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Chapter: Medical Physiology: Reproductive and Hormonal Functions of the Male (and Function of the Pineal Gland)

Stages of the Male Sexual Act

Penile Erection—Role of the Parasympathetic Nerves., Lubrication, a Parasympathetic Function., Emission and Ejaculation—Function of the Sympathetic Nerves.

Stages of the Male Sexual Act

Penile Erection—Role of the Parasympathetic Nerves. Penileerection is the first effect of male sexual stimulation, and the degree of erection is proportional to the degree of stimulation, whether psychic or physical. Erection is caused by parasympathetic impulses that pass from the sacral portion of the spinal cord through the pelvic nerves to the penis. These parasympathetic nerve fibers, in contrast to most other parasympathetic fibers, are believed to release nitric oxide and/or vasoactive intestinal peptide in addition to acetyl-choline. The nitric oxide especially relaxes the arteries of the penis, as well as relaxes the trabecular mesh-work of smooth muscle fibers in the erectile tissue of the corpora cavernosa and corpus spongiosum in the shaft of the penis, shown in Figure 80–6.

This erectile tissue consists of large cavernous sinu-soids, which are normally relatively empty of blood but become dilated tremendously when arterial blood flows rapidly into them under pressure while the venous outflow is partially occluded. Also, the erectile bodies, especially the two corpora cavernosa, are surrounded by strong fibrous coats; therefore, high pressure within the sinusoids causes ballooning of the erectile tissue to such an extent that the penis becomes hard and elongated. This is the phenomenon of erection.

Lubrication, a Parasympathetic Function. During sexualstimulation, the parasympathetic impulses, in addition to promoting erection, cause the urethral glands and the bulbourethral glands to secrete mucus. This mucus flows through the urethra during intercourse to aid in the lubrication during coitus. However, most of the lubrication of coitus is provided by the female sexual organs rather than by the male. Without satisfactory lubrication, the male sexual act is seldom successful because unlubricated intercourse causes grating, painful sensations that inhibit rather than excite sexual sensations.

Emission and Ejaculation—Function of the Sympathetic Nerves. Emission and ejaculation are the culminationof the male sexual act. When the sexual stimulus becomes extremely intense, the reflex centers of the spinal cord begin to emit sympathetic impulses that leave the cord at T-12 to L-2 and pass to the genital organs through the hypogastric and pelvic sympathetic nerve plexuses to initiate emission, the forerunner of ejaculation.

Emission begins with contraction of the vas defer-ens and the ampulla to cause expulsion of sperm into the internal urethra. Then, contractions of the muscu-lar coat of the prostate gland followed by contraction of the seminal vesicles expel prostatic and seminal fluid also into the urethra, forcing the sperm forward.

All these fluids mix in the internal urethra with mucus already secreted by the bulbourethral glands to form the semen. The process to this point is emission.

The filling of the internal urethra with semen elicits sensory signals that are transmitted through the pudendal nerves to the sacral regions of the cord, giving the feeling of sudden fullness in the internal genital organs. Also, these sensory signals further excite rhythmical contraction of the internal genital organs and cause contraction of the ischiocavernosus and bulbocavernosus muscles that compress the bases of the penile erectile tissue. These effects together cause rhythmical, wavelike increases in pressure in both the erectile tissue of the penis and the genital ducts and urethra, which “ejaculate” the semen from the urethra to the exterior. This final process is called ejaculation. At the same time, rhythmical contractionsof the pelvic muscles and even of some of the muscles of the body trunk cause thrusting movements of the pelvis and penis, which also help propel the semen into the deepest recesses of the vagina and perhaps even slightly into the cervix of the uterus.

This entire period of emission and ejaculation is called the male orgasm. At its termination, the male sexual excitement disappears almost entirely within 1 to 2 minutes and erection ceases, a process called resolution.

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