Author Topic: My Theory  (Read 41836 times)

Chris

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Re: My Theory
« Reply #60 on: August 27, 2013, 04:00:11 PM »
Kstat,
Your situation may be different.  Of course, since women lack a frank ejaculatory reflex it may be difficult to discern if you're having a physical orgasm without the pleasurable sensation.  Some women do have muscular contractions involving vaginal and perineal muscles, so it is possible, just not as clear cut as with men.  So, you could have the female equivalent of EA.  It certainly sounds like it from the early childhood chronology.  I'm always intrigued by the number of people who report its onset so early in adolescence. 
I'm not sure what's next for me.  I continue to think about my theory and refine it, and I always consider alternative explanations.  I was reading on some men's sexual health forum the other day stories of young men who lost orgasmic sensation after certain "exercises" involving excessive penile pressure.  I thought that was interesting.  Perhaps it can be iatrogenic?  Perhaps I did something in my early life that I can't remember that damaged/compressed the dorsal nerve of the penis?  Memories are so faint, I just can't recall.
I keep on coming back to the fact that, for me, the EA started at the onset of what was supposed to be orgasm.  This supports the notion that the physical orgasm itself (i.e. muscle contractions) damaged the nerve...strange idea...how can the nerve be irrevocably damaged from one brief compressive event??  or is it cumulative compressive events?? but maybe it's not the anatomy, but rather a defect in the way nerve fibers are "protected" by layers of connective and fatty tissue.  Maybe we're susceptible to compressions of all sorts.  The dorsal nerve of the penis is just a very unusual nerve in that it's susceptible to extreme pressures in an erectile organ repetitively with each sexual act.  I still feel somewhat unsatisfied with the theory.  I feel I'm missing something.  In any event, I highly doubt it's fixable at this point....

lostmojo

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Re: My Theory
« Reply #61 on: August 28, 2013, 05:30:33 AM »
I was reading on some men's sexual health forum the other day stories of young men who lost orgasmic sensation after certain "exercises" involving excessive penile pressure.  I thought that was interesting.  Perhaps it can be iatrogenic?  Perhaps I did something in my early life that I can't remember that damaged/compressed the dorsal nerve of the penis?

In my teen years I often masturbated in the prone position and was not very gentle in doing it either. How does this fit in with this theory? Could this possibly damage the dorsal nerve?

Yanni

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Re: My Theory
« Reply #62 on: August 29, 2013, 07:13:31 AM »
I'm becoming more confident that my issue is caused by pain signals preferentially blocking pleasure signal pathways rather than nerve damage.  The difficulty is that I don't know of an analgesic that doesn't also block pleasure pathways.  It is interesting that one of the posters mentions chronic back pain at an early age and I wonder if that is also the mechanism of his EA:  pain overwhelming the nerve pathways to the exclusion of pleasure.

This doesn't readily explain my perception of poor orgasmic pleasure before the onset of chronic pain, although my history has been one of constant fear and anxiety which means potentially continual energisation of danger signals (adrenaline?), which presumably would also trump pleasure.  Once again, how would one decrease anxiety without also decreasing the pleasure pathways?

I also experience something odd when taking codeine:  as I understand it, the codeine gets converted in the body into morphine and should give a high, however I just experience relief of pain symptoms and a floating feeling but nothing that I would consider a high.  Perhaps when one experiences chronic pain, the natural endorphins produced over a long time period desensitise the brain to the euphoric release of chemicals normally produced during orgasm.

I recently experienced something unusual for me whilst my penis was being stimulated:  normally if my penis is stimulated too vigorously or for too long, I experience discomfort bordering on pain that is like a milder form of post-ejaculatory sensitivity;  on this occasion when the stimulation was for too long and generating discomfort, I tried to endure it and after a while I felt the buildup to ejaculation, but it was much slower than usual and eventually I went over the edge and actually felt something that was closer to an orgasmic feeling.  It was as if the orgasm was determined to overwhelm the pain block this time but was barely succeeding.  I can't say that it was particularly pleasurable as it was competing with the pain, but it was certainly more than I have experienced for some time and has renewed hope that the orgasmic potential exists but is being impeded by other factors that the body takes more notice of because it represents danger and danger trumps pleasure.

