Posts Tagged ‘bulbocavernosus muscle’

No Erections Without A Solid Base

May 27, 2017

Andrew Siegel MD  5/27/2017  Happy Memorial Day Weekend!

A flagpole needs a solid base of support in order to stand tall and not be felled by the elements.  One that is poorly mounted will falter as soon as the wind picks up or other adverse circumstances surface.  This is analogous to a tree and its root system with no tree able to stand tall and bear the elements without a deep and powerful root system.  In both cases, the hidden, behind-the-scenes support system is equally important to the exposed product.

at20op_-03__topflight-telescoping-20ft-flagpole_1_1.jpg

Flagpole base

Exposed_mango_tree_roots

Exposed roots of a mango tree, by Aaron Escobar [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)%5D, via Wikimedia Commons

…And so it is with the penis. Like the flagpole and the tree that require a solid base of support, the penis also necessitates a sturdy foundation in order to be able to morph into a “proud soldier,” tall and erect in posture.  This foundation also enables the ability to maintain this rigid stability despite exposure to the “elements”– the substantial torquing and buckling forces the penis is subjected to at the time of sexual activity.

* Thank you to Paul Nelson–friend, colleague and president of the Erectile Dysfunction Foundation and launcher of FrankTalk.org–who came up with the clever  flagpole analogy.

What You See is Not What You Get

Half the penis is exposed and half is hidden.  The visible portion of the penis (pendulous penis) is the external half.  The internal half (infrapubic penis) lies under the surface and is known as the penile roots or in medical speak, the crura. Like the roots of a tree or the base of a flagpole responsible for foundational support, the roots of the penis stabilize and support the erect penis so that it stays rigid and skyward-angling with excellent “posture.”  Without functioning penile roots, the penis would remain limp, would dangle in accordance with gravity and have slouching posture at best.

4extintpenis

Illustration above by Christine Vecchione from “Male Pelvic Fitness: Optimizing Sexual & Urinary Health”

The penile roots are enveloped by two pelvic floor muscles, the BC (bulbocavernosus) and the IC (ischiocavernosus).  These rigidity muscles compress the roots of the penis, causing backflow of pressurized blood into the penis.  In a sexual situation, these muscles engage and contract, forcing blood within the roots of the penis into the external penis.  Not only is pressurized blood pushed into the external penis promoting rigidity, but also the contractions of these muscles causes the clamping of venous outflow—a tourniquet-like effect—that results in penile high blood pressure and full-fledged rigidity.  These muscles are also responsible for ejaculation—rhythmically compressing the urethra (urinary channel that runs through the penis) at the time of climax to cause the expulsion of semen.

Factoid: It is the BC and IC muscles that are responsible for the ability to lift one’s erect penis up and down (wag the penis) as they are contracted and relaxed.

00001Illustration above by Christine Vecchione from “Male Pelvic Fitness: Optimizing Sexual & Urinary Health”

The BC and the IC muscles together with the transverse perineal muscles and the levator muscles are collectively known as the pelvic floor muscles, a muscular hammock located between scrotum and anus  (“inner taint”). Although unseen and behind-the-scenes, hidden from view, these often unrecognized and misunderstood muscles have vital functions in addition to erection and ejaculation, including urinary and bowel control. As part of the core group of muscles, they affect posture, the lower back and the hips.

Take home message: The pelvic floor muscles are the rigidity muscles, necessary for transforming the stimulated penis that becomes plump into a rock-hard penis. When these muscles are not functioning optimally, one loses the potential for full rigidity.

Factoid: An erection—defined in hydraulic terms—is when the penile blood inflow is maximized while outflow is minimized, resulting in an inflated and rigid penis. The pressure in the penis at the time of an erection is sky-high (greater than 200 millimeters), the only organ in the body where high blood pressure is both acceptable and necessary for healthy functioning. This explains why blood pressure pills are the most common medications associated with erectile dysfunction.

Bottom Line: Neither flagpole, tree nor penis can be firmly supported without a solid foundation.  The penile roots and the pelvic floor muscles that surround them are the foundation.  Not only do these muscles support the deep roots of the penis, but they are also responsible for the high penile blood pressures responsible for erectile rigidity and are the motor power underlying ejaculation.  The IC muscle should be known as the “erector muscle” and the BC muscle the “ejaculator muscle.” Although not muscles of glamour, they are certainly muscles of “amour.”

Straddling the gamut of being vital for what may be considered the most pleasurable and refined of human pursuits—sex—they are equally integral to what may be considered the basest of human activities—bowel and bladder function.  These hidden muscles deserve serious respect and are capable of being intensified by training in order to improve and often prevent sexual, urinary and bowel issues. Why not consider exercising your erector and ejaculator muscles, as you do for so many other muscle groups in the body?

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a practicing physician and urological surgeon board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  Dr. Siegel serves as Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community that is in such dire need of bridging.

Author of MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health http://www.MalePelvicFitness.com

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health  http://www.TheKegelFix.com

Co-creator of the PelvicRx male pelvic floor exercise program: http://www.PelvicRx.com

 

 

 

 

 

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The Female Love Muscles

January 7, 2017

Andrew Siegel MD 1/7/16

Optimal muscle functioning is integral to sexual activity. There would be no “jump” in the term “jump one’s bones” without fit muscles that permit the coordinated movements and muscle contractions that are necessary to engage in sexual coupling.

The following is a short poem I have composed about the muscles of love:

 Limber hip rotators,

A powerful cardio-core,

But forget not

The oft neglected pelvic floor.

Sex is a physical activity involving numerous muscles that coordinate with seamless efficiency. Sexual activity demands movement, a synchronized kinetic chain integrating core muscles and external hip rotators in which both pelvic thrusting and outward rotation of the hips work effectively together to forge a choreographed motion. It is a given that cardiac (aerobic) conditioning is a prerequisite for any endurance athletic endeavor, including SEX-ercise.

Three muscle groups are vital for optimal sexual function—core muscles, which maintain stability and provide a solid platform to enable pelvic thrusting; external hip rotators, which rotate the thighs outward and are the motor behind pelvic thrusting; and the floor of the core muscles—pelvic floor muscles (PFM), which provide pelvic tone and support, permit tightening and relaxing of the vagina, support clitoral erection, and contract rhythmically at the time of climax. When these three groups of muscles are in tiptop shape, sexual function is optimized.

The core muscles are a cylinder of torso muscles that surround the innermost layer of the abdomen. They function as an internal corset and shock absorber. In Pilates they are aptly referred to as the “powerhouse,” providing stability, alignment and balance, but also allowing the extremity muscles a springboard from which to push off and work effectively. It is impossible to use your limbs without engaging a solid core and, likewise, it is not possible to use your genitals effectively during sex without engaging the core muscles.

Who Knew? According to the book “The Coregasm Workout,” 10% of women are capable of achieving sexual climax while doing core exercises. It most often occurs when challenging core exercises are pursued immediately after cardio exercises, resulting in core muscle fatigue. 

Rotation of your hips is a vital element of sexual movement. The external rotators are a group of muscles responsible for lateral (side) rotation of your femur (thigh) bone in the hip joint. My medical school anatomy professor referred to this group of muscles as the “muscles of copulation.” Included in this group are the powerful gluteal muscles of your buttocks.

