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
Showing posts with label premature ejaculation. Show all posts
Showing posts with label premature ejaculation. Show all posts
Sunday, August 21, 2011
Thursday, June 30, 2011
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
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
Thursday, April 14, 2011
When is Male Masturbation Harmful
When is Male Masturbation Harmful?
The Traumatic Masturbatory Syndrome.
Woody Allen is accredited with saying about sexual self-pleasuring: “Don’t knock masturbation – its sex with someone I love”. While George Carlin remarked: “If God intended us not to masturbate, He would have made our arms shorter!” Even so, for a sexual practise, often learnedly referred as “universal”, male masturbation still has the power to engender a huge amount of guilt and even foreboding around the globe. A day scarcely goes by but that I do not have some young man seeking reassurance that his pornography watching and self pleasuring are not going to impart some irreparable damage to his potential sexual function.
Young men in particular, despite all they would have surely read about and learned in today’s information saturated world, still seem extraordinarily willing to accredit masturbation with almost mystical powers to cause anything from erectile dysfunction to premature ejaculation even to, most feared of all, infertility itself. In my enthusiasm to expunge these often irrational fears it used to be my habit to universally dismiss all concerns about masturbation. Nowadays however, my reassurances about the safety of all masturbation, is not quite so total. Now I realise that there is at least one exception to the rule that all male masturbatory practises are innocence and safe and of no real consequence.
I refer to the practise of prone or face down masturbation where a pillow or cushion or mattress, are used to basically hump against. This is a minority practise. Kinsey, studying this subject as far back as 1948, discovered that the majority of men masturbate in the sitting up position using their hand to stroke their penis up and down. When asked, only about 12% of Kinsey’s volunteers said that they masturbated in anyway other than in the sitting up position as their majority practise. In fact when this figure is further finessed the real figure is closer to 5 to 10%. Prone masturbation as an exclusive practise is therefore rare.
This is probably just as well. It is only in the last decade or less that the dangers of developing what is today we call the Traumatic Masturbatory Syndrome is known to be directly related to the practise of using prone masturbation as an exclusive or near exclusive masturbatory technique. This syndrome often only comes to light as the boy grows into man and starts to engage in couple sexual activity. It is manifested occasionally by erectile dysfunction but more typically by delayed or absence of ejaculation from intercourse alone or a condition sometimes referred to as ejaculatory incompetence.
The reason why prone or face down masturbatory practises give rise to these unique dysfunction may be multifaceted but are probably as follows. Young men who practise prone masturbation tend to start doing so at a younger age that do those who practise sitting up masturbation. They also tend to do it more often. In the face down position the young practitioner does no ever rely on pornography simply because to do so in that position would be impracticable. Instead, he looses himself inside of his own head and relies on the physical pleasure experienced from friction of whatever it is that’s underneath him to bring him to orgasm. These circumstances do not prevail during sitting up masturbation or intercourse and therefore failure to climax is to be almost expected in later live when couple sex becomes a feature of his life.
There are perhaps a number of points to be taken from this recent research into the Traumatic Masturbatory Syndrome. and they are:
(1) When a man complains about ejaculatory incompetence it is now a wise practise to enquire into his ejaculatory practise history. The chances are that this will include predominately or near predominately prone masturbation.
(2) This information arms the therapist with a scientific explanation for this sexual dysfunction and a road map for its resolution.
(3) In advising young men about the normality of masturbation, a caveat needs to be attached to this to the effect that the position in which a man predominately masturbates is important and has at least potential implications for future sexual function. Where this is predominately practised in the prone position then the man needs to be advised that such a practise is neither safe nor sensible.
Dr Andrew Rynne.
Thursday, February 10, 2011
Excessive Pre-ejaculation Discharge or Too Much Precum.
Excessive Pre-ejaculation Discharge or Too Much Precum.
It is very difficult to come up with good solid scientific information on this subject. In the many articles and journals that I have been perusing, Excessive Pre-ejaculate is invariably described as a “rare” condition. Yet from my perspective, as an Online Sexual Medicine Consultant, there is nothing at all rare about Excessive Pre-ejaculate. In fact, hardly a week goes by that I do not fine myself helping some other young man come to terms with this common problem.
