Codeine. An Unusual Cause of Ejaculatory Failure

Codeine. An Unusual Cause of Ejaculatory Failure.
Dr Andrew Rynne.

Delayed ejaculation or so-called anorgasmia is a common male sexual dysfunction. In order of frequency it comes third to erectile dysfunction and premature ejaculation. It can be a deeply frustrating and devastating problem for which there are many causes. Drugs, both illicit and prescribed are common culprits. Common among the latter are all antidepressants and all antipsychotics. Not so well known however is Codeine. This over the counter addictive medicine is a major cause of ejaculatory incompetence. Yet very few people seem to realise it.

Just because it’s easy to get – usually without a prescription, this does not mean that codeine is just another Headache Medicine like paracetamol or aspirin.  Far from it!  Codeine is classified as an opioid. In other words its effects are not on the peripheral nervous system but on the brain chemistry itself. Any drug that has the potential to interfere with brain chemistry also has the capacity to bring about some serious sexual dysfunction and other problems..

Think of it this way: Messages are constantly been sent around your central nervous system via chemical known as neurotransmitters. This sophisticated communications system relays feelings of pleasure from your penis up to your brain. When your brain has had sufficient of this it relays a message to your ejaculatory ducts to ejaculate or reach orgasm.
But like all sophisticated systems it is easy to upset it.

Any drug that has a central brain action and the capacity to alter brain chemistry can also cause major disruption to messages to and from the brain. This in turn brings about a numbing of feelings from penis to brain such that the brain is insufficiently stimulated to respond with a message to ejaculate. When this happens there is but one solution – discontinue taking the offending medicine.
Indeed there are many other good reasons to discontinue taking codeine on regular bases.  It is addictive. It causes a strain on your liver. And now as we have seen, it can cause major disruption to healthy sexual functioning. I have found in practise that it is sometimes very difficult to sell this idea of discontinuing codeine. Like nicotine and all addictive substances, codeine infuses in its victims a built-in resistance to the notion of quitting.

And yet quitting is not difficult if taken in easy bite-sized stages. By reducing the dose by 1/10 th per week over ten weeks most people succeed in quitting very easily. And just look at the advantages! Release from the tyranny of having to take a drug every day is one. Reduction of chronic liver damage is another. And now as we have just seen, return of normal healthy sexual functioning is perhaps greatest of all.

More information available at: www.doctorrynne.com

Dhat Syndrome or Loss of Semen Disease

Dhat  Syndrome --- Loss of Semen Disease.
A Uniquely Indian Neurosis.

Dr Andrew Rynne.

Being is the business of Sexual Medicine, particularly Internet Sexual Medicine, I had long been aware of a syndrome unique to India and her sub-continent. And while being aware of it and my own obvious inability to do anything about it, I did not know that this culture bound malady actually had a name and was well described in the medical literature. One learns something new every day.
Dhat Syndrome is a sexual neurosis unique to India, Pakistan, Sri Lanka, Nepal and areas where the Hindu culture prevails or used to prevail. Some ancient teachings in that noble culture portray semen as a vital life giving force, as essential to life as blood itself.  Variants of Dhat Syndrome do occur further east and in the orient, though here its prevalence is less obtrusive. In parts of India the prevalence of this very debilitating neurotic disorder may be as high as 30% which is very high indeed. This figure however needs further analysis.
The following symptoms would be classical for Dhat Syndrome:
(1) A morbid preoccupation with the loss of semen. This loss, or perceived loss, may arise from the imagined passage of semen in the urine. The loss of semen through spontaneous nocturnal emissions. And of course, perceived the most damaging of them all -- the loss of semen through masturbation.
(2) Sexual dysfunction or perceived dysfunction – erectile dysfunction and premature ejaculation.
(3) Unhappiness about the size or the shape of his penis. A conviction that his penis is shrinking.
(4) Fatigue, lassitude, tiredness, weakness, anxiety, depression and classically guilt about masturbation.
(5) Worry about future potency, fertility and an ability to father children.
(6) A preoccupation with pre-ejaculation discharge.
(7) An attitude of helplessness and dependency.



The overall incidence of Dhat Syndrome in India is between 10 and 30% which, as stated earlier, makes it almost endemic. This figure of course depends on how the researcher defines the condition. To reach that higher incidence of the disease, I suspect the statistician would need to utilise a very broad definition of Dhat Syndrome to include all young men with more than a passing concern about semen loss. 
Then, although the literature does not say much about this, there are varying degrees or grades of Dhat Syndrome. Indeed it could well be the subject of a future Doctorate Degree in Medicine. This sexual neurosis could be graded from one to five in classic fashion. At one end of the spectrum are young men overly preoccupied with the ‘damage’ they are doing to themselves through masturbation. These men may be otherwise unscathed.
At the other end of this spectrum is Grade 5 severe Dhat Syndrome where the unfortunate sufferer is moribund and institutionalised within his neurosis, constantly preoccupied with thought of sexual negativity brought about by his own past behaviour.  The literature, such as it is indeed, tends to lump Dhat Syndrome in with anxiety or, more usually, with depressive illness. To this writer it actually sounds more like an Obsessive Compulsive Disorder. In any case treatment, in severe cases, can be quite a challenge.
While this is not an area in which I can claim any expertise --  beyond trying to help these men and usually failing miserably, it does nonetheless occur to me that Dhat Syndrome may be a preventable disease. If, as seems to be the case, its geneses lies in the deeply embedded and erroneous notion that semen is sacrosanct to life and health, then surely it’s prevention equally lies in the purging of such misinformation at an early age. I would love to hear your thoughts on this. It is a very important subject if only because literally millions of lives are adversely affected by it every day. 

Doctor Rynne  www.doctorrynne.com