Who Knew? Not only do your gluteal muscles give your bottom a nice shape, but they also are vital for pelvic thrusting power.

The PFM make up the floor of the core. The deep layer is the levator ani (“lift anus”), consisting of the pubococcygeus, puborectalis, and iliococcygeus muscles. These muscles stretch from pubic bone to tailbone, encircling the base of the vagina, the urethra and the rectum. The superficial layer is the bulbocavernosus, ischiocavernosus, transverse perineal muscles and the anal sphincter muscle.

The following two illustrations are by Ashley Halsey from The Kegel Fix:

2.deep PFM 3. superficial and deep PFM

The PFM are critical to sexual function. The other core muscles and hip rotators are important with respect to the movements required for sexual intercourse, but the PFM are unique as they directly involve the genitals. During arousal they help increase pelvic blood flow, contributing to vaginal lubrication, genital engorgement and the transformation of the clitoris from flaccid to softly swollen to rigidly engorged. The PFM enable tightening the vagina at will and function to compress the deep roots of the clitoris, elevating blood pressure within the clitoris to maintain clitoral erection. An orgasm would not be an orgasm without the contribution of PFM contractions.

Who Knew? Pilates—emphasizing core strength, stability and flexibility—is a great source of PFM strength and endurance training. By increasing range of motion, loosening tight hips and spines and improving one’s ability to rock and gyrate the hips, Pilates is an ideal exercise for improving sexual function.

PFM Training to Enhance Sexual Function: The Ultimate Sex-ercise

The PFM are intimately involved with all aspects of sexuality from arousal to climax. They are highly responsive to sexual stimulation and react by contracting and increasing blood flow to the entire pelvic region, enhancing arousal. Upon clitoral stimulation, the PFM reflexively contract. When the PFM are voluntarily engaged, pelvic blood flow and sexual response are further intensified. During climax, the PFM contract involuntarily in a rhythmic fashion and provide the muscle power behind the physical aspect of an orgasm. The bottom line is that the pleasurable sensation that one perceives during sex is directly related to PFM function and weakened PFM are clearly associated with sexual and orgasmic dysfunction.

PFM training improves PFM awareness, strength, endurance, tone and flexibility and can enhance sexual function in women with desire, arousal, orgasm and pain issues, as well as in women without sexual issues. PFM training helps sculpt a fit and firm vagina, which can positively influence sexual arousal and help one achieve an orgasm. PFM training results in increased muscle mass and more powerful PFM contractions and better PFM stamina, heightening the capacity for enhancing orgasm intensity and experiencing more orgasms as well as increasing “his” pleasure. PFM training is an excellent means of counteracting the adverse sexual effects of obstetrical trauma. Furthermore, PFM training can help prevent sexual problems that may emerge in the future.  Tapping into and harnessing the energy of the PFM is capable of improving one’s sexual experience. If the core muscles are the “powerhouse” of the body, the PFM are the “powerhouse” of the vagina.

Bottom Line: Strong PFM = Strong climax. The PFM are more responsive when better toned and PFM training can revitalize the PFM and instill the capacity to activate the PFM with less effort. PFM training can lead to increased sexual desire, sensation, and sexual pleasure, intensify and produce more orgasms and help one become multi-orgasmic. Women capable of achieving “seismic” orgasms most often have very strong, toned, supple and flexible PFM. Having fit PFM in conjunction with the other core muscles and the external hip rotators translates to increased self-confidence.

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”: www.HealthDoc13.wordpress.com

Dr. Andrew Siegel is a practicing physician and urological surgeon board-certified in urology as well as in female pelvic medicine and reconstructive surgery. Much of the content of this entry was excerpted from his recently published book The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health: http://www.TheKegelFix.com

He is also the author of MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health http://www.MalePelvicFitness.com

 

 

What You Don’t Know About Your Pelvic Floor Muscles, But Should

June 18, 2016

Andrew Siegel, M.D. 6/18/16

* Please note that although this entry is written for women, it is equally applicable to men.

In dogs, the pelvic floor muscles (PFM) play an important role with respect to tail position and movement. They are responsible for tail wagging in circumstances when dogs are happy and for the tail being held down between the legs when dogs are frightened or anxious. Weak PFM are virtually unheard of in the canine population, suggesting that with constant tail movement, the PFM are exercised sufficiently to maintain tone and vitality.

 

foot in water bowl

Photo above is Charley, my English Springer Spaniel.  Note her happy, erect tail and her curious habit of eating with her foot in her water bowl.

For better or worse, humans do not have tails to wag or place between our legs.  Tails became extinct with the evolutionary process (with the exception of the character played by Jason Alexander in the movie “Shallow Hal”). If we did have tails, our PFM would likely get a great deal more exercise than they typically do.

Sadly, the PFM don’t get the respect that the glitzy, for-show, mirror-appealing, external glamour muscles do. However, the PFM are hidden gems that work diligently behind the scenes–muscles of major function and not so much form-offering numerous powers and benefits, particularly so when intensified by training. Although not muscles of glamour, they are muscles of “amour,” and have a profoundly important role in sexual, urinary, and bowel function as well as in supporting our pelvic organs.

What are the PFM?

The PFM—commonly known as the “Kegel muscles”—are a muscular hammock that form the bottom of the pelvis. They are also referred to as the “saddle” muscles because you sit on them when seated on a bicycle. They are part of the “core” group of muscles.

What are the “core” muscles?

The core muscles are the “barrel” of muscles comprising the torso, consisting of the abdominal muscles in front, the lumbar muscles in back, the diaphragm muscle on top and the PFM on the bottom. The core muscles are responsible for stabilizing the pelvis and holding the spine erect.

1.core muscles

                              Illustration of core muscles by Ashley Halsey from                                            The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health

Where are the PFM?

The deep PFM (pubococcygeus, iliococcygeus, coccygeus) span from the pubic bone in front to the tailbone in the back, and from pelvic sidewall to pelvic sidewall, between the “sit” bones.

2.deep PFM              Illustration of deep PFM muscles by Ashley Halsey

The superficial PFM (ischiocavernosus, bulbocavernosus, transverse perineal, anal sphincter) are situated under the surface of the external genitals and anus.

3. superficial and deep PFM

            Illustration of superficial and deep PFM muscles by Ashley Halsey

 

What is the function of the PFM?                                                                      

The PFM muscles intertwine with the muscles of the vagina, bladder and rectum,  provide support for the pelvic organs, play a vital role in sexual function and contribute to the control mechanism of the urinary and intestinal tracts.

What is PFM dysfunction?

PFM “dysfunction” is a common condition referring to when the PFM are not functioning properly. PFM dysfunction ranges from “low tone” to “high tone.” Low tone occurs when the PFM lack in strength and endurance and is often associated with stress urinary incontinence (urinary leakage with coughing, sneezing, laughing, exercising and other physical activities), pelvic organ prolapse (when one or more of the pelvic organs fall into the space of the vagina and at times outside the vagina) and altered sexual function (decreased sensation, difficulty accommodating a penis because of looseness, difficulty achieving climax, etc.). High tone occurs when the PFM are too tense and unable to relax, giving rise to a pain syndrome known as pelvic floor tension myalgia (this situation is entirely analogous to the high-strung dog with its tail between its legs).

