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In 1952, when my twin brother John and I first emerged into the world by cesarean section, our exhausted mother took one glance at our minuscule nether regions and cried out bittersweetly: “It’s a…boys!”
Manhood, on a philosophical level, transcends mere flesh, inhabiting instead the mind and soul. But the mind and soul are not where new parents look for the leading indicator of their baby’s fate. With the debatable exception of wisdom teeth, most body parts are important, but very few are definingly so. The penis, testicles, epididymis, and prostate—”male reproductive organs” to the high-minded, “privates” to the polite, and endless trendy variations on “package” or “junk” to our buddies—these items are the embodiment of maleness.
I can’t speak for John, but as far back as I remember I’ve been fascinated with, and more than occasionally appalled by, my own urogenital organs. On the “uro” side of this elegant system, I’ve managed to live unremarkably so farno kidney stones or urethral blockages, no incontinence or bladder cancer.
The genital side has proved a different story. Basted with an ever-shifting stew of hormones, linked to heart and brain by interconnected loops of blood and spark, it’s hard to imagine a more potent driver of male vitality and despair. At times convinced I was the one giving the orders, at other times knowing full well I was the dummy of a barely-6-inch ventriloquist, I’ve followed the rise and fall of my manhood for decades.
But as quixotic and misguided as my male impulses have sometimes proved, I know I’d be nothing without them. I owe the best parts of my life—my ambitions, my family, my capacity for love—to the unceasing inspiration of these drives.
Flush with our weekly 35-cent allowances, John and I combed the magazine racks for the latest Marvel comics. Spying nothing new, we began grazing through the regular magazines, i.e., those intended for readers older than 8, which is the age we were at the time. I checked out a Time and a Sports Illustrated. John perfunctorily glanced through a US News & World Reportbefore opening something called Rogue.
Almost immediately he called me over, chortling lowly. “Look at this,” he said, pointing to a page labeled “pictorial.”
It documented, in black-and-white photographs, a blonde lady who for some reason had decided to enter an Irish pub wearing nothing but her freckles. The camera hovered close on her heels as she sashayed about, ordering a beer, interacting with fully clothed male customers and laughing at their jokes. Her golden hair apparently added to the amusement by ever so lightly tickling her “callipygian” buttocks, whatever that word meant.
John and I exchanged glances and immediately started laughing, too. Truth is, neither of us liked girls. In fact, we actively disliked them. Not that this 20something pubgoer was a girl, exactly. Still, whatever she was, we quickly discovered how hard it can be to take your eyes off something you don’t see every day or, for that matter, ever.
That night from our twin beds, John and I recapped the day’s events before falling asleep. We briefly dissected the Pirates doubleheader and the plot of Sea Hunt. At some point in the discussion I remembered an odd quirk I’d meant to mention before.
“I got a feely at the newsstand today,” I said, using the term we’d coined to refer to that peculiar penile stiffening-and-tingling sensation.
“Me too!” exclaimed John. “And I didn’t even have to go!”
Both of us understood, of course, that a guy’s “privates” had only one function: urination. Waking up in the morning with a feely made perfect sense: It’s simply nature’s way of telling you your bladder’s full. Other feely triggers—like climbing a rope in gym class, for example—remained to be sussed out by our young scientific minds.
And now this. How the woman in the pictorial might trigger the feely phenomenon was even more baffling. We bandied theories in some detail before concluding that her link to a feely had most likely been some kind of fluke.
Though erections fueled by erotic stimulation may be the most memorable kind, the vast majority that men sprout in their lifetimes have little, if any, direct connection to sex. Studies in the Journal of Ultrasound in Medicine, for instance, show that erections actually predate birth itself—with male fetuses as young as 16 weeks sporting telltale in-utero protuberances that ebb and flow spontaneously throughout the remainder of gestation.
With our transition to the outside world, these alternating cycles of tumescence and flaccidity continue, though we remain largely oblivious to them. The reason: They happen when we’re sound asleep, by way of a process called NPT, or “nocturnal penile tumescence”–otherwise known as sleep erections.