Some small amounts of pre-ejaculation secretion are common to most young men during the early phase of sexual arousal. It is a clear, sticky mucous liquid produced by Cowper’s glands along the urethra. The function of this normal secretion is to create a friendly environment for the passage of sperm and to facilitate intercourse. Amounts can vary from a few minuscule drops to as much as 5ml and more.
The problem though is this: Who defines what is “excessive” pre-ejaculate or pre-ejaculation discharge? At the moment it is the customer who decides this question. Hence we have a situation where one young man may perceive his 3ml of pre-ejaculate as a “problem” while another young man, with the exact same volume of discharge, may perceive it as a joy! Is it any wonder then that this subject makes such a sparse appearance in the medical literature!
From my work as an Internet Medical Consultant I have noticed enormous geographical and cultural variations in the reported incidence of “problems” of too much Pre-ejaculate or Pre-cum to use the vernacular. From this remove, it is difficult to say if the difference is in the reality of “too much Pre-cum” or in the acceptability of what is an equal distribution of a common phenomena. That be as it may, Asia would appear to be in a league of its own when it comes to “excessive Pre-cum.” In this department anyway, young Asian men would appear to have an unassailable lead.
This is not to say that this complaint should not be taken seriously. If it is upsetting the young man in question sufficiently for him to take the trouble to write to me seeking my advise, then of course it needs to be taken seriously. In the absence of a better solution I normally advise as follows:
(1) Try, if at all possible, to look on this “excessive Pre-cum” as normal, healthy and pleasurable – not as something dirty or shameful.
(2) Understand that as you get older, within the next very few years in fact, amounts of Pre-ejaculate are likely to decline quite dramatically.
(3) Absorbent towels are all that are usually required.
(4) There is a medical treatment if all normal reassurance fails. But there is a strong element of using “a sledgehammer to crack a nut” about this approach to management.
It is very difficult to come up with good solid scientific information on this subject. In the many articles and journals that I have been perusing, Excessive Pre-ejaculate is invariably described as a “rare” condition. Yet from my perspective, as an Online Sexual Medicine Consultant, there is nothing at all rare about Excessive Pre-ejaculate. In fact, hardly a week goes by that I do not fine myself helping some other young man come to terms with this common problem.
Some small amounts of pre-ejaculation secretion are common to most young men during the early phase of sexual arousal. It is a clear, sticky mucous liquid produced by Cowper’s glands along the urethra. The function of this normal secretion is to create a friendly environment for the passage of sperm and to facilitate intercourse. Amounts can vary from a few minuscule drops to as much as 5ml and more.
The problem though is this: Who defines what is “excessive” pre-ejaculate or pre-ejaculation discharge? At the moment it is the customer who decides this question. Hence we have a situation where one young man may perceive his 3ml of pre-ejaculate as a “problem” while another young man, with the exact same volume of discharge, may perceive it as a joy! Is it any wonder then that this subject makes such a sparse appearance in the medical literature!
From my work as an Internet Medical Consultant I have noticed enormous geographical and cultural variations in the reported incidence of “problems” of too much Pre-ejaculate or Pre-cum to use the vernacular. From this remove, it is difficult to say if the difference is in the reality of “too much Pre-cum” or in the acceptability of what is an equal distribution of a common phenomena. That be as it may, Asia would appear to be in a league of its own when it comes to “excessive Pre-cum.” In this department anyway, young Asian men would appear to have an unassailable lead.
This is not to say that this complaint should not be taken seriously. If it is upsetting the young man in question sufficiently for him to take the trouble to write to me seeking my advise, then of course it needs to be taken seriously. In the absence of a better solution I normally advise as follows:
(1) Try, if at all possible, to look on this “excessive Pre-cum” as normal, healthy and pleasurable – not as something dirty or shameful.
(2) Understand that as you get older, within the next very few years in fact, amounts of Pre-ejaculate are likely to decline quite dramatically.
