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Case Study:  On the biochemical, nervous and mechanical factors of premature ejaculation. Why over-masturbation,  over-ejaculation or excessive orgasm cause premature ejaculation
Reader: 3/27/2008>
Hi Dr Lin,
I read your reply about causes to premature ejaculation and you seem to have great knowledge on the subject. I am 20 years old, I started watching pornography and masturbating when I was about 14 (a few times a week), had my first intercourse with a prostitute at 15 (lasted 2 minutes), continued masturbating and tried to stop at 18, had occational periods when I stopped (about 2-4 months), completely stopped masturbating for a whole year between 19 and 20, now started masturbating again at 20 (usually 1-2 times a week, sometimes a couple times a day), went to a prostitute again at 20 (lasted 1 minute). When I masturbate I sometimes ejaculate very quickly, within a minute or before full erection. I also have great sensitivity during first few minutes and have to take long pauses to avoid ejaculation. I masturbate because I enjoy it and mostly because I want to gain self control over ejaculation when I have sex with a woman, so I usually try to masterbate for at least 30 minut es, and if I ejaculate too early I take a break and try again. My fear is that this can happen when I meet a woman I love and have sex with her, like it happened with the prostitute a few months ago. I have looked for solutions over the internet and mostly found tips like doing PC excercises (you seem to be against it), stopping arousal before ejaculating, and pressing the point between scrotum and anus to stop ejaculation (none of them seems very good to me). You seem to explain this problem in physiological terms, and I read that you can have sex for 3 hours. How can I achieve these results? I have condoms with benzocaine that can help last longer, but this is only a quick fix until I solve this problem. I don't want to use any medications or nutrition supplements. I want to find the complete information on premature ejaculation and techniques to solve this problem permanently. I am willing to pay if you have a book on the subject.
Thank you for your kind help and support,
Dr. Lin: 3/27/2008>
Premature ejaculation is a very complicated issue.
Its general causes are due to the sympathetic nervous fight or flight responses with a lack of serotonin, GABA, endorphin, and prostaglandin E1 to counteract the over-excitatory effects from inflammatory hormone prostaglandin E2, stress hormones norepinephrine/epinephrine in the andrenergic alpha receptors,  glutamate and histamine.
Chronic over-masturbation generally burns out the serotonin and GABA nervous control and exhausted the hypothalamus-pituitary-adrenal and -testicular axis for excessive prostaglandin E2,  norepinephrine and epinephrine production and prostaglandin E1 and endorphin deficiency.
If you penis is over-sensitive, your penile tissues produce excessive prostaglandin E2 and histamine, but lack of serotonin, GABA and endorphin nervous control.
You have a precum leakage, your sympathetic nervous function in your prostate, bulbourethral glands and urethra are over-excited. You may also have your brain overheated and have excessive prostaglandin E2 production everywhere, particularly in your brain, prostate, urethra, testicles, penis and seminal vesicles.
The other factors of premature ejaculation are due to an excessive oxytcoin, DHEA, testosterone or DHT production with a lack of prolactin to counteract their biological stimulation on the sympathetic nervous system.
There is also a mechanical prostate abrasion and excessive prostate/PC muscle exercises for induction of the excessive prostaglandin E2 production in the prostate, bulbourethral gland and pelvic floor tissues.
A chronic training of the prostate for fast ejaculation during masturbation or a chronic PC muscle exercise can cause the nervous plasticity of the L1 and L2 sympathetic nervous function for faster orgasm and ejaculation.
Therefore, the solutions for premature ejaculation must include the nervous control,  rejuvenation of the prostate/bulbourethral glands, improvement of semen chemistries, reduction of the sympathetic nervous fire and its resulted inflammatory hormone prostaglandin E2, and undoing the prostate/PC muscle nervous plasticity.

Reader: 3/30/2008>
What is HTP-5? I stopped taking RIsperdal about 6 months ago. Does that still affect me? I also had the problem of PE before I started taking it. Also I don't feel anxiety when I masturbate, I feel that my penis is really sensitive.

Dr. Lin: 3/30/2008> For 5-HTP and serotonin, please read http://en.wikipedia.org/wiki/5-HTP
Masturbation is completely different from intercourse. You don't have to worry about erection and premature ejaculation and you are very relaxing during masturbation, while during intercourse you worry about erection and ejaculation control and her naked body, particularly the beautiful breasts and wet vulva, and her moaning, over-stimulate your hypothalamus-pituitary-adrenal axis for excessive dopamine-norepinephrine/epinephrine conversion and cortisol release for the sympathetic nervous Fight or/and Flight responses via your visual and auditory nervous input.  That is, your brain is overheated during intercourse.
By the way, the drug produces a long-term effect on the liver ability to release enzymes  tryptophan synthaseenzyme aromatic-L-amino-acid decarboxylase and coafctor Tetrahydrobiopterin (BH4) for serotonin production, the enzymes L-glutamic acid decarboxylase and pyridoxal phosphate for GABA release, and the enzymes prohormone convertases for the Proopiomelanocortin-endorphin conversion.  The drug also affects the hypothalamus-pituitary-adrenal and -testicular axis for synthesis of Proopiomelanocortin.

Serotonin, GABA and endorphin can reduce the penile sensitivity.
Prostaglandin E2 in semen and the prostate, urethral and bulbourethral tissues, can trigger precum leakage and enhance the penile and urethral nervous sensitivity for premature ejaculation.  Prostaglandin E2 is synthesized from Omega-6 with the final stage enzyme COX-2. It is the immune suppressor and inflammatory hormone, It helps sperms to survive in the urethral and vaginal/uterine environment, disable the egg and uterus immune to allow the sperm to fertilize the egg and to implant in the uterine lining.
GABA and endorphin also assist the sperm to fertilize the egg.
Prostaglandin E1 also helps the sperm to survive and to penetrate the egg shell; however, like serotonin, GABA and endorphin, prostaglandin E1 can prolong erection, reduce inflammation and prevent  premature ejaculation.
Other excitatory neurohormones, neurotransmiiters or hormones, such as testosterone, DHEA, DHT, histamine, glutamate, dopamine, oxytocin, epinpehrine, and norepinephrine, when they become excessive,  can trigger psychological premature ejaculation, while the calm neurohormones, neurotransmiiters or hormones, such as serotonin, GABA, glycine, agmatine, endorphin and prolactin can calm the nerves down.
An optimal cortisol can prolong sex due to its anti-inflammatory effect and anti-DHEA/testosterone, but, like prolactin, it can suppress the DHEA/testosterone production and causes sympathetic nervous Fight or Flight responses when it becomes excessive. A moderate exercise can optimize the cortisol release.

 If you want to last longer from biochemical and neurohormonal effects, you will have to take our LoveLonger (production Code 3-008) with Fish Oil 1000 mg a day to boost your prostaglandin E1, serotonin, GABA and endorphin level and reduce your precum leakage.
LoveLonger will also power your erectile function into the 2nd stage erection - the penile ballooning stage where the over-expanding penile tissues will likely release endorphin to numb or desensitize the penis.
Endorphin production can be mechanically enhanced in the penile tissues, pelvis, tailbone, hips, groins  and thighs with penile ballooning, anal breathing, medication, certain love-making postures that loads the local tissues and penis the body weight or stimulating stress, and squeezing the penile skin or tissues with slight stimulating pain, without inflammation,  like what the acupuncture needle produces. These mechanical endorphin technicals during sex have been well-documented in my CD-ROM book (Product Code 0-001)

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