Thanks to the secret life of the sleeping penis, even the most monastic male becomes aroused for half an hour or longer during each of the four to six REM (rapid eye movement) stages we experience every night. These erections, especially in adolescence, are occasionally associated with nocturnal emissions. But research in sleep labs has shown that the vast majority of them don’t seem to be linked to sexual feelings at all.
Researchers have long puzzled over the reason healthy men spend up to 12 percent of their lives with unconscious, asexual erections. Some have proposed that sleep erections are merely the collateral effect of another quirk of the REM stage—sleep paralysis. During dream sleep, the sympathetic nervous system, which regulates our fight-or-flight responses, shuts down, temporarily preventing the contraction of our skeletal muscles. This well-documented phenomenon keeps us from acting out our dream, saving us from trying to fly out of a window, for instance.
Erections, on the other hand, are controlled by the parasympathetic nervous system. This system regulates our “rest and digest” responses through its actions on smooth muscles from the gut to blood-vessel walls. In a healthy penis, parasympathetic nerves release nitric oxide, which relaxes the smooth muscles lining the penile arteries. This allows extra blood to flow in and engorge two spongy, parallel chambers called corpora cavernosa (literally, “cavelike bodies”). In the process, the veins that normally drain blood out of these sacs are squeezed down. Presto: Blood enters and is effectively trapped, putting the magic into your wand.
These two nervous systems work in a coordinated, if opposite, fashion. While one serves as an accelerator, the other acts as a brake, and vice versa. As one doctor friend explained it, this is why you can’t get an erection when there’s a gun to your head. Conversely, erections may sprout spontaneously, when your capacity for fight or flight is shut down by REM sleep.
That might explain part of the puzzle, but other researchers are convinced that nighttime erections are so dramatic and lifelong—affecting males from the womb to the nursing home—that they must be more than an accident of our physiology.
“My theory is that the flaccid penis is in a precarious state of oxygen delivery, and erections serve as a way of more or less recharging the battery,” says Irwin Goldstein, M.D., the director of sexual medicine at San Diego’s Alvarado Hospital and editor-in-chief of the Journal of Sexual Medicine. To study this possibility, Dr. Goldstein and his colleagues took samples of penile smooth muscle and subjected them to varying levels of oxygen. The results: During the low-oxygenation levels associated with flaccidity, smooth muscle begins to break down and convert to scar tissue. But at the higher oxygen levels seen during erections, the body naturally produces enzymes that undo the damage.
“The penis is in an interesting balance,” says Dr. Goldstein, “where it forms scar tissue and then digests it at the same rate later in the day.”
If Dr. Goldstein’s theory is correct, it may help drug researchers find novel ways to counter and possibly help reverse some forms of erectile dysfunction. For now, it’s consoling to know that the body in its wisdom is keeping us in shape while we sleep. There’s also one immediate application of this information.
“When I give lectures on this topic,” says Dr. Goldstein with a laugh, “I tell the men they have a new excuse to have sex. Go home and tell your partner, ‘Honey, it’s time to oxygenate!'”
Enter, a Girl
I was trying, for the second time in 4 minutes, to lose my virginity by the technical definition of the term. In order to do this, my brain feverishly calculated equations from linear algebra class. While most guys thought about batting averages, it was far more effective for me to concentrate on pitiless abstractions from a class I was failing, imperiling all of my future prospects.
Beneath me, her green eyes lidded and full lips slightly parted, lay a gorgeous 19-year-old Finnish expatriate named Lena. As an infant, Lena had won the Most Beautiful Baby pageant in her native Finland. As a young woman, she’d become a high-cheek-boned reincarnation of Kim Novak in Vertigo. I myself was vertiginous now with lust and shame. Minutes ago, as she’d unzipped my jeans, I had instantly reached the point of no return—what sexologists call “ejaculatory inevitability.”
Lena only smiled and kissed me, knowing what I did not yet realize: Soon enough, we’d try again.
The “refractory period,” a.k.a. recharge time, varies greatly from man to man, depending on everything from age to level of excitement. All I know is that for me, at age 18, in this circumstance, 2 minutes proved to be more than enough time for me to steel my resolve once more. It was, if anything, too much rest.