Trivia: PFM dysfunction often causes symptoms in several domains, e.g., women with urinary control issues often have trouble achieving orgasm, both problems contributed to by weak PFM.

What causes PFM dysfunction?

The PFM can become weakened, flabby and poorly functional with pregnancy, labor, childbirth, menopause, weight gain, a sedentary lifestyle, poor posture, sports injuries, pelvic trauma, chronic straining, pelvic surgery, diabetes, tobacco use, steroid use, and disuse atrophy (not exercising the PFM). Sexual inactivity can lead to their loss of tone, texture and function. With aging there is a decline in the bulk and contractility of the PFM, often resulting in PFM dysfunction.

Why are the PFM so vital to your health?

The PFM are perhaps the most versatile yet under-appreciated muscle group in your body. They provide vaginal tone, support to the pelvic organs, a healthy sexual response–enhancing arousal and orgasm–and urinary and bowel sphincter control. They play a key role in your ability to carry and deliver a baby as well as contributing to the mobility and stability of your torso.

A simplified way of thinking of the female pelvic organs–bladder, uterus and bowel–is as “storage containers” for urine, fetuses, and stool, respectively. Each organ is connected to the outside world by tubular structures, the urethra, vagina and anal canal, respectively, through which flow the contents of the organs. The PFM play a strong role in compressing the tubes for storage and relaxing them for emptying.

What Is the muscle function of the PFM?

Whereas most skeletal muscles function as movers (joint movement and locomotion), the PFM are unique in that they function as stabilizers—helping to keep the pelvic organs in proper position—and compressors—helping to tighten the vagina, urethra and rectum—important to urinary and bowel control as well as to sexual function. During sex the PFM activate, causing a surge of genital blood flow that helps lubrication and clitoral engorgement; at the time of orgasm, the PFM contract rhythmically.

Why bother exercising your PFM?                                                        

The PFM are out of sight and out of mind; however, they have vital functions, so are muscles that you should be exercising. PFM training is based upon solid exercise science and can help maintain PFM integrity and optimal function into old age. The PFM are capable of making adaptive changes when targeted exercise is applied to them. Pelvic training involves gaining facility with both the contracting and the relaxing phases of PFM function. Their structure and function can be enhanced, resulting in broader, thicker and firmer PFM with a stronger resting tone and the ability to generate a powerful contraction at will. PFM training can be effective in stabilizing, relieving, improving and even preventing issues with pelvic support, sexual function, and urinary and bowel control. In addition to the muscle-training benefit of PFM training, it also supports tissue healing by stimulating the flow of oxygenated, nutritionally-rich blood to the vagina and other pelvic organs.

Because of pregnancy, labor and delivery, the PFM get stretched more than any other muscle group in the body. Through pelvic training, the PFM have the capacity of rebounding from this obstetrical “trauma,” recovering tone and function. Prenatal pelvic training can help fortify the PFM in preparation for pregnancy, labor and delivery.

Bottom Line: The PFM may literally be at the bottom of the barrel of our core muscles, but in terms of their important functions, they are figuratively furthermost from the “bottom of the barrel.” Without functioning PFM, your organs would dangle out of your pelvis, you would be wearing adult diapers and your sexual function would be non-existent. It behooves you to keep these vital muscles in tip-top shape. 

Please check out the following 3 minute video entitled “Why Kegel?”:

https://www.youtube.com/watch?v=kclY1vY3wG8

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health– and MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health available on Amazon Kindle, Apple iBooks, B&N Nook and Kobo; paperback edition available at TheKegelFix.com

Author page on Amazon: 

http://www.amazon.com/Andrew-Siegel/e/B004W7IM48

Apple iBook:

https://itunes.apple.com/us/book/the-kegel-fix/id1105198755?mt=11

The Kegel Fix trailer: 

https://www.youtube.com/watch?v=uHZxoiQb1Cc  

Co-creator of Private Gym and PelvicRx: comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training programs. Built upon the foundational work of Dr. Kegel, these programs empower men to increase pelvic floor muscle strength, tone, power, and endurance: www.PrivateGym.com or Amazon.  In the works is the female PelvicRx pelvic floor muscle training DVD. 

Pelvic Rx can be obtained at http://www.UrologyHealthStore.com, an online store home to quality urology products for men and women. Use promo code “UROLOGY10” at checkout for 10% discount. 

When You Can GET It Up, But Can’t KEEP It Up

February 20, 2016

Andrew Siegel MD 2/20/16

Lost In Evolution

Many mammals have a bone in the penis (os penis) that maintains constant penile stiffness. This is the case with primates including gorillas and chimpanzees, but–for better or for worse– is not the case with human males. The good thing about having an os penis is that there is no such thing as ED in primates, as males are “ever ready.”  The bad thing is having a 24/7/365 “boner,” literally and figuratively. Furthermore, having a bone in the penis makes it much more susceptible to injuries such as a fracture of the penis.

The Human Penis

The human penis is a highly evolved and unique organ comprised of 3 cylindrical chambers that contain erectile sinus tissue. These cylinders run the length of the external and internal aspects of the penis. The main “erectile apparatus” consists of the paired cavernous chambers with the ischiocavernosus muscle (IC) that surrounds and supports them. The auxiliary “erectile apparatus” is the head of the penis (glans) with the solitary spongy erectile chamber that envelops the urinary channel and the bulbocavernosus muscle (BC) that surrounds and supports it. The IC and BC muscles are two of the all-important pelvic floor muscles that provide supportive, sphincteric and sexual functions.

The paired cavernous erectile chambers become rigid at the time of sexual stimulation and provide the wherewithal for vaginal penetration. The head of the penis and spongy chamber provide additional plumpness and fullness, but not rigidity.

Corporal Bodies And Glans Clean

Blue arrows point to paired cavernous chambers that become rock-hard with stimulation. Red arrow points to solitary spongy chamber and yellow arrow to head of penis, both of which become plump with stimulation. (From Gray’s Anatomy of the Human Body, 20th Edition, original publication 1918, public domain)

12muscles

IC and BC muscles that surround the inner aspects of the cavernous chambers and spongy chamber respectively.  These pelvic muscles support the roots of the penis and when they contract they push pressurized blood into the external penis, creating rock-hard rigidity. (Illustration by Christine Vecchione from “Male Pelvic Fitness: Optimizing Sexual & Urinary Health”)

Did you know that penile erectile sinus tissue is virtually identical to nasal sinus tissue? …  IDENTICAL: a pathologist would be hard pressed (no pun intended!) to tell the difference between the two under a microscope.  Congested sinuses =  penile erection. The oral ED medications increase blood flow to both the nasal and penile sinuses and thus commonly cause sinus congestion as a side effect.   

Clever Mother Nature

Nature evolved a brilliant alternative to the os penis for human males. In the absence of such a practical bone,  nature capitalized on principles of hydraulics. Blood—not used for its typical purpose (transporting oxygen and other nutrients)—is pressurized to create rock-hard penile rigidity. This process has 3 requirements:

  1. arterial inflow of blood to the penis
  2. relaxation of the smooth muscle within the erectile sinus tissue to allow the penis to inflate
  3. trapping blood to maintain the erection

The blood trapping mechanism is incompletely deciphered, but our current understanding is that as the erectile sinus tissue becomes swollen with blood, the vessels that conduct blood away are pinched closed. The IC and BC muscles also play a key role by tourniquet-like compression of the inner erectile chambers, forcing pressurized blood into the erectile chambers. Penile high blood pressure in excess of 200 mm– the only place in the body where hypertension is desirable and necessary –is what is responsible for penile rock-hard rigidity.

