Posts Tagged ‘limp’

Eating Yourself Limp

January 2, 2016

Andrew Siegel MD   1/2/16


Today’s entry is on the topic of how overeating and obesity affect one’s manhood and vitality (this holds true for female sexual function as well).  While optimal sexual function is based on many factors, it is important to recognize that our food choices play a definite role. What we eat—or don’t eat—impacts our sex lives.  It’s a new  year– a fresh start–and time for many resolutions, which often involve weight loss and a healthier lifestyle.  Yet another benefit of becoming leaner and fitter is improved sexual function. 

Sexuality is an important part of our human existence. Healthy sexual function involves a good libido, the ability to obtain and maintain a rigid erection and the ability to ejaculate and experience a climax. Although not a necessity for a healthy life, diminished sexual function can result in loss of self-esteem, embarrassment, a sense of isolation and frustration and even depression.

Sexual functioning is complicated and dependent upon a number of systems working in tandem– the endocrine system (which produces hormones); the central and peripheral nervous systems (which provide nerve control); the vascular system (which conducts blood flow); and the musculo-skeletal system (specifically the pelvic floor muscles that help maintain the high blood pressures in the penis necessary for erectile rigidity).

Sexual function is a good indicator of underlying cardiovascular health. A healthy sexual response is largely about blood flow to the genital and pelvic area. The penis is a marvel of engineering, uniquely capable of increasing its blood flow by a factor of 40-50 times over baseline, this surge happening within seconds and responsible for the remarkable physical transition from flaccid to erect. This is accomplished by relaxation of the smooth muscle within the penile arteries and erectile tissues. Pelvic muscle engagement and contraction help prevent the exit of blood from the penis, enhancing penile rigidity and creating penile blood pressures that far exceed normal blood pressure in arteries. For good reason, Gray’s Anatomy textbook over 100 years ago referred to one of the key pelvic floor muscle as the “erector penis.”

Blood flow to the penis is analogous to air pressure within a tire: if there is insufficient pressure, the tire will not properly inflate and will function sub-optimally; at the extreme the tire may be completely flat. Furthermore, slow leaks (that often occur with aging and failure of the smooth muscle within the penile arteries and erectile tissues to relax) promote poor function.

Just as your car suffers a decline in performance if it is dragging around too much of a load, so you penis will function sub-optimally if you are carrying excessive weight. Obesity steals your manhood and reduces male hormone levels. Abdominal fat converts the male hormone testosterone to the female hormone estrogen. Obese men are more likely to have fatty plaque deposits that clog blood vessels–including the arteries to the penis–making it more difficult to obtain and maintain good-quality erections. Additionally, as your belly gets bigger, your penis appears smaller, lost in the protuberant roundness of your large midriff and the abundant pubic fat pad.

Remember the days when you could achieve a rock-hard erection—majestically pointing upwards—simply by seeing an attractive woman or thinking some vague sexual thought? Chances were that you were young, active, and had an abdomen that somewhat resembled a six-pack. Perhaps now it takes a great deal of physical stimulation to achieve an erection that is barely firm enough to be able to penetrate. Maybe penetration is more of a “shove” than a ready, noble, and natural access. Maybe you need pharmacological assistance to make it possible.

If this is the case, it is probable that you are carrying extra pounds, have a soft belly, and are not physically active. When you’re soft in the middle, you will probably be soft where it counts.  A flaccid penis is entirely consistent with a flaccid body and a hard penis is congruous with a hard body. If your is penis difficult to find, if you have noticed man-boob development, and your libido and erections are not up to par, it may be time to rethink your lifestyle habits.

Healthy lifestyle choices are of paramount importance towards achieving an optimal quality and quantity of life. It should come as no surprise that the initial approach to managing sexual issues is to improve lifestyle choices. These include proper eating habits, maintaining a healthy weight, engaging in exercise, adequate sleep, alcohol in moderation, avoiding tobacco and minimizing stress.