On the second try, at least I managed to achieve insertion. But even with arcane math running riot in my head, I lasted less than a minute before a second climax. It was, nevertheless, the most enjoyable 47 seconds of my life to that date.
Afterward we slipped into sleep. I awoke with another erection an hour later, and used this to nudge her awake as well. She didn’t mind. Lasting a full 7 minutes, my sexual endurance—in my opinion, at least—now bordered on the epic. Again we fell asleep and again we woke for another round. More sleep, more sex, more sleep, more sex, over and over again, until I coined a term for this state: slex.
By early morning I could finally look at Lena without fear of losing control. I could also listen, touch, smell, taste her—appreciate in every way her many sensual beauties.
With lust satiated by slex, rationality began ebbing like a tide. Over breakfast I asked her a question that hadn’t occurred to me in the heat of the night.
“So what kind of birth control did you say you use?”
She regarded me curiously.
“I never said I used birth control.”
I’d assumed she knew what she was doing, that she had to be more experienced than I was. Technically, this was true: Before me, she explained, she’d had sex only one other time in her life.
“And nothing bad happened then, right?” I asked.
“No, no,” she said with that ever-so-cute accent. “Nothing bad. But I did get pregnant.”
As one hoary chestnut holds, men reach their sexual peak in youth and women not until middle age. The problem for horny young men, of course, is that fatherhood typically demands more than just successful insemination. Humans are not salmon, after all, where the male’s “care” starts and ends with the spilling of milt. Unlike fish fry, our newborns are helplessly dependent on their parents–and for significantly longer than any other species on earth.
“So why do ‘men’ become capable of producing babies when they’re 12 or 13 years old,” asks evolutionary biologist Richard Alexander, Ph.D., of the University of Michigan, “a decade before they can reasonably hope to obtain and keep a mate, let alone be good fathers? And why is early male sexuality correlated with very rapid ejaculatory time? These two things taken together suggest what has been called ‘sneaky copulation’.”
In societies that have allowed polygamy, says Alexander, older, powerful men have traditionally taken practically all the women for themselves. In such a scenario, the reproductive success of younger men likely depended upon a furtive “you’re quick or you’re dead” approach. In his pioneering surveys, sex researcher Alfred Kinsey, Ph.D., found that up to 75 percent of men reach orgasm within 2 minutes of initiating sex—which was called “premature ejaculation.” But rather than being a sexual disorder, the condition may actually be an evolutionary adaptation promoting what one biologist has dubbed the “survival of the fastest.”
Eventually, some of these fast young survivors would age to the point where they, too, became powerful enough to start monopolizing the women. Our most successful male ancestors apparently reproduced using both strategies—furtive cuckoldings early on, followed by faithful pair bondings later in life—bondings sometimes coerced but no doubt sometimes strengthened, as well, by the aphrodisiac of power and resources.
Our history of competitive copulation is also reflected in the actual length, thickness, and shape of the penis. As a 2004 study in Evolutionary Psychology suggests, the human penis evolved not just as a device for depositing sperm but also as a means for suctioning out the sperm of a recent rival. This phenomenon, known as semen displacement, is well documented in many species that have evolved penile barbs, hooks, combs, and other adaptations for removing sperm left by another male.
MRIs taken during intercourse show that the human penis swells up and expands the vaginal walls, with the head frequently bumping up against a woman’s cervix at maximum thrusting. Unlike other primates, men also sport an oversized glans, or penile head, which features a pronounced coronal ridge. This combination of characteristics led SUNY at Albany researchers to test a variety of artificial phallus models during simulated sex. Their discovery: The size and shape of a man’s penis during sex is uniquely suited to scoop out the semen of others.
Women’s privates have almost certainly evolved to exhibit their own clandestine adaptations, from selective orgasm with attractive and successful men to hormone-driven changes in cervical mucus in order to block certain sperm. In many other mammals, from rabbits to pigs, females have also evolved specialized sperm reservoirs for long-term storage. Women, it now appears, provide a similar haven in their fallopian tubes, where sperm can be maintained in a fertile state for up to 5 days.