Did you know that Dr. Gray of Gray’s Anatomy 1909 textbook referred to the IC muscle as the “erector” muscle and the BC as the “ejaculator” muscle?

Observe Your IC and BC Muscles In Action

The next time you get an erection, stand up and observe your penis. Vigorously contract your IC and BC muscles (by tightening up the anus) and observe what happens as more hydraulic fuel (blood) surges into the penis: the erect penis should lift up and point to the heavens above…pelvic floor muscle magic!

Erectile Dysfunction

ED can result from a problem in any of the three hydraulic requirements. If you cannot obtain an erection, it is most often due to impaired arterial blood flow to the penis or to a problem with the smooth muscle of the sinus tissue, which fails to relax appropriately and thus will not allow penile inflation. Similar to high blood pressure—which is commonly due to arterial smooth muscle becoming stiffer—failure of relaxation of the smooth muscle within the erectile sinus tissue is often an age-related problem.

If you can achieve an erection but lose it prematurely, it is often due to two causes: One is venous leakage of blood from the sinuses. The other is weakened IC and BC muscles. Unfortunately, there is not a lot that can be done about age-related impaired functioning of the erectile sinus tissue that promotes venous leakage.  However, healthy lifestyle measures will optimize function of the erectile sinus tissue and smooth muscle.  This includes the following: good eating habits, maintaining a healthy weight, engaging in exercise, obtaining adequate sleep, consuming alcohol in moderation, avoiding tobacco and minimizing stress.  The good news is that the IC and BC muscles are capable of being strengthened to improve their form and function, improving the blood trapping mechanism to enhance erectile rigidity and durability.  This is possible through Kegel exercises, a.k.a. pelvic floor muscle training programs (see below).

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Amazon Kindle, Apple iBooks, Barnes & Noble Nook, Kobo) and paperback: www.MalePelvicFitness.com. In the works is The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health.

Co-creator of Private Gym, a comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training program. Built upon the foundational work of Dr. Arnold Kegel, Private Gym empowers men to increase pelvic floor muscle strength, tone, power, and endurance: www.PrivateGym.com or Amazon.

When Ejac-“elation” Becomes Ejac-“frustration”

February 13, 2016

Andrew Siegel MD  2/13/2016

800px-Fireworks4_amk

(Fireworks, 8/2007, author AngMoKio)

In the arena of male sexual dysfunction (MSD), ejaculation problems play second fiddle to erectile dysfunction (ED). Today’s entry explores common issues with ejaculation other than premature ejaculation, which I have previously addressed: https://healthdoc13.wordpress.com/tag/premature-ejaculation/

What my patients tell me: 

“It takes me too long.”

 “I can’t ejaculate.”

 “It happens, but not much fluid comes out.”

 “It just dribbles out with no force.”

 “I barely know that it happened; I just don’t get the same feeling that I used to.”

One would think that MSD is the same as ED, which seems to get all the press. However, MSD is more complex and all-encompassing than having soft or short-lived erections, which is just one aspect of MSD. Sex drive (libido) is an important part of the picture. Ejaculation is another vital component. With regard to ejaculatory issues, premature ejaculation (rapidly achieving climax) gets all the attention. However, there are other ejaculatory issues that contribute in a major way to MSD.

The processes of having an erection and ejaculating are separate, even though they usually occur at the same time. However, it is possible to have a rock-hard erection and be unable to ejaculate, and conversely, to ejaculate with a limp penis. Regardless, it sure is nice when the two processes harmonize. All things being equal, with a good quality erection, ejaculation will be more satisfying.

Why is ejaculation better with a rigid erection than without?

The urethra (tube within the penis that conducts semen) is the “barrel” of the penile “rifle.” It is surrounded by spongy erectile tissue called the corpora spongiosum (“spongy body”) which constricts and pressurizes the “barrel” to optimize ejaculation and promote the forceful expulsion of semen, the “ammo.” The word ejaculation derives from ex, meaning out + jaculari, meaning to throw, shoot, hurl, cast for a good reason!

Additionally, the pelvic floor muscles play a key role in the process of ejaculation. The bulbocavernosus (BC) is a compressor muscle that surrounds the spongy body and at the time of ejaculation it contracts rhythmically, sending wave-like pulsations rippling down the urethra to forcibly propel the semen in an explosive eruption, providing the horsepower for forceful ejaculation. This BC muscle engages when you have an erection and becomes maximally active at the time of ejaculation.

Issues with ejaculation are extremely common complaints among middle-aged and older men. These are often bothersome and distressing, and include the following:

  • Delayed ejaculation
  • Absent ejaculation
  • Skimpy ejaculation volume
  • Weak ejaculation force and arc
  • Diminished ejaculatory sensation

Ejaculatory problems often correlate with aging, weight gain, the presence of lower urinary tract symptoms and ED. The older you are, the heavier you are, the more that you are having problems with urination and obtaining/maintaining an erection, the greater the likelihood that you will also have ejaculatory problems. This is often on the basis of an age-related decline of sensory nerve function as well as weakened pelvic floor muscles. Additionally, aging reproductive glands produce less fluid and the ducts that drain genital fluids can obstruct. Furthermore, medications that are used to treat prostate enlargement can profoundly affect ejaculatory volume.

So What’s The Big Deal Anyway?

Most men do not appreciate meager, lackadaisical-quality ejaculations and orgasms. Sex is important and getting a rigid erection is vital, but the culmination—ejaculation and orgasm—is equally important. We may be 40, 50, 60 years old or older, but we still want to point and shoot like we did when we were 20 and desire to retain that intensely pleasurable feeling of yesteryear.

Delayed Ejaculation

I have previously addressed this topic:

https://healthdoc13.wordpress.com/2015/02/21/im-almost-there-what-you-need-to-know-about-delayed-ejaculation/

Absent Ejaculation

This is part of the spectrum of delayed ejaculation, except in this instance, climax is never achieved. Alternatively, it happens with surgical removal of the reproductive organs, as occurs with radical prostatectomy or radical cystectomy for prostate and bladder cancer, respectively.  It can also occur in the presence of  neuropathy, e.g., with diabetes and other neurological disorders. In these circumstances, orgasm can still be experienced, although ejaculation is absent.

Skimpy Ejaculation Volume

This is very common with aging as the reproductive organs “dry out” to some extent. It also happens with certain medications that either reduce reproductive gland secretions (Proscar, Avodart) or cause some of the ejaculate to go backwards into the urinary bladder (Flomax, Rapaflo, Uroxatral).

Weak Ejaculation Force, Arc and Sensation

What was once an intense climax with a substantial volume of semen that could be forcefully ejaculated in a arc several feet in length gives way to a lackluster experience with a small volume of semen weakly dribbled out the penis.  These issues clearly correlate with aging, weakened pelvic floor muscles and ED.

