premature ejaculation explained

Amazing work. There is so much talk only about dopamine receptor dysregulation but not much is spoken about the serotonin imbalance and the adverse effects it causes on us. PREMATURE EJACULATION and cicardian rhythm dysregulation (insomina) being the worst among them. I believe PMO leads to Dopamine receptor dysregulation which causes PIED and serotonin imbalance causes PE or DE.

I too have researched a lot on this topic. But you are one step ahead of me by experimenting with them which is amazing. I have been trying to find natural ways to bring back the neurotransmitters to its natural levels and make the brain attain homeostasis.

Here's a link which discusses how HT2C affects on numerous aspects and a lot of these effects can be seen in pmo addicts and during PAWS :


some research has associated relatively increased stimulation of these receptors with a variety of potentially negative effects, such as increased fatigue, reduced dopamine levels and lower motivation, elevated stress reactivity (increased HPA axis activity), undesired wieght loss, and lower insulin levels.

unlike many other neurotransmitter receptors, 5-HT2C receptors appear to decrease in strength and number both when they are chronically stimulated or chronically blocked.

They cause:

1.Eating Behavior and Weight gain

2.reported to regulate dopamine release in the striatum, prefrontal cortex, nucleus accumbens, hippocampus, hypothalamus, and amygdala,among others.

3.Mood and Anxiety Disorders

4.chronic fatigue syndrome (CFS)

5.Inflammation-Related Pain

6.The Circadian Rhythm

The parts of the brain that are believed to be highly involved in regulating the circadian rhythm – such as the suprachiasmatic nucleus, or SCN for short – receive many serotonin-based signals from other parts of the brain, such as the raphe nuclei.

7.TheHPA Axis

The HOA axis is one of the brain’s main systems involved in the stress response, and is known to be particularly sensitive to serotonin in particular.

8.Hormones

Stimulation of 5-HT2C receptors has been reported to lead to an increase in several different hormones including vasopressin, prolactin, (ACTH), and oxytocin.

5-HT2C receptors (in the prefrontal cortex) may be involved in the “reward response” caused by the abuse of cocaine, and may, therefore, play some role in drug addiction

 

It's very