It’s not yet known for certain whether such traits evolved in part as a way for women to counter men’s strategies to control their reproduction. But just as with the continual one-upping technologies of the old Spy vs. Spy comic, it’s hard to believe that one gender will ever gain a complete advantage over the other.
The nurse removed the cuff from my arm, conceded that my blood pressure was “a little elevated,” and then added, “The doctor will be in shortly with your biopsy results.”
As tense as I felt at that moment, it was a wonder blood had not begun oozing from my pores. I took a deep breath and mentally recited my latest calming mantra: Herpes is not a fatal disease…. Herpes is not a fatal disease…
It had been 3 weeks since I discovered the lesion, a reddish bump centered on the glans of my penis. This was not my first STD scare. Over the decades, I’ve found numerous anomalies in my nether regions, from a spongy, golf ball-size lump slightly above and to the right of my scrotum to a hard circle of fibrous tissue that suddenly appeared one morning like an O-ring paralleling the coronal ridge. Mercifully, my layman’s diagnoses for these conditions—groin cancer and subcutaneous shaft syphilis, respectively—turned out to be wrong, in part because no such diseases exist.
A veterinarian on my swim team eventually diagnosed the golf ball as an inguinal hernia, adding, “I see the same thing in poodles.” It took a regular doctor to explain the O-ring—a classic case of sclerosing lymphangitis. Men who come in with this, I was told, are uniformly terrified because it’s such a sudden and dramatic change. The good news: It’s completely benign and usually goes away on its own in a few weeks, barring further “athletic” sex.
As vexatious as all these urological travails had proved, none of them evoked sheer terror like this red penile lesion. At the time, I viewed herpes as a form of sexual leprosy. If my own self-diagnosis was confirmed, I was convinced that I’d be branded with a scarlet H for life. No woman in her right mind would ever want to touch me again.
I was in the midst of such thoughts when the urologist entered the room, studying my file. “Tests were negative,” he said without preamble. “You definitely don’t have herpes.”
I held my breath, waiting for the other shoe to drop. If not herpes, I had little doubt, it must be something even worse.
“I don’t really know what that thing is,” the doctor told me.
“If I had to guess, I’d say a mosquito bite.”
With the exception of HIV, which is an equal-opportunity infection, anatomy makes men decidedly better disseminators than victims of most sexually transmitted infections. “Gonorrhea, chlamydia, the strains of HPV that cause cervical cancer—these all pose very serious dangers to women, but by and large are not all that dangerous to men’s health,” says H. Hunter Handsfield, M.D., a professor of medicine at the University of Washington and a nationally renowned researcher on STDs.
In pre-antibiotic days, for instance, records suggest that most men infected with gonorrhea healed in 6 to 12 weeks without any treatment. True, there was discharge from the penis early in the infection, and this could be quite painful. But only in a minority of the cases did the infection scar the urethra to the point of impeding urine flow, or ascend to the epididymis and/or testes, triggering severe pain and impaired fertility. In the exceedingly rare case that bacteria managed to leak into the bloodstream, an acute form of arthritis could result. In a few infected men, the microbes caused fatal damage to their heart valves.
Contrast this with gonorrhea in women. Once introduced into the cervix, the infection typically spreads from the lower genital tract into the uterus and fallopian tubes, environments that are ideal for the bacteria’s proliferation. This is called pelvic inflammatory disease, or PID, which may cause symptoms that include pain and fever. Uncontrolled infections often trigger pelvic abscesses that could, in turn, lead to peritonitis and death.
The difference in consequences to men and women could not be more stark. You’re not likely to hear this on public-service ads, Dr. Handsfield acknowledges, “but the real significance when a penis is dripping with discharge is not the threat to the guy’s health but the fact that it’s a conduit of bad things happening to his partner.”
This may seem unfair, but it’s a matter of anatomy. During vaginal intercourse, a man’s penis is inside the woman for an average of 3 to 13 minutes. His ejaculate–along with any infectious agents it becomes contaminated with—remains inside her for days.
“But it’s not just this difference in time exposure,” says Dr. Handsfield. In men, most of the penis is protected by a barrier of 50 layers of dead skin cells before you reach living tissue susceptible to infection. Women lack such bark. The lining of the vagina and cervix is a single cell layer thick. In men, the only vulnerable tissue is the lining of the urethra, which is accessible by a small opening, and underneath the foreskin in uncircumcised men.