Eating properly is incredibly important, obviously in conjunction with other smart lifestyle choices. Maintaining a healthy weight and fueling up with wholesome and natural and real foods will help prevent weight gain and the build-up of harmful plaque deposits within blood vessels. Healthy fuel includes vegetables, fruits, legumes, nuts, whole grains and fish. Animal products—including lean meats and dairy—should be eaten in moderation. The Mediterranean-style diet is an excellent one for minimizing both sexual dysfunction and heart disease. Poor dietary choices with meals full of calorie-laden, nutritionally-empty selections (e.g., fast food, processed foods, excessive sugars or refined anything), puts one on the fast tract to obesity and clogged arteries that can make your sexual function as small as your belly is big.

Bottom Line: If you want a “sexier” lifestyle, start with a “sexier” style of eating that will improve your overall health and make you feel better, look better and enhance your sexual function.  Smart nutritional choices are a key component of sexual fitness. If you are carrying the burden of too many pounds, now is the perfect time to start on the pathway towards better health and reversing the sexual dysfunction that has been brought on by poor lifestyle choices. 

Wishing you a healthy, peaceful, happy (and sexy) 2016,

2014-04-23 20:16:29

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”:

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

Author of Promiscuous Eating: Ending Our Self-Destructive Relationship With Food:

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: or Amazon.


You Can’t Think It Up, But You Can Think It Down

November 21, 2015

Andrew Siegel MD   11/21/15


(Above fortune from Chinese fortune cookie relevant to this discussion.)

Q: What is the most powerful sex organ?

A: If you think it is the erect and throbbing penis, you are incorrect. The BRAIN is the bossman and the most influential force driving sexuality. The penis is a mere buck private soldier that responds and bends to the will of the five-star general and commander-in-chief of sexuality, the central nervous system.

Despite the authority and assertive presence of the brain, it is only under rare circumstances that it is capable of willing the limp penis to become erect. Some form of touch or erotic stimulation is most often necessary to get the erection process going, with the exception of nighttime-related erections associated with a phase of sleep known as REM (Rapid Eye Movement).

If the central nervous system cannot will the limp penis to become erect, it certainly can will the erect penis to become limp or will the limp penis to remain limp. This is the case with performance anxiety, a classic instance of the powerful mind-body connection. In this circumstance, stress or anxiety causes the output of high levels of adrenaline, which functions to constrict penile blood flow and erectile smooth muscle relaxation, resulting in a limp penis.

The central nervous system is the commander-in-chief of sexuality, but it demands working the way it likes to work, i.e., naturally, unhindered and unburdened by cognitive thought. Conscious and willful thought clearly can interfere with the smooth function of the central nervous system. When conscious thought enters the picture, the ability to perform many complex movements goes south. Much the same as a golf swing or any action like using a fork to feed yourself or walking down a flight of stairs, when it comes to sexuality, the brain works best when it is working subconsciously. Overthinking is the enemy of any complex motor activity. With all of these examples, one needs to be in the moment and engaged in the activity without conscious thought, in order to enable a smooth execution.

The moment one starts overthinking, the complex motion is virtually destined to be flawed. The golf swing is a classic example, with a poor shot almost guaranteed if one has too many swing thoughts that confound execution and performance. For the non-golfers, try walking down a flght of stairs at a good clip, stating to yourself in your inner voice each step in the process and you will likely trip up. When you are in a sexual situation, if you focus on thinking about your sexual function or lack thereof or reliving a previous problem, then your performance will most often be doomed to failure.


(Thank you, Pixabay for image above)

Too much thought is capable of empowering self-fulfilling prophecies and bringing them to fruition. If one has had erection issues and in a passionate moment starts thinking, assessing, evaluating and analyzing, he is almost certain to be incapable of obtaining or maintaining an erection. Likewise, if one suffers with premature ejaculation and his thought pattern becomes obsessively focused on this possibility instead of being in the moment and enjoying the situation, he is almost certain to ejaculate way sooner than desired. The same is true with the rarer but equally disturbing problem of delayed ejaculation. Focusing on trying to make oneself ejaculate will most often bring on the inability to ejaculate.

Masters and Johnson coined the term spectatoring, an intense self-focus during sexual interactions as opposed to immersing oneself in the sensory aspects of the sexual experience. Essentially, spectatoring is observing and monitoring yourself having sex as if you were a third party, often accompanied by an anxious internal, self-conscious dialogue with concerns about some aspect of your sexual performance. It is being a spectator instead of the player and it will DESTROY your game.