The other thing I will say is that for those of us who may have never experienced a proper orgasm, we have no baseline against which to measure our experiences.  Speaking for myself, I'm not sure what an orgasm is supposed to feel like, but I gather it is primarily a brain thing with additional sensations from muscle contractions.  It is strange that the medical profession does not have a comparative chart of orgasmic experience.  This is similar to their approach to pain:  it infuriates me when a Doctor asks me to rate pain on a scale of 1-10 without providing some objective measure of what a 10 is supposed to be (like, think of the worst pain you have experienced before as a 10 and what would that be?).
« Last Edit: August 29, 2013, 07:17:19 AM by Yanni »

Kstat

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Re: My Theory
« Reply #63 on: August 29, 2013, 02:07:26 PM »
Yanni, what kinds of pain symptoms do you have? Is it localized to the genitals? I'm thinking pain in that area may likely be a symptom of some kind of damage to the tissue/nerves. I'm assuming by "chronic pain" you mean in other parts of your body as well, so could you please clarify?

Yanni

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Re: My Theory
« Reply #64 on: August 29, 2013, 09:42:40 PM »
Yanni, what kinds of pain symptoms do you have? Is it localized to the genitals? I'm thinking pain in that area may likely be a symptom of some kind of damage to the tissue/nerves. I'm assuming by "chronic pain" you mean in other parts of your body as well, so could you please clarify?

My chronic pain is mainly in the muscles down my back and across the shoulders, but sometimes extends to arm/leg muscles:  it's like having a variable version of flu constantly but without the respiratory or congestion symptoms.  I believe it is an offshoot of the chronic fatigue I experience.

I get a mild tearing pain when the penile shaft/foreskin is stretched even slightly, despite the skin itself not being taught;  yet I do not get the pain through erection.  It seems as though sexual excitement somehow changes the perception of pain or which nerves become more sensitive and which become dulled.

If the penis is stimulated too vigorously, I get a milder form of post-ejaculatory sensitivity pain (the type that makes you cringe away from it when the penis is stimulated immediately after ejaculation).

The chronic pain is more deep muscle, whilst the genital pain (when it occurs) feels more surface.

Kstat

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Re: My Theory
« Reply #65 on: September 01, 2013, 11:29:04 AM »
This is a selfish question, but do you think it's fixable for me? I know it's hard to discern this from posts online, but I've had this for 7 years if that helps. I'll probably take what you say with a grain of salt because I don't like to give up easily, but I'd still like to get your opinion since as a doctor you have quite a bit of knowledge about human anatomy.

Chris

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Re: My Theory
« Reply #66 on: September 02, 2013, 05:03:33 PM »
Kstat,
Seven years is a long time.  What impresses me most about my own course and alot of the forum's members is how the syndrome is so unforgiving.  The course is not stuttering, it does not wax and wane, there has never been a hint of return.  It's almost like a bad stroke:  one bad hit and loss of function FOREVER.  So, historically speaking, if it has not returned in 7 years, it's not likely to return in 8 or 10 or 20.  I am 30 years on and counting.
This natural history is odd to me...I would not expect a compressive neuropathy to behave this way.  The most common compressive neuropathies stutter for months to years before causing permanent neurologic damage.  So, perhaps EA is a compressive neuropathy of a different flavor and I am still studying various possibilities.
I am sorry I am not hopeful for your case.  If my theory is correct, the sufferers with the most chance of return of function would be the early birds (< 1 year) who seek and get corrective surgery in a hasty manner.  Problem is this syndrome starts so young:  I surely wasn't thinking through my options when I was 13 years old!
Chris


 

andrew_b

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Re: My Theory
« Reply #67 on: September 04, 2013, 09:06:00 AM »
But if the nerves are being compressed by chronically tight muscles this must surely be reversible. I have seriously tight muscles in a number of areas one of which being the gluteals and surrounding area and I'm sure these could be impacting on the penile nerves. I had a good deep tissue massage yesterday and she did a bit of work on my glute muscles and this morning in the shower I felt some good sensations on the area served by the dorsal nerve, so much so that if I'd had time I think the shower spray would have resulted in ejaculation, it was that strong. The guy who cured himself with foam rolling had the same issues going on so I really think all is not lost Chris. I've had this for 7 years like kstat and I'm still very optimistic that its curable. We really appreciate your medical insights by the way Chris.

TriumphForks

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Re: My Theory
« Reply #68 on: September 05, 2013, 11:47:31 AM »
I still feel that theories involving nerve compression/damage don't hold water. Personally, I've had an MRI scan and a few nerve conduction tests and everything turned out to be normal. In addition, the presence of normal ejaculation and contraction indicate that the problem does not lie in the penis.
The penis is not the only erogenous zone on the body, yet sufferers often say that they have lost *all* erotic feeling in the body.
So my conclusions come to this probably being a problem with receptors in the brain, as opposed to transmitters in the genitals.

