Perform or be gone!

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Men are obviously fixated on performance. Performance in athletics, the job, and of course in the bedroom. Sexual performance can be rewarding but can also be a source of pressure and discontentment and of course women play a part here too. In this three-part blog we will discuss sexual performance by looking at what “normal” performance is. We’ll investigate what happens physiologically when we are aroused, then see what happens when that performance diminishes. Lastly how do we improve our sex lives? Read on for tips on making her squeal! but also how to manage out collective expectations. Let’s first look into what happens as we are aroused and how that translates into an erection. I’ve chosen three major players and contributors to physiological male sexual response. The earliest is Havelock Ellis in the early 20th century. He proposed a two-stage model of build up and release. We all can relate to that right? In the 50s and 60s masters and Johnson, (Currently being depicted in the ShowTime series, “Maters of Sex”), Wrote books about a 4-stage model: Excitement, Plateau, Orgasm and Arousal. Then came Helen Singer Kaplan in 77, right in time for the sexual revolution and added a component of desire. Other research has been done to expose the psychological aspects of arousal and response but for now lets focus on the physicality of getting turned on and getting an erection.

Mens’ bodies really kick into gear when that someone turns us on! As we are Aroused, the brain activates the central and autonomic nervous system and metabolic rates increase. Hormonal outputs include testosterone, serotonin and dopamine. All regulated perfectly. Ever wonder why when interrupted during sexual arousal you are slow to respond and feel out of it? …. Simply put, you are high on the bodies’ own internal drugs!!

Next the neuropathways play a part by increasing blood flow to the main cavities of the penis called the corpora cavernosa and corpus spongiosum. The release of nitric oxide contributes to the vasodilation of this tissue by relaxing smooth muscles to let the blood in. To prevent venous leakage the I and B muscles, (you really want it? Ok … Ischioavernisus and Bulbospongiosus- whew! ) contract keeping the blood in the penis for intercourse. Yikes there is a lot going on in men when we are aroused and even more going to obtain and maintain an erection. And this is obviously just scratching the surface.

Author: drmaxmccullen

When Max McCullen first read Alfred Kinsey’s landmark book, Sexual Behavior In the Human Male, he began contemplating why so little is known about human sexuality. Since its publication in 1948 that body of knowledge has grown marginally. Why do we think about sex all the time? How much does sex really influence our behavior? And why do we still know so little about it? He completed undergraduate studies at University of the Pacific and The University of London and then his research led him to the Institute for the Advanced Study of Human Sexuality in San Francisco. IASHS was founded by Kinsey’s research assistant, Wardell Pomeroy. His initial curiosity soon evolved into a passion, which drove him to acquire his Doctorate of Education in Human Sexuality and Gender Studies. In 2004 Dr. Max began working for GlaxoSmithKline Pharmaceuticals (GSK), one of the largest pharmaceutical companies worldwide. This experience contributed to his understanding of medical treatments for male sexual dysfunction. He became familiar with how Viagra, Levitra, and Cialis function on a biological level and their social implications. His expertise naturally transitioned into him working with some of the most prestigious Urology offices in Southern California. These doctors and passionate medical personal, illustrated firsthand the impact treatment of male sexual dysfunction can have on patient care and their overall well being. This experience made him yearn for more direct contact with patients in a clinical setting. So after GSK he worked with Boston Medical Group (BMG), an international, clinic based organization, comprised of board certified Urologists and other specialties. BMG focuses on low libido, erectile dysfunction, premature ejaculation and testosterone replacement therapy. With BMG, Dr. Max was not only their spokesperson doing radio interviews and lecturing but worked as the physician liaison connecting patients with doctors for treatment. He also worked as a consultant for University Specialty Urologicals, based in San Diego, meeting with Urologists all over the west coast to train them on various treatments for men and women's sexual health issues, including hormone replacement therapy. During this time he also hosted online webinars for patients with questions; he also has a written and video blog series and does private consultation for patients. Dr. Max McCullen brings a historical knowledge of the human sexuality field together with the reailties of living in a digital age. “The issues that confronted our elders in the 50’s and 60’s are different today - but no more impactful. Where they were learning about their sexuality and beginning to embark into the sexual revolution we are over exposed to the commodification of sex. This makes the navigation of sex and emotional intimacy difficult” Dr. Max McCullen

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