The solution to spectatoring is to “be present” and “in the moment,” totally immersing yourself in the experience without observation or conscious internal thoughts. When you lose yourself in the sensations and do not allow thoughts to interfere with the process, you maximize your chances for an optimal performance. When distracting thoughts uncontrollably float into the present like dark clouds in the sky, take a deep breath, exhale slowly and allow the thoughts to pass and return to a state of being present.

Bottom Line: Overthinking is the enemy of complex actions, including erections and ejaculation. Allow the central nervous system to do what it does so well– subconsciously– without trying to help things along with deliberate thought.  Let instinct prevail over conscious thought–you cannot make it happen, you have to let it happen. There is an  time and place for conscious thought, but it is not in the heat of the moment in the bedroom.  Be present without thought of the past or future. 

Wishing you the best of health,

2014-04-23 20:16:29

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”:

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

Limping Along

November 14, 2015

Andrew Siegel MD   11/14/15


(Above image courtesy of: staff. “Blausen gallery 2014“. Wikiversity Journal of MedicineDOI:10.15347/wjm/2014.010ISSN 20018762.)

This  entry is intended to be unisex, since both genders are equally susceptibility to clogged arteries and impaired blood flow to muscles and other vital organs (a.k.a., ischemia).  Although sexual dysfunction resulting from compromised pelvic blood flow is outwardly more obvious in the male with the inability to achieve an erection or difficulty in obtaining or maintaining an erection, females as well can suffer with sexual consequences to a similar degree with impaired arousal, lubrication and climax.

Male sexual response is so evident, conspicuous and literally palpable, a binary system with a digital “one” or “zero” response, whereas female sexuality is to all appearances so much less obvious and so much more subtle and nuanced. However, this framing of human sexual response is off target as the female sexual response results in genital anatomical changes as profound as those that occur in males, just less apparent. Under normal circumstances, the vagina is no more “primed” for sex than is a flaccid penis, the un-stimulated vagina being merely a potential space with the vaginal roof and floor in direct contact. However, when stimulated, the vaginal walls lubricate and the vagina expands, lengthens and widens in order to accommodate an erect penis, changes that are as dramatic as the transition of a flaccid penis to an erect penis.  

Because the primary driver of the human sexual response is BLOOD FLOW, females can be as susceptible as males to compromised circulation and can “limp” in the bedroom just as much as males can. It’s just not as ovvious and apparent. Furthermore, both genders are susceptible to limping in the street. 

In terms of ambulation, many people limp instead of walk because of peripheral arterial disease (PAD), a medical condition in which the arteries in the legs clog due to a buildup of fatty plaque. This impairs blood flow and the delivery of oxygen and nutrients to muscles and other tissues, giving rise to pain when exercise increases the muscle’s demand for oxygen.

PAD commonly occurs on the basis of poor lifestyle–obesity, diabetes, an unhealthy diet, a sedentary existence and often the use of tobacco. When muscles are denied the increased blood flow required with the demands of movements such as walking or exercisizing, pain and limping result, known as claudication, from the Latin “claudeo,” meaning “to limp.”

Claudication often does not demonstrate itself until there is significant blockage–usually about a 70% restriction– to arterial flow. It occurs because of insufficient oxygen to the leg muscles causing the buildup of lactic acid, which causes discomfort and pain. Claudication typically responds to stopping movement, which resolves the pain.

Claudication is by no means limited to the leg muscles, but can happen to any muscle in the body. “Claudication” of the heart muscle—which occurs when the coronary arteries are compromised—is known as angina. “Claudication” of the brain—which occurs when the carotid arteries are compromised—can give rise to mini-strokes or transient ischemic attacks (TIA). “Claudication” of the penis—which occurs when the penile arteries are clogged with years of accumulation of fatty plaque—is known as erectile dysfunction (ED), a.k.a., when the penis limps along.