Chris

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Re: My Theory
« Reply #69 on: September 05, 2013, 03:16:23 PM »
The presence of normal ejaculation and penile contractions does not rule out a peripheral neuropathy.  The final branch of the pudendal nerve (dorsale nerve of penis/clitoris) is a 100% sensory nerve fiber.  It does not carry any motor or autonomic fibers.  So, compression of this part of the nerve would have NO impact on ejaculatory mechanics.

I am beginning to think that the the so called term "ejaculatory anhedonia" and our general obsession with orgasm in particular has distracted both myself and others on this forum from the fact that the OVERALL sensory experience (whether it be to touch, electrical stimulation or erogenous pleasure during the entire sexual response cycle) is greatly impaired in this syndrome.  It is not just a disease of orgasm or ejaculation!  The fact that sensations drop off even more during orgasm in particular I now believe to be simply a sign of a very damaged nerve that is simply choked by the normal contractions that occur in the pelvic floor muscles.  Normal, healthy men also contract these muscles involuntarily and experience sexual pleasure just fine.  We are somehow different.

MRI scans and nerve conduction studies may be useful, but the person interpreting them must know exactly what to look for and where.  Moreso, routine MRI protocols aren't designed to resolved fine structures like the pudendal nerve, and must be specifically protocoled as a MR neurogram if you want to have a chance of seeing any pathology.

I am now more focused on external events that could have damaged our pudendal nerves (or the final branch, dorsal nerve of the penis).  I am recalling more memories from my early adolescence that is pertinent.  I have memories of a heavy, dull ache in the scrotum, penis, and perineum in general following mastubatory episodes.  I also recollect that sitting down made it worse, and standing better.  I also recollect at least one instance in my early twenties of severe scrotal pain that was confused with epididymitis that followed a LONG CAR RIDE.  To this day, I don't like sitting for long periods of time, and often change position, not because of intolerable pain, but just MILD discomfort, and perhaps partly a subconcious reflex I have acquired since adolesence. 

Ask yourself this question:  did you ride a bicycle alot during your childhood/adolescence or any period of time leading up to your acquisition of EA?  Did you sit alot on hard surfaces?  Did you suffer extreme pressure in your perineum for any reason(s)? 

Perhaps the reason EA comes on and never seems to remit is that there is ISCHEMIC (i.e. no blood flow) damage to nerve fibers from severe external compressive events.  This sort of injury is often irreversible or very slow to recover (much like a bad stroke).  Once the nerve is inflamed from compression, pain would likely be an early feature, but maybe not a late feature.  The late feature may be simply genital anesthesia or so called EA.    Food for thought.



andrew_b

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Re: My Theory
« Reply #70 on: September 07, 2013, 02:13:32 PM »
Great insights Chris. The only trauma I suffered prior to the onset of my symptoms was a massive emotional one which seemed to lead to my endocrine system going into melt down. I got hot flushes, weight loss, fatigue, loss of social skills, depression etc plus the sexual dysfunction. Which makes me think for me at least, there's a clear hormonal etiology evident perhaps a bit like low grade chronic fatigue syndrome. The chain of events being something like:  emotional insult leads to loss of energy, body enters survival mode and shuts down non essential services which in turn leads to weak tense muscles, libido and stamina loss etc. Alan cured himself with a supplement and nutrition regime and searchingforacure (I think) has been cured with the stimulant focalin, then there's those who've benefited from cannabis so there's definitely some aspect to this syndrome that's more than just peripheral neuropathy. There would seem to be some endocrine system involvement too. Certainly for me there are good days and bad days and I'm at last starting to see a trend towards more good days than bad so I remain optimistic.

IwantMyMojoBack

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Re: My Theory
« Reply #71 on: September 08, 2013, 12:51:06 PM »
I've spent decades looking for a cure and I've tried hundreds of different things, some at great cost.
The only scientific article that I have ever found that details a cure for ejaculatory anhedonia is Journal of Sex and Marital Therapy Volume 20, Vol 1 Spring 1994 by Philip A Garippa. I know that this probably won't go down well, but the treatment was psycholgical/ integrative therapy based. I have a pdf copy of it, if there is any way of distributing it? 