Even men in the latter population still have much less vulnerable surface area than women have. According to research published in the British Medical Journal, the net result of these anatomical differences is that STD transmission rates from penis to vagina are at least twice as high as they are in the other direction. And once infected, as indicated above, women are much more likely to suffer consequences.
So why should men even care about STDs?
“Though the odds are not zero,” says Dr. Handsfield, “the truth is that for many STDs, most guys would ‘get away with it,’ so to speak. The reason men should care is really a sense of altruism for their female partners.”
My depression began after I lost my job, and then, in quick order, the woman I’d hoped to marry. She found my replacement in less than a week. Not that it mattered at this point: Between my mood and medication, alcohol and insomnia, I’d lost all interest in sex. It felt like a blessing.
I was working on a pitcher at a local bar when I spied the agent of my salvation. She had the bluest eyes I’d ever seen, and they were set wide apart in a way that can make women look both beautiful and heartbreakingly kind. She wore a gray business suit tailored to her athletic figure. When she caught me ogling, she came over.
“Hi,” she said, extending her hand. “My name is Kyra.”
I introduced myself, shaking her hand limply. “So,” I said, now sure that I knew the score, “what’s the name of your organization?” Only once before had such a beautiful stranger approached me. That girl turned out to be a missionary for a religious cult.
Kyra, thank God, was no missionary. She worked in marketing for a grain company in Des Moines. She was in town for a conference and was flying back to Iowa the next day. I got her a glass and ordered another pitcher. We ended up talking for the next 2 hours.
At 1 a.m., Kyra looked at her watch and said she had to head back to her hotel. “Could you walk me over?” she asked.
When we arrived, she hesitated on the threshold. “Do you want to sleep here tonight?” she asked. “But just sleep?”
“Yes,” I said, relieved by the second condition.
She brushed her teeth, then donned a flannel nightgown. I thought about keeping my clothes on, but peeled down to my briefs and climbed into bed beside her. We talked some more, and she kissed me. My first reaction was panic. Her body was beautiful, alive with health–such a contrast to my emaciated bag of bones.
“I’m sorry,” I said, choking on my words. “It’s just that I…”
She shushed me gently.
“It’s okay,” she said. “Just hold me.”
And so I did. The image of a worry stone soon came to mind—a strange comparison, I suppose, for flesh and blood. But in her soft, curved contours, an undeniable peace settled on me. My racing thoughts slowed down, letting months of underlying exhaustion reveal itself in a drowsiness that bordered on pleasure.
After a while, another hint of pleasure emerged, too: the faintest tingling in a long dead zone. Like a match struck in a blizzard, it wasn’t much. But it was there.
For the first time in months, I slept until morning.
It all starts and ends, of course, with the biggest sex organ you have: your brain. Any compelling sexual stimulus, from the sight of a nymph in a tight summer dress to the feel of her toes playing footsie underneath the banquet table, instigates a riot of neurons within the thalamus. From there, a lit fuse of nerves fires quickly down the spinal cord, exits through nerve roots in our lower vertebrae, then speeds in a flash to the penis itself. It is here where nitric oxide is released, triggering the blood engorgement necessary for healthy erections.
If erections are conceived in the brain and born in the penis, orgasms move in the opposite direction. Tactile stimulation of the erect penis and surrounding area causes sensory nerves to fire signals back up to the spinal cord and onward to the brain.
As more and more nervous stimulation courses up from the genitals to the thalamus, it triggers a gradual buildup of the neurotransmitter dopamine, which slowly accrues like combustible gas from a leaking pipe. When enough fuel has accumulated, the thalamus explodes in a kind of seizure that sends a shock wave through the rest of the brain.
Part of this wave fires off new nerve signals to the pelvis. These coordinate contractions in the pelvic-floor muscles, prostate, seminal vesicles, and epididymis, in the process propelling sperm and semen through the urethra and ejaculating it from the penis.
At the same time, another part of the shock wave hits. “When it reaches the regions that perceive pleasure,” says Dr. Goldstein, “that’s what triggers the orgasmic response.”