Bottom Line: In addition to sex drive issues, erectile dysfunction and premature ejaculation, there are a spectrum of other male sexual problems that are bothersome and distressing.  With aging, weight gain and weakening of the pelvic floor muscles, ejaculation and orgasm often become less spirited, with diminished volume, force and trajectory. However, there are solutions!

 To Optimize Ejaculation:

  1. Maintain a healthy lifestyle: good eating habits, healthy weight, engage in exercise, obtain adequate sleep, consume alcohol in moderation, avoid tobacco and minimize stress.
  1. Pelvic floor muscle training: Whereas a weakened BC muscle may result in semen dribbling with diminished force or trajectory, a strong BC can generate powerful contractions to forcibly ejaculate semen. Keep the BC and the other pelvic floor muscles fit through pelvic floor muscle exercises.

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Amazon Kindle, Apple iBooks, Barnes & Noble Nook, Kobo) and paperback: www.MalePelvicFitness.com. In the works is The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health.

Co-creator of Private Gym, a comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training program. Built upon the foundational work of Dr. Arnold Kegel, Private Gym empowers men to increase pelvic floor muscle strength, tone, power, and endurance: www.PrivateGym.com or Amazon.

Erection Recovery Program

December 5, 2015

Andrew Siegel MD   12/5/15

Reviresco – (Latin, re- + viresco) “I become green or verdant again”; “I am renewed or revived.”

Outliving Your Penis

It is very possible that you will “outlive” your penis. It will always be there for you in terms of a “spigot” to allow you the privilege of standing up to aim your urinary stream with reasonable accuracy, although this too suffers the ravages of time. However, in terms of being able to obtain or maintain an erection, your penis may perish decades before you do, for a variety of reasons.

The focus of today’s blog is ED due to prostate cancer treatment, although it is equally relevant to any man suffering with ED for any reason.  Having one’s prostate removed is a highly successful means of curing prostate cancer.  However, despite advances in technical and surgical approach, trauma to nerves, blood vessels, and muscular tissue during surgery can compromise sexual function, with ED being the most common complication.  The effect of radical prostatectomy on the penis is not unlike the effect of a stroke on the brain: in both situations a neuro-vascular (nerve/blood vessel) event occurs that may profoundly disturb function.  90% of men experience some degree of ED in the early post-surgery recovery period. The good news is that there are effective “rehab” and even “prehab” methods to optimize preservation and return of sexual function.  

Even if your penis has “expired” in terms of becoming rigid, it is still capable of being stimulated to ejaculation and orgasm, a phenomenon eventually discovered by many men. This is a small consolation (pun intended) for suffering with ED.

If your penis is not completely lifeless, it may be impaired such that you can obtain an erection, but lose it prematurely, or you can obtain at best a partially firm, non-penetrable erection. As if having a crippled penis were not severe enough punishment, to add insult to injury one of the consequences of lack of erections and sexual inactivity is further compromise of the future potential for erections. In other words, you need to obtain erections in order to maintain erections.

Use It Or Lose It

Erections not only provide the capacity for penetrative sex, but also serve to keep the erectile chambers (erectile smooth muscles and vascular sinus tissues) richly oxygenated, elastic and functioning. If one goes too long without an erection, damage to this erectile apparatus can result in penile atrophy (shrinkage) and compromised function. In a vicious cycle, the poor blood flow from disuse induces scarring and further damage to erectile smooth muscle and sinus tissues that often gives rise to venous leakage (rapid loss of erections as blood cannot be properly trapped within the erectile chambers). The bottom line is that in the absence of regular erections, one will likely lose length, girth and function, with the penis hobbled by its inability to properly trap blood.

As an aside, one of the functions of sleep erections—the spontaneous nocturnal erections that occur during REM (rapid eye movement) sleep in healthy men—is to maintain the erectile chambers in good working order. As sleep has an important restorative function for the human body, so sleep erections have a vital restorative function for the human penis.

Penile Resurrection

Achieving erections when they fail to occur by natural means is vital for sexual “resurrection” (l like the sound of this word—say it slowly). In time, the nerves that were “stunned” and/or injured by radical prostatectomy will usually heal and during this convalescing time, obtaining erections will help preserve erectile tissue. The implication is that even if you are sexually inactive, if you anticipate being sexually active in the future, you need to keep the penis and erectile apparatus fit.

Many urologists recommend penile “rehabilitation” when healed up after radical prostatectomy. Traditional rehab involves a combo of pills, injections and vacuum therapy, a.k.a. vacuum suction device (VSD). Some men use one, two or all three of these rehab strategies.

The oral ED medications (Viagra, Levitra, Cialis, and Stendra) can help maintain penile blood flow and provide the benefits that derive from maintaining tissue oxygenation. However, they are double-edged swords as they cannot be used in the face of certain medical conditions, have side effects, are expensive (costing about $40 per pill) and are not effective in all comers.

For those who do not respond to pills, the next step is often penile injections. Vasodilator drugs are injected directly into the erectile chambers to induce an erection. A mixture of one or more medications is often used for this purpose. Unfortunately–despite its effectiveness–many men are not fond of putting a needle in their penis and often nix this means of treatment.

The VSD is the third traditional rehab element. Starting 6 weeks or so after surgery and pursued for 10 minutes daily, the VSD mechanically engorges the penis in an effort to keep the erectile chambers healthy.

The Erection Recovery Program

“Prehab” is a means of pre-rehabilitation that is started shortly after the diagnosis of prostate cancer, during the time period when one awaits being operated upon. Instead of waiting for after-the-fact rehab, prehab intends to maximize sexual function before surgery in an effort to hasten recovery of erectile function after surgery. Committing to the erection recovery program before the trauma of surgery permits one to go into the operation optimally prepared.

The Erection Recovery Program combines two non-pharmacological, non-invasive tools—vibratory nerve stimulation and pelvic floor muscle training—to stimulate the nerves that produce erections and to strengthen the muscles that contribute to erectile rigidity, respectively. The traditional rehab program can be highly effective; however, it addresses primarily blood flow, a vital element of erectile physiology, while not focusing on nerve stimulation and pelvic floor/perineal muscle function, important contributors to the erectile process.

Vibratory-tactile nerve stimulation in men was originally conceived (pun intended) for spinal cord injured patients who desired to father children but were incapable of doing so because of their inability to ejaculate. However, vibro-tactile nerve stimulation is equally effective in inducing erection as well as ejaculation/orgasm in the non-spinal cord injured population and its use has been expanded to the general male population.

The pelvic floor/perineal muscles activate at the time of sexual stimulation, compressing the deep roots of the penis and fostering hypertensive blood pressures in the erect penis in excess of 200 mm, responsible for rock-hard rigidity. Pelvic floor muscle training has been used to bolster the strength, power and endurance of these muscles in order to optimize erectile rigidity and durability. Without well functioning pelvic floor/perineal muscles, full rigidity will not occur.

Oral meds, injection and/or vacuum therapy help prevent erectile tissues from losing elasticity and becoming scarred and less functional from the absence of erections. Similarly, nerve stimulation and pelvic floor/perineal muscle training help maintain the integrity of the erectile tissues as well as help prevent the pelvic floor/perineal muscles from atrophying in the absence of erections.  By keeping the pelvic floor/perineal muscles fit, when erections ultimately do return, function can be optimized.