NoFun

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Re: My Theory
« Reply #72 on: September 08, 2013, 09:45:43 PM »
The presence of normal ejaculation and penile contractions does not rule out a peripheral neuropathy.  The final branch of the pudendal nerve (dorsale nerve of penis/clitoris) is a 100% sensory nerve fiber.  It does not carry any motor or autonomic fibers.  So, compression of this part of the nerve would have NO impact on ejaculatory mechanics.
...
I am beginning to think that the the so called term "ejaculatory anhedonia" and our general obsession with orgasm in particular has distracted both myself and others on this forum from the fact that the OVERALL sensory experience (whether it be to touch, electrical stimulation or erogenous pleasure during the entire sexual response cycle) is greatly impaired in this syndrome.

I like the theory in terms of a generalized inability to feel sensory pleasure, particularly in the penis.  I know that many of us have talked about penis stimulation being no more stimulating than rubbing your elbow. The level of pleasure from stroking definitely varies at different times, with it often being little more than stroking my elbow. Sometimes less.

Nerve compression would be one possible cause, but I don't think in my case.

I've had nerve conduction tests done by urologists. They detected no anomalies in both the left and right dorsal nerve. But it could be that it's the various vibration sensors and not nerve conduction that is the problem.

Yanni

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Re: My Theory
« Reply #73 on: September 10, 2013, 09:07:39 PM »
The most orgasmic pleasure I can remember is during a wet dream when I was about 19yo:  nothing before or since has compared.

I'm intrigued by this, since I believe there is no physical nerve stimulation:  it's all done in the brain.  In fact, I have always understood that an orgasm was principally a brain thing, primarily triggered by physical stimuli but augmented by imagination and other stimuli.  That being the case, I have hope that a way can be found to trigger an orgasm without the involvement of potentially compromised nerves.

I remember when I was younger, bringing myself someway towards the point of ejaculation by imagining genital stimulation and the feelings that produced, but without any physical stimulation.  I'm sure an orgasm could be achieved by this method, although I found it hard work to imagine the sensations sufficiently to exceed the threshold.

A group of men found their way to heightened pleasure by experimenting with prostate massage.  It seems that they can re-train their brain to experience the stimulation of the prostate as an orgasmic-type trigger.  They recommend no penile stimulation involvement during this training process.  Pre-requisites to progress include relaxation and fantasization/imagination, augmented by pleasure vocalisation and other aural material.  An interesting element of this technique is that ejaculation does not happen and the men can experience multiple serial whole-body orgasms.  I have not been able to get this technique to work for me, possibly because my nerves are compromised (by constant pain) which interferes with the process of orgasmic threshold excess.

I have heard of spinal injury cases that have lost sensation below the waist and thus orgasmic potential, finding that other parts of their bodies take over the stimulation sensory role and permit them to experience an orgasm.

The reason I mention the above is that there are other ways of experiencing pleasure that don't rely on the traditional penile stimulation process and I wonder if we are spending too much time focusing on fixing an impediment to the only pleasure trigger most of us have attempted, instead of looking at other approaches to generating orgasmic feeling.  I don't think there has been enough research into all the possible ways that an orgasm can be triggered in a man, to offer us options.  Then there will be the necessity of de-programming ourselves that the only way to be a functional man is to experience a penile-triggered orgasm.  I think women have had a taste of this in the past with the failure to understand that their orgasm trigger may involve something other than penetration.

Maybe our particular impediment means that many other techniques are similarly compromised, but I'm not sure many of us have an understanding that there are other techniques available.  Certainly I don't recall other options being tried in discussions on this forum.

I'm particularly interested in how a wet dream might be created during a waking state.


NoFun

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Re: My Theory
« Reply #74 on: September 11, 2013, 02:55:00 AM »

I'm intrigued by this, since I believe there is no physical nerve stimulation:  it's all done in the brain.  In fact, I have always understood that an orgasm was principally a brain thing, primarily triggered by physical stimuli but augmented by imagination and other stimuli.  That being the case, I have hope that a way can be found to trigger an orgasm without the involvement of potentially compromised nerves.

I went to a University researcher on penile nerve issues. She tested me out and concluded that the nerves were fine. Her conclusion about the problem was that it was a supraspinal (brain) issue, with "a threshold set too high".

Not to be Debbie Downer here, but the fault may actually be in the brain, and can't be bypassed.

Interesting that you had your one and only in a wet dream, though.

I had a poll on that, and found that the group as a whole had much fewer wet dreams than average.

 

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