Sexual dysfunction in either gender can be a warning sign that an underlying medical problem exists, the quality of sexual response serving as a barometer of cardiovascular health. When it comes to men, the presence of rigid and durable erections is an indicator of overall cardiovascular health, and conversely, the presence of ED can be a clue to poor cardiovascular health. For this reason, men with ED should consider undergoing a basic medical evaluation seeking arterial disease elsewhere in the body (heart, brain, aorta, and peripheral blood vessels). Since the penile arteries are generally rather small—1 to 2 millimeters in diameter—and the coronary (heart) arteries are about 4 millimeters in diameter, it stands to reason that if vascular disease is affecting the tiny penile arteries, it may well be soon affecting the larger coronary arteries as well. The presence or absence of erections may thus be considered a genital “stress test.”  The same applies to females who are limping in the bedroom.

The presence of ED is as much of a predictor of cardiovascular disease as is a strong family history of cardiac problems, tobacco smoking, or elevated cholesterol. The British cardiologist Graham Jackson expanded the meaning of the initials ED to: Endothelial Dysfunction (endothelial cells being the type of cells that line the insides of arteries); Early Detection (of cardiovascular disease); and Early Death (if missed).

Bottom Line: Heart-healthy and blood vessel-healthy is sexual-healthy (and vice versa). If you do not care to limp when you walk or be limp in the bedroom, commit to a healthy lifestyle. Minimizing the buildup of fatty arterial plaque will prevent claudication everywhere in the body. To do so requires weight management, healthy eating, regular exercise, avoiding tobacco, etc. And if you are already limping (whether it is on the sidewalk or the bedroom), a lifestyle “angioplasty”—cleaning up your unhealthy lifestyle habits—can help reverse the problem.  This applies equally to both men and women. 

Wishing you the best of health,

2014-04-23 20:16:29

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”:

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

The Many Moods Of The Penis

August 25, 2015

Andrew Siegel, MD  8/25/15

There was a terchnical problem with the previous uploading of this blog, so I apologize if you have already received it.

phases of moon

(Thank you and credit for image above, which is in original form, created by Rafa Castillo;

The penis is a very moody organ–it can be temperamental, volatile, excitable, up and down, unpredictable and hot-headed at times.  Like the moon, it has many phases of existence, with a multitude of different states, ranging from soft as a marshmallow to hard as a rock. Between deflated and rigid, there are an infinite number of intermediate states, dependent on the dynamic balance between the constricting and relaxing mechanisms of the blood flow to the erectile chambers of the penis.  Human sexual response is all about “vasocongestion” a.k.a., blood flow.

When the mechanisms that regulate inflow and outflow are not functioning properly, problems may occur, ranging from absent erections to poor erections to satisfactory erections that do not last, to prolonged erections that do not quit (priapism).

The penis is a marvel of human hydraulic engineering with four recognizable “phases”:

  • Flaccid phase—On a scale of 0-100% inflated, this is 0-10%. The penis is lackluster and droopy, with enough blood flow to maintain tissue oxygenation and nutritional and metabolic demands. Since the penis is an organ of both sexual and urinary function, thankfully the flaccid state still allows its owner to enjoy the advantage of standing to urinate.

ad-70507_1280Did you know? The flaccid penis is incapable of penetration, but is fully capable of being stimulated to ejaculation and orgasm.

  • Tumescent phase—On a scale of 0-100% inflated, this is 10%-75%. The penis is softly swollen and engorged, but not stiff. It is in the process of being inflated, gradually filling and plumping as blood is pumped into and trapped within the erectile chambers. Like a New Year’s Eve party blowout, the toy that when blown unfurls and extends outwards, so does the tumescent penis as it becomes inspired and shows some spirit, lifting somewhat from its dangling position.
  • Penetration capable phaseOn a scale of 0-100% inflated, this is about 75%-80% or so. The penis has become firmer, but not rigid and is competent to penetrate, although it may require some manipulation to do so. It is animated and peppy and starts to elevate a bit more.
  • Rigid phaseOn a scale of 0-100% inflated, this is 90%-100%. The penis is as stiff as if it had a bone within. The rock-hard penis makes penetration effortless. The energetic, eager and confident penis now defies gravity, proudly pointing towards the horizon, if not the heavens, when its owner assumes the standing position.