The combination of nerve stimulation and pelvic floor muscle strengthening is a powerful alliance that is prescribed “prehab” as well as after radical prostatectomy to shorten the time it takes to recover erections. Its merits are its simplicity, safety, efficiency and the fact that it is actually pleasurable to pursue. It does not preclude the use of the traditional rehab program, which can be used in conjunction with the Erection Recovery Program.

Specifically, the Erection Recovery Program consists of the Viberect nerve stimulation device and the Pelvic Rx pelvic floor muscle training program. Viberect, manufactured by Reflexonic, is an FDA-certified hand-held penile vibro-tactile nerve stimulation device that triggers erection and ultimately ejaculation. The Pelvic Rx program, manufactured by Adult Fitness Concepts, is a FDA-registered, comprehensive, interactive follow-along exercise program to increase pelvic floor muscle strength, tone, power, and endurance. Basic Training strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises, while Complete Training provides maximum opportunity for gains via resistance equipment.

Bottom Line: 

The critical principle for erectile recovery is achieving an erection for at least several times weekly during the recovery period after prostate surgeryPenile vibro-tactile nerve stimulation coupled with pelvic floor muscle training is a synergistic combination that promotes initiation and maintenance of erections, respectively. 

This Erection Recovery Program is used prehab (prior to radical prostatectomy) and continued after surgery.  It offers a non-pharmacological option for erection recovery, but can also be used in conjunction with traditional penile rehab programs that use medications.  The Erection Recovery Program is also appropriate for any man who wants to improve sexual function, regardless of the underlying cause.  

To obtain the Erection Recovery Program:

http://www.viberect.com/erection-recovery-program-combo-pack.html

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Amazon Kindle, Apple iBooks, Barnes & Noble Nook, Kobo) and paperback: www.MalePelvicFitness.com. In the works is The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health.

Co-creator of Private Gym, a comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training program. Built upon the foundational work of Dr. Arnold Kegel, Private Gym empowers men to increase pelvic floor muscle strength, tone, power, and endurance: www.PrivateGym.com or Amazon.

The Muscles Of Love

April 11, 2015

Andrew Siegel MD   4/11/14

375px-Gray408Gray406

Limber hip rotators,

A powerful cardio-core,

But forget not

The oft-neglected pelvic floor

Three Important Muscle Groups

Sex is an activity that involves many muscles that coordinate with seamless efficiency. Three muscle groups are vital for sexual functioning—core muscles, which maintain stability and enable pelvic thrusting; external hip rotators, which enable outward rotation of the thighs; and the floor of the core muscles—the pelvic floor muscles (PFM)which support erectile rigidity in men and clitoral erection in women and contract rhythmically at the time of orgasm in both men and women. When these muscles are in tiptop shape, sexual function will be optimized. Obviously, cardiac (aerobic) conditioning is a prerequisite for any endurance athletic endeavor, including “sexercise.”

The All-Important Core: The Missing Link

The core muscles are the cylinder of torso muscles that surround the innermost layer of the abdomen and function as an internal corset and shock absorber. In Pilates they are known as the “powerhouse,” as they provide a much greater contribution to overall strength than do our limbs. Our core provides stability, alignment and balance and allows the peripheral muscles an effective springboard from which to push off and work effectively.

The major muscle groups in the core are the following: in the front, the transversus abdominis and rectus abdominis; on the sides, the obliques; in the back, the erector spinae; the roof is the diaphragm; and the floor consists of the pelvic floor muscles. These are both stabilizers that maintain the spine and pelvis in alignment and movers as they rotate the torso and extend (straighten) and flex (bend) the spine.

The core muscles are a “missing link” when it comes to fitness, often neglected at the expense of other muscles. Tremendous core strength is evident in dancers, swimmers, and practitioners of yoga, Pilates and martial arts. It is impossible to use our arms and legs effectively in any athletic endeavor without engaging a solid core. Likewise, it is not possible to use our genitals effectively during sexual activity without engaging our core muscles. One can think of the core as the “sexual engine.” A stronger core results in greater sexual “horsepower” and more powerful pelvic thrusting.

Hip Rotators

Rotation of our hips is a vital element of sexual movement. The external rotators are a group of muscles responsible for lateral rotation of our femur (thigh) bone in the hip joint: piriformis, gemellus superior and inferior, obturator internus and externus, and quadratus femoris. My medical school anatomy professor referred to this group as the “muscles of copulation.” The gluteals and the ilio-psoas deserve mention as well, because of their important contribution to external rotation.

The Floor Of The Core

The pelvic floor muscles (PFMs) make up the floor of the core. The deep layer is the levator ani (“lift the anus”), consisting of the pubococcygeus (PC muscle), puborectalis, and iliococcygeus muscles. The superficial layer is the bulbocavernosus (BC), the ischiocavernous (IC), the transverse perineal muscles (TPM), and the anal sphincter muscle.

The PFM muscles are of critical importance to sexual function. The other core muscles and the hip rotators deal with the kinetics and movements necessary for sex, as optimal sexual functioning demands a powerful sexual engine that enables coordinated pelvic thrusting and hip rotation. However, the PFM are distinctive as they directly involve the genitals. The BC and IC muscles engage at the time of sexual activity, stabilizing the erect penis so that it stays rigid and skyward-angling with excellent “posture.” They compress the deep roots of the penis, responsible for the transformation of the penis from plump to rigid and maintaining that rigidity; additionally, they compress the urethra (urinary channel that runs through the penis) rhythmically at the time of ejaculation. In the female, these muscles are responsible for clitoral erections and contract rhythmically at the time of orgasm.

Movement And Motion

Unless we are dealing with Tantric techniques, sex is all about movement and motion—it is a kinetic chain, a series of coordinated events in action. It involves the smooth and efficient integration of your core muscles and external rotators in which both pelvic thrusting and lateral rotation of the hips work effectively together to forge a well-choreographed, dance-like motion.

Q. Why did Willie Sutton rob banks?

A. Because that’s where the money is. When it comes to sex, the PFM are where the money is.

Wishing you the best of health,

2014-04-23 20:16:29

AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in your email in box go to the following link and click on “email subscription”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Amazon Kindle, Apple iBooks, Barnes & Noble Nook, Kobo) and paperback: http://www.MalePelvicFitness.com

Co-creator of Private Gym pelvic floor muscle training program for men: www.PrivateGym.com Gym—also available on Amazon

The Private Gym is a comprehensive, interactive, follow-along exercise program that provides the resources to strengthen the pelvic floor muscles that are vital to sexual and urinary health. The program builds upon the foundational work of Dr. Arnold Kegel, who popularized exercises for women to increase pelvic muscle strength and tone. This FDA registered program is effective, safe and easy-to-use. The “Basic Training” program strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises and the “Complete Program” provides maximal opportunity for gains through its patented resistance equipment

“Un-Juiced”: When Ejaculation Goes South

March 27, 2015

Andrew Siegel MD   3/21/15

shutterstock_side view manjpeg

There is scarce medical literature on ejaculatory problems aside from those of ejaculatory timing issues (premature and delayed ejaculation) and hematospermia (blood in the semen). Despite being given short shrift in medical academia, not a day goes by in my clinical urology practice where I do not see at least several patients who complain of declining ejaculation function.

