats may be increased expression of the immediate-early gene c-fos, which may mediate longer term responses to copulation. Furthermore, increased sexual experience led to increased immunoreactivity to Fos, the protein product of c-fos, following copulation to one ejaculation. Another intracellular mediator of DA’s effects, particularly in castrates, may be the phosphorylation of steroid receptors. Finally, while DA is facilitative to copulation, 5-HT is generally inhibitory. 5-HT is released in the LHA, but not in the MPOA, at the time of ejaculation. Increasing 5-HT in the LHA by microinjection of a selective serotonin reuptake inhibitor (SSRI) increased the latency to begin copulating and also the latency to the first ejaculation, measured from the time the male first intromitted. These data may at least partially explain the decrease in libido and the anorgasmia of people taking SSRI antidepressants. One means by which LHA 5-HT decreases sexual motivation (i.e. increases the latency to begin copulating) may be by decreasing DA release in the NAcc, a major terminal of the mesolimbic system. Thus, reciprocal changes in DA and 5-HT release in different areas of the brain may promote copulation and sexual satiety, respectively.
Article
Previous data have indicated that orgasm produces marked alterations in plasma prolactin concentrations in men and women. Thus, the current study aimed to extend these data by examining prolactin response to coitus in healthy males and females. Ten pairs of healthy heterosexual couples participated in the study. Blood was drawn continuously for 20 min before, during, and until 60 min following sexual intercourse and orgasm. Plasma was subsequently analysed for prolactin concentrations. Coitus-induced orgasm produced a marked elevation of plasma prolactin in both males and females. Plasma prolactin concentrations remained elevated 1 h following orgasm. These data, together with previous evidence that masturbation-induced orgasm produces pronounced, long-lasting increases in plasma prolactin concentrations in both males and females, suggest a role for acute prolactin alterations in modifying human sexual desire following orgasm.
Article
Despite the widespread use of androgen in the treatment of hypogonadal men, its efficacy in restoring sexual behavior to hypogonadal patients has not been established in appropriately controlled behavioral studies. Accordingly, testosterone enanthate or vehicle was injected once every 4 weeks im in a double blind experiment. The subjects were six adult males, aged 32-65 yr, two with gonadal failure and four with secondary hypogonadism. Two doses of testosterone (100 and 400 mg) were administered for approximately 5 months, with the treatments varied at random within and among subjects. Details of sexual activity and experience were followed by the use of daily logs. Frequencies of erections, including nocturnal erections and coitus, showed significant dose-related responses to androgen treatment which closely followed the fluctuations in the circulating testosterone level. As indicated by the Profile of Mood States test, behavioral responses did not appear to be mediated by changes in mood. We concluded that the stimulatory effects of testosterone on sexual activity are rapid, reliable, and not due to a placebo effect. To maintain plasma testosterone and adequate sexual function within normal levels, even high doses of testosterone enanthate should be given no less frequency than once every 3 weeks.
Article
The hypothesis is tested that luteinizing hormone (LH) and follicle stimulating hormone (FSH( may be released from the anterior pituitary in response to a psychological state of sexual arousal. LH levels in 10 male volunteers were found to be higher after viewing a sexually arousing film than after a control film. The magnitude of LH response was found to be positively correlated with the subjective evaluation of sexual arousal. FSH levels tended in the same direction bu the predominant and unexpected finding for this hormone was that levels were consistently lower during the first session, when anxiety was high, and higher during the second session, when anxiety was less, whether control or stimulus film had been shown. This study is analogous to those demonstrating the responsiveness of other anterior pituitary hormones to specific psychological states.