Factors That Lead to Penile Inflation

  • Sensual erotic excitement: sight of a beautiful woman; scent of perfume; sexy whisper; taste of a kiss; soft touch
  • Genital touch: direct stimulation
  • Brain induced erotic stimulation: thoughts, memories, fantasies
  • Dreaming: unique brainstem mediated mechanism that occur during REM (rapid eye movement) phase sleep
  • Spontaneous: occurs for a combination of factors or unknown factors
  • Reflex: full bladder
  • Warm environment: hot bath or shower
  • Gravity: standing upright as opposed to lying down (similar to veins in your arm popping out when arm is lower than heart).

Factors That Lead to Penile Deflation

  • Absence of sexual stimulation
  • Medical issues that interfere with hormones, arterial inflow, venous outflow, nerve supply to penis, smooth muscle in erectile chambers, pelvic floor muscles
  • Medications that interfere directly with blood flow or act centrally on the brain
  • Adrenaline-fueled constriction of penile blood vessels: stress hormone released by fear, anxiety, fighting, fleeing, performance anxiety, etc.
  • Cold exposure (cold shower, bath, swimming, etc.–remember George from the “shrinkage” Seinfeld episode?)
  • Exercise: creates a “steal” of blood flow to large muscles that demand it and away from “unessential” organs
  • Cycling: blood vessels, nerves and pelvic muscles take a beating from compression “trauma”

Hard Science

Note: The following is a brief summary of the science of erections, which may be TMI for many, but will help you understand penis magic.

A limp penis is the state when the arteries and smooth muscle within the erectile chambers are in a constricted state. Penile swelling occurs when stimulation results in increased arterial inflow and relaxation of erectile smooth muscle, permitting filling and expansion of the erectile chambers. The magic chemical that governs this is nitric oxide, present within penile nerves and penile blood vessels. Nitric oxide is what makes it all happen.

 Did you know? Nitric oxide is manufactured from arginine, which is why some feel that arginine supplements may be good for the erectile process; however, the jury is not out on this.

With stimulation, nitric oxide is activated and gets into the smooth muscle cells of the penile arteries and erectile smooth muscle of the erectile chambers where it activates GMP (guanosine monophosphate), which causes the smooth muscle to relax and blood to pour in. This smooth muscle relaxation results in penile blood pressure becoming equal with systolic blood pressure and an engorged penis, plump but not rigid.

Once engorgement occurs, rigidity will follow after the pelvic floor muscles engage. There is no bone in the human penis as there is in many mammals, so nature has evolved a clever trick to generate rigidity using highly pressurized blood.

 Is nature brilliant? Pressurize a liquid to obtain almost a solid state. It’s like freezing water to turn it into ice!

To achieve maximal penile rigidity, penile blood pressure must exceed systolic pressure (the top number of your blood pressure) by 100 millimeters of mercury. This means a penile blood pressure above 220 must be achieved for the average man!

 Did you know? The penis is the only place in the body where high blood pressure is desirable and necessary for proper function. A hypertensive penis is an erect penis and a happy penis. This explains why blood pressure pills are the most common medications associated with erection difficulties.

How does one achieve a hypertensive penis? This is where the “rigidity” muscles come into play. In response to penile stimulation, the pelvic floor muscles (ischiocavernosus and bulbocavernosus) that surround the deep roots of the penis contract rhythmically, clamping venous outflow and compressing the deep roots of the penis, pushing more blood into the erect penis, resulting in penile high blood pressure and full-fledged rigidity. Without the rigidity muscles, the penis would be plump at best.

Did you know?  Would you like to see your rigidity muscles in action?  Stand upright when you have an erection and contract your pelvic floor muscles and watch the penis lift up towards the sky…penis magic! 

After ejaculation, an enzyme known as PDE5 (phosphodiesterase type 5) inactivates the GMP, ending the party, as rigidity dwindles to tumescence to flaccidity. Viagra, Cialis, Levitra and Stendra are PDE5 inhibitors that prevent the inactivation of GMP.

Wishing you the best of health,

2014-04-23 20:16:29

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”:

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: Available in e-book (Kindle, iBooks, Nook, Kobo) and paperback:  In the works is The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health.

Co-founder 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: or available on Amazon