What Is The Origin Of The Word “Ejaculation”?

Ejaculation derives from ex, meaning “out”  and jaculari, meaning “to throw, shoot, hurl, cast.”

Trivia: You do not need an erection to ejaculate and achieve an orgasm. A limp penis cannot penetrate, but is eminently capable of ejaculation and orgasm.

If  “Semen” Or “Ejaculate” Is Too Medical For You:

The most popular slang is “cum.” It originates from the expression “come to climax” shortened to “come” and ultimately to “cum,” but not to be confused with the Latin “cum,” e.g., I graduated summa cum laude or the word meaning “along with being,” e.g., my basement-cum-gym! “Jizm,” “jism,” and “jizz” are also popular and are not to be confused with other         “–ism” words that mean a doctrine, e.g., socialism and capitalism! We cannot forget “splooge,” “spooge,” “spunk,” “wad,” “nut,” “load” and “man juice.”

What Happens To Ejaculation As We Age?

Ejaculation and orgasm often become less intense, with diminished force, trajectory and volume of semen. What was once an intense climax with a substantial volume of semen that could be forcefully ejaculated in an arc several feet in length gives way to a lackluster experience with a small volume of semen weakly dribbled out the penis.

Fact: I have never heard a patient complain that his penis is too large, nor have I ever heard anyone protest that his ejaculate volumes are too abundant.

Fact: The pervasive porn industry–where many male stars are hung like horses and whose penises seem capable of ejaculating flooding pools of semen– has given the average guy a bit of a complex.

So What’s The Big Deal?

Men don’t appreciate meager, lackadaisical-quality ejaculations and orgasms. Sex is important to many of us and getting a good quality rigid erection is foremost, but the culmination—ejaculation and orgasm—is equally vital. We may be 40 or 50 years old or older, but we still want to point and shoot like we did when we were 20. As the word origin indicates, we desire to be able to shoot out, hurl or cast like an Olympian Master Blaster and we yearn for that intensely pleasurable feeling of yesteryear.

Ejaculation Science 101

Sexual climax consists of three phases—emission, ejaculation, and orgasm. When the intensity and duration of sexual stimulation surpasses a threshold, emission occurs, in which secretions from the prostate gland, seminal vesicles, epididymis, and vas deferens are deposited into the urethra within the prostate gland. During ejaculation the pelvic floor muscles contract rhythmically, sending wave-like contractions rippling down the urethra to forcibly propel the semen in a pulsating and explosive eruption. Orgasm is the intense emotional excitement that accompanies the physical act of ejaculation.

Big Head Versus Little Head

Ejaculation is an event that takes place in the penis; orgasm occurs in the brain. The process of emission and ejaculation is actually a very complex and highly coordinated neurological event involving several specific centers in the brain (amygdala, thalamus and other areas), spinal cord and peripheral nervous system.

What’s Makes Up The Reproductive Juices?

Less than 5% of the volume of semen is actually sperm and the other 95+% is a cocktail of genital juices that provide nourishment, support and safekeeping for sperm. 70% of the volume comes from the seminal vesicles, which secrete a thick, viscous fluid and 25% from the prostate gland, which produces a milky-white fluid. A negligible amount is from the bulbo-urethral glands, which release a clear viscous fluid (pre-come) that has a lubrication function.

What’s Normal Volume?

The average ejaculate volume is 2-5 cc (one teaspoon is the equivalent of 5 cc). While a huge ejaculatory load sounds like a good thing, in reality it can cause infertility. The sperm can literally “drown” in the excessive seminal fluid.

Why Does The Seminal Tank Dry With Aging?

As we age, there are changes in the reproductive organs, particularly the prostate gland, one of the few organs in the body that enlarges as we get older. The aging prostate and seminal vesicles produce less fluid; additionally the ducts that drain the genital fluids can become blocked. In many ways, the changes in ejaculation parallel the changes in urination experienced by the aging male. Many medications that are used to treat prostate enlargement profoundly affect ejaculatory volume. Additionally, the pelvic floor muscles—which play a vital role in ejaculation—weaken with aging.

What About Those Pelvic Floor Muscles?

The pelvic floor muscles play a key role in ejaculation. The bulbocavernosus muscle (BC) is the motor of ejaculation, which supplies the “horsepower.” The BC surrounds the inner, deepest portion of the urinary channel. It is a compressor muscle that during sex engorges the spongy erection chamber that surrounds the urethra and also engorges the head of penis. At the time of climax, the BC expels semen by virtue of its strong rhythmic contractions, allowing ejaculation to occur and contributing to orgasm. A weakened BC muscle may result in semen dribbling with diminished force or trajectory, whereas a strong BC can generate powerful contractions that can forcibly ejaculate semen at the time of climax. 

How To Get The Juices Flowing Again?

Pelvic floor muscle training can be useful to improve the dynamics of ejaculation. The stronger the BC, the better the capacity for engorgement of the erection chamber that envelopes the urethra and the higher the ejaculatory horsepower, resulting in optimized urethral pressurization and ejaculation. The intensified ejaculation resulting from a robust BC can enhance the orgasm that accompanies the physical act of ejaculation.

Wishing you the best of health,

2014-04-23 20:16:29

AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in your email in box go to the following link and click on “email subscription”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Amazon Kindle, Apple iBooks, Barnes & Noble Nook, Kobo) and paperback: http://www.MalePelvicFitness.com

Co-creator of Private Gym pelvic floor muscle training program for men: www.PrivateGym.com Gym—also available on Amazon

The Private Gym is a comprehensive, interactive, follow-along exercise program that provides the resources to strengthen the pelvic floor muscles that are vital to sexual and urinary health. The program builds upon the foundational work of Dr. Arnold Kegel, who popularized exercises for women to increase pelvic muscle strength and tone. This FDA registered program is effective, safe and easy-to-use. The “Basic Training” program strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises and the “Complete Program” provides maximal opportunity for gains through its patented resistance equipment.

5 Things You Can Do To Cure Post-Void Dribbling (PVD)

March 20, 2015

Andrew Siegel MD 3/21/15

“No matter how much you shake and dance,

The last few drops end up in your pants.

PVD

PVD is “after-dribbling” of urine that is more annoying and embarrassing than serious. Although it commonly occurs after age forty, it can happen to men at any age.  Immediately or shortly after completing urination, urine that remains pooled in the urethra (tubular channel that conducts urine) drips out, aided by gravity and movement.

One specific pelvic floor muscle (PFM) is responsible for ejecting the contents of the urethra, whether it is urine after completing urination or semen at the time of sexual climax. With aging and loss of PFM strength and tone, both PVD and ejaculatory dysfunction may occur. The specific muscle responsible for ejecting the contents of the urethra is the bulbocavernosus muscle, which compresses the deep, inner portion of the urethra to function as the “urethral stripper.” In fact, the 1909 Gray’s Anatomy textbook referred to this muscle as the “ejaculator urine.”

Factoid: Dr. Grace Dorey published the landmark article in the British Journal of Urology that proved the effectiveness of PFM exercises for erectile dysfunction (ED), but also demonstrated an association between the occurrence of ED and PVD. She essentially showed that ED and PVD are linked and parallel issues, one sexual and the other urinary—both manifestations of PFM weakness, and both treatable by PFM exercises.