The vast majority of times, ejaculation and orgasm occur so simultaneously that most men believe they are the same thing. Not true: Depending on problems in nerve conduction and chemical transmission, a man can have an orgasm without ejaculation as well as ejaculation without an orgasm. Or, alas, neither one.
Because our brains are an inseparable part of an intricate system that makes procreation possible and pleasurable, anything that tinkers with brain chemistry—from mood to medication—can have an impact on erection, ejaculation, and orgasm.
For example, as noted earlier, fight-or-flight compounds prime us to take action, not get some. “Fear triggers our nerves into producing a chemical called norepinephrine, which stops an erection immediately,” says Ken Goldberg, M.D., of the Male Health Institute. Only when stress levels abate, allowing calming chemicals like acetylcholine to take over, can smooth muscles relax enough to permit erections. Being “in the mood,” in other words, is not just an expression—it’s an essential part of our physiology.
For reasons not fully understood, men with chronic mood disorders like clinical depression frequently suffer from erectile dysfunction (ED). A first-line treatment for depression–antidepressant drugs that target the feel-good neurotransmitter, serotonin—has helped many men lift their moods, but at further cost to their manhood. Side effects of these selective serotonin reuptake inhibitors, or SSRIs, range from ED and decreased libido to delayed ejaculation and anorgasmia.
“Sexual side effects are very common with SSRI antidepressants,”says psychiatrist Anna Lembke, M.D., a senior researcher at Stanford University. “In men whose depression is well controlled by the drugs, sexual side effects is the number one reason they go off the medication.”
It’s a depressing choice: your sex life, or your will to live.
Fortunately, there’s a promising alternative: Wellbutrin, an effective antidepressant that works on dopamine, not serotonin. Says Dr. Lembke, “I have never encountered sexual dysfunction in patients who are on Wellbutrin. On the contrary, there have been anecdotal reports that it’s sometimes pro-sexual. The patients are often very pleased.” Case in point: An article in the New York Times reported that one woman claimed to have experienced a spontaneous 2-hour orgasm after switching to the med.
Now that’s an antidepressant.
A New Member
The thermometer doesn’t lie: A sudden rise in the basal body temperature of my lovely 35-year-old wife, Debbie, signaled that she was ovulating. At 102.6°F, my own basal temperature had risen even higher—from flu, alas, not passion. Not that viral load mattered: It was go time.
After 8 months of increasingly robotic attempts, we’d supplanted the joy of sex with a relentless pressure to procreate. At this point, we were nearing a diagnosis of infertility–1 year of regular intercourse that does not result in pregnancy.
It was Debbie’s idea to try a video to add a little novelty and verve. After checking to make sure our son was fast asleep, she popped the tape into the VCR, and the two of us cuddled up on the couch.
It took 10 minutes of frenetic activity by a Victorian lothario and a succession of “novelty stimulus” chambermaids before Debbie concluded, “This movie’s pretty stupid.”
“Yes,” I agreed, trying to hide how stimulating I was actually finding chambermaid No. 4. “Really stupid.”
In my fluish mind, I was thinking: Thank God the remote control is out of reach.
It was No. 6 that pushed me over the edge. Thanks to her randy abandon, my epididymis emptied completely.
Two weeks later—a reasonably close approximation of my refractory period at this point—Debbie and I visited a fertility specialist. To my astonishment, my sperm count, under laboratory conditions, tested out at 300 million per cc, for a total of 965,000,000 per ejaculation. Their average motility was also good, and the healthy-to-gimp ratio of live sperms was well within normal limits.
The thought that I might, at least theoretically, reproduce China was scant consolation. My fertility only placed more of the burden on Debbie, who I knew felt bad enough already. Our doctor said he would set up some tests for her, but that he couldn’t schedule these for another month. “Keep on trying till then,” he told us.
We didn’t need to.
Our second child was born just shy of Christmas. At the moment of delivery, we both knew where to look. “It’s a boy!” the doctor said, confirming what our own eyes had already told us.
I can only hope he’ll derive as much pleasure and purpose from his manhood as I have from mine.
Source: Men’s Health