(3) Absorbent towels are all that are usually required.
(4) There is a medical treatment if all normal reassurance fails. But there is a strong element of using “a sledgehammer to crack a nut” about this approach to management.
For more information about causes and treatment for men who have problems with too much pre-cum or excessive pre sex ejaculation please do visit my website at http://www.doctorrynne.com
Treatment for Retrograde Ejaculation
Retrograde Ejaculation or ejaculating backwards or Dry Ejaculation may be defined as the persistent inability to ejaculate forwards through the penis as is normal and to instead ejaculate backwards and into the urinary bladder.
Normally, just at the point of ejaculating, the muscular valve at the base on the bladder automatically snaps closed preventing the semen from moving backwards into the bladder and propelling it forwards instead. When there is retrograde ejaculation this mechanism fails to function properly allowing the ejaculate to take the line of least resistance and move backwards into the bladder.
Causes of Retrograde Ejaculation: Anything that interferes with the closing of the valve at the bladder neck at the point of ejaculation will cause Retrograde Ejaculation. In the main there may be surgical or medical factors at play in this situation.
Surgery to the prostate gland and its nerve supply such as TURP, prostatectomy or bladder surgery, may cause retrograde ejaculation.
Medical conditions like diabetes, multiple sclerosis or spinal cord injury can interfere with the nerve supply to the bladder neck and cause Retrograde Ejaculation or Dry Climax.
Certain medications used to treat high blood pressure or benign prostate hypertrophy can cause this condition as indeed can certain anti-depressants like those in the MAOI and SSRI group of antidepressants.
Retrograde Ejaculation does not of itself cause too much of a problem. Ejaculation can usually be felt as pleasurable and the semen can later be flushed from the bladder during normal urination with ease. Where retrograde ejaculation can cause considerably difficulty is in the area of fertility and reproduction. Today however, by using trans-rectal electro-stimulation of the prostate grand, healthy sperm can be retrieved for later use in AI and ICSI procedures.
Normally, just at the point of ejaculating, the muscular valve at the base on the bladder automatically snaps closed preventing the semen from moving backwards into the bladder and propelling it forwards instead. When there is retrograde ejaculation this mechanism fails to function properly allowing the ejaculate to take the line of least resistance and move backwards into the bladder.
Causes of Retrograde Ejaculation: Anything that interferes with the closing of the valve at the bladder neck at the point of ejaculation will cause Retrograde Ejaculation. In the main there may be surgical or medical factors at play in this situation.
Surgery to the prostate gland and its nerve supply such as TURP, prostatectomy or bladder surgery, may cause retrograde ejaculation.
Medical conditions like diabetes, multiple sclerosis or spinal cord injury can interfere with the nerve supply to the bladder neck and cause Retrograde Ejaculation or Dry Climax.
Certain medications used to treat high blood pressure or benign prostate hypertrophy can cause this condition as indeed can certain anti-depressants like those in the MAOI and SSRI group of antidepressants.
Retrograde Ejaculation does not of itself cause too much of a problem. Ejaculation can usually be felt as pleasurable and the semen can later be flushed from the bladder during normal urination with ease. Where retrograde ejaculation can cause considerably difficulty is in the area of fertility and reproduction. Today however, by using trans-rectal electro-stimulation of the prostate grand, healthy sperm can be retrieved for later use in AI and ICSI procedures.
For more information about how I can help you treat Retrograde Ejaculation please go to my website at: http://www.doctorrynne.com.
Tuesday, February 8, 2011
Curing Performance Anxiety
Performance Anxiety in the bedroom is a common and powerful blocker of enjoyment and can actually destroy an otherwise good relationship. Here I want to address Performance Anxiety (PA) as it effects men, or in other words PA as a leading cause of Erectile Dysfunction. Women too of course, can be effected where PA gives rise to a condition known as vaginismus. But I will talk about that another day.