Factoid: Dr. Grace Dorey wrote the foreword to my book, Male Pelvic Fitness: Optimizing Sexual and Urinary Health. She also serves as a board member at Private Gym and helped design the Private Gym male pelvic floor training program for men.

What To Do About PVD?

  • PFM training has been proven to be an effective remedy for PVD, with the premise that a more powerful BC muscle will help the process of ejecting the contents of the urethra. Not only will PFM training optimize emptying the urethra, but it also has collateral benefits of improving erections and ejaculation.
  • Try not to rush urination. Urologists interpret “Haste makes waste” as “Haste makes PVD.”
  • When you are finished urinating, vigorously contract your PFMs to displace the inner urethra’s contents. By actively squeezing the PFM by using the Private Gym “rapid flex” technique—3-5 quick pulsations—the last few drops will be directed into the toilet and not your pants.
  • If necessary, PFM contractions can be supplemented with manually compressing and stripping the urethra, but this is usually unnecessary since the PFM—particularly when conditioned—are eminently capable of expelling the urethral contents. To strip the urethra, starting where the penis meets the scrotum, compress the urethra between your thumb on top of the penis and index and middle fingers on the undersurface and draw your fingers towards the penile tip, “milking” out any remaining urine.
  • Gently shake the penis until no more urine drips from the urethra. Apply a tissue to the tip of the penis to soak up any residual urine.

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

6922

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Kindle, iBooks, Nook, Kobo) and paperback: http://www.MalePelvicFitness.com

Co-creator of Private Gym pelvic floor muscle training program for menhttp://www.PrivateGym.com Gym-available on Amazon as well as Private Gym website

The Private Gym is a comprehensive, interactive, follow-along exercise program that provides the resources to strengthen the pelvic floor muscles that are vital to sexual and urinary health. The program builds upon the foundational work of Dr. Arnold Kegel, who popularized exercises for women to increase pelvic strength and tone. This FDA registered program is effective, safe and easy-to-use: The “Basic Training” program strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises and the “Complete Program” provides maximum opportunity for gains through its patented resistance equipment.

Your BFF Muscles

January 3, 2015

Andrew Siegel, MD  1/3/2015

(For those not into current slang, BFF refers to “Best Friends Forever,” describing a long-standing friendship that will go on forever.)

** Although this blog is seemingly directed towards men, au contraire. This information is equally relevant to the ladies! Remember that the clitoris is the female counterpart to the penis and it is qualitatively the same, although smaller in stature, and the pelvic muscles that support the genitals are virtually the same.

Gray1119

(Thank you Gray’s Anatomy 1918 for above image of comparative embryology of male and female genitals.)

 

> 600 Muscles, But Some You Just Can’t Live Without

There are over 600 muscles in your body and let’s face it, they are all important. However, some muscles are more critical to your survival and well being than others. It’s a no-brainer that your heart muscle is valedictorian, followed by your diaphragm. Your heart pumps blood and your diaphragm moves air, functions essential to your existence and quantity of life. Not far down from the top of the list are your pelvic floor muscles (PFM), which provide support to your pelvic organs, allow urinary and bowel control and give you the means to function sexually. Without them you are nothing other than diapered and limp.

A Brief Review of Muscles

There are three kinds of muscles: cardiac (heart), smooth (arteries, intestine, bladder, etc.) and skeletal. Skeletal muscles have numerous different functions, acting as movers, stabilizers, and compressors.

Movers (such as your biceps) act across joints, which allows you to curl your arm up. Stabilizers (such as the multifidis of the back) enable you to maintain good posture and stability. Compressors (such as the rectus abdominis, obliques and transversus abdominis) squeeze the abdominal contents. Other compression muscles act as sphincters; wrapped around the urinary and intestinal tracts, they open and close to provide valve-like control.

Your BFF

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(Thank you Gray’s Anatomy 1918 for images of male and female PFM)

Two of the PFM —the bulbocavernosus (BC) and ischiocavernosus (IC) muscles—are particularly beneficial for your sexual health. They function as movers, stabilizers and compressors. When your penis is erect, these are your friends that are responsible for lifting your penis up and down as you contract and relax them. They stabilize the erect penis so that it stays rigid and skyward-angling with excellent “posture.” They compress the deep roots of the penis, responsible for the transformation of the penis from plump to rigid and maintaining that rigidity; additionally, they compress the urethra (urinary channel that runs through the penis) rhythmically at the time of ejaculation.

The BC surrounds the inner, deeper portion of the urethra. I refer to it as the ejaculator. In its relaxed state, it acts as an internal strut that helps anchor the deepest, internal aspect of the penis. When the muscle is contracted actively after urination, it compresses the urethra to expel (ejaculate) the last few drops of urine that sit in the deep urethra. During sex, it helps support the spongy erectile body that surrounds the urethra and the head of penis. At the time of climax, it is responsible for the expulsion of semen (ejaculation) by virtue of its strong rhythmic contractions.

The IC surrounds the inner, deeper portion of the erectile bodies, so I refer to it as the erector. In its relaxed state, it acts as an internal strut that helps anchor the deepest aspect of the erectile bodies to the pelvic bones. The IC stabilizes the erect penis and compresses the erectile bodies, decreasing the return of blood to foster penile blood pressures in the severe hypertensive range that allow the penis to have bone-like penile rigidity. At the time of climax, it contracts rhythmically and is responsible for maximal erectile rigidity at the time of ejaculation.

How to Turn Your Best Friends Into Super-Compressors

Use It Or Lose It. Keep your BC and IC muscles in shape by using them the way nature intended. Studies have clearly demonstrated that men who are more sexually active tend to have fewer problems with ED as they age.

Exercise Your BFF Muscles. The BC and IC muscles play a vital role with regards to both erections and ejaculation. Numerous studies have documented the benefits of pelvic exercises in the management of erectile dysfunction. But why wait for dysfunction to set in? Since sexual function inevitably declines with aging, whip your pelvic muscles into shape to help maintain your function. Take it even one step further: work out your pelvic muscles to achieve optimal function. As your pelvic floor muscles increase in strength, tone, and endurance, erections and ejaculation will improve accordingly. The pelvic muscles—like other muscles in your body—will gradually and progressively adapt to the load placed upon them and will strengthen in accordance with the resistance applied.

Bottom Line: If the core muscles are the “powerhouse” of the body, the pelvic floor muscles (floor of the core) are the “powerhouse” of the penis.  To maintain optimal “horsepower,” keep your pelvic floor muscles fit and toned. 

 

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

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A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Kindle, iBooks, Nook, Kobo) and paperback: http://www.MalePelvicFitness.com

Co-creator of Private Gym pelvic floor muscle training program for menhttp://www.PrivateGym.com Gym-available on Amazon as well as Private Gym website

The Private Gym is a comprehensive, interactive, follow-along exercise program that provides the resources to strengthen the pelvic floor muscles that are vital to sexual and urinary health. The program builds upon the foundational work of Dr. Arnold Kegel, who popularized exercises for women to increase pelvic strength and tone. This FDA registered program is effective, safe and easy-to-use: The “Basic Training” program strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises and the “Complete Program” provides maximum opportunity for gains through its patented resistance equipment.