PA as a leading cause of erectile dysfunction or impotence can literally happen overnight. All it takes for PA to give rise to a lifetime of erectile dysfunction is just one single mishap. It could have been too much to drink, or maybe just a throwaway comment about your size or preparedness for intercourse, or perhaps it was a new relationship that you were worried about, the smallest thing can give rise to a single "failure" leaving a man wondering about his potency forever thereafter.
Do you see, for an erection to develop there must be no distractions whatsoever. What is required is pleasure, desire, arousal and excitement. With these emotions running high the blood supply to the penis increased and the man has an erection. It's like magic. Questions in the mind like is it hard enough, is it long enough, will I put it in now - any little niggling doubts at all will kill off the magic and erection process stone dead in the water.
And, another thing to remember. It is not your fault that this is happening and it is not her fault that its happening and it is very important that that be made clear and that you discuss it between yourselves. There is no room here for any blame games. Once negative thoughts begin to invade the bedroom it is extremely difficult to banish them. The thing can become a self-fulfilling prophecy and a vicious circle all rolled into one.
So what is the remedy doc? Today we are lucky -- we have two choices. Twelve years ago, we had only one. Which you choose depends on your circumstances. It does not necessarily have to be one or the other either, a little of both can also be very effective. Remedy number one is predominately for couples in a stable relationship and remedy number two is predominately for men not in a steady relationship.
Number one: Stop performing. If you, the man, are not expected to perform then you cannot have performance anxiety. This may take a week or two of practice of course but you the woman do all the pleasuring creating an erection and allowing it to die down until you are eventually confident enough with this. Now kneel over your partner, one knee on each side and place his penis in you vagina. Over the next few weeks move along from there. A sense of humour might also help.
Number two: Ask your doctor for a prescription for tadalafil 20mg. Take one a day for a few days. Then take on only on day you expect to be having intercourse. These should give you PA resistant erections and return your confidence such that you will not need to take them all the time. Please visit my website for more information and help.
PA as a leading cause of erectile dysfunction or impotence can literally happen overnight. All it takes for PA to give rise to a lifetime of erectile dysfunction is just one single mishap. It could have been too much to drink, or maybe just a throwaway comment about your size or preparedness for intercourse, or perhaps it was a new relationship that you were worried about, the smallest thing can give rise to a single "failure" leaving a man wondering about his potency forever thereafter.
Do you see, for an erection to develop there must be no distractions whatsoever. What is required is pleasure, desire, arousal and excitement. With these emotions running high the blood supply to the penis increased and the man has an erection. It's like magic. Questions in the mind like is it hard enough, is it long enough, will I put it in now - any little niggling doubts at all will kill off the magic and erection process stone dead in the water.
And, another thing to remember. It is not your fault that this is happening and it is not her fault that its happening and it is very important that that be made clear and that you discuss it between yourselves. There is no room here for any blame games. Once negative thoughts begin to invade the bedroom it is extremely difficult to banish them. The thing can become a self-fulfilling prophecy and a vicious circle all rolled into one.
So what is the remedy doc? Today we are lucky -- we have two choices. Twelve years ago, we had only one. Which you choose depends on your circumstances. It does not necessarily have to be one or the other either, a little of both can also be very effective. Remedy number one is predominately for couples in a stable relationship and remedy number two is predominately for men not in a steady relationship.
Number one: Stop performing. If you, the man, are not expected to perform then you cannot have performance anxiety. This may take a week or two of practice of course but you the woman do all the pleasuring creating an erection and allowing it to die down until you are eventually confident enough with this. Now kneel over your partner, one knee on each side and place his penis in you vagina. Over the next few weeks move along from there. A sense of humour might also help.
Number two: Ask your doctor for a prescription for tadalafil 20mg. Take one a day for a few days. Then take on only on day you expect to be having intercourse. These should give you PA resistant erections and return your confidence such that you will not need to take them all the time. Please visit my website for more information and help.
Dr Andrew Rynne
http://www.doctorrynne.com
Dr Andrew Rynne is a medical practitioner and writer. He has thirty years experience in treating Sexual Dysfunction but most particularly Erectile Dysfunction and Premature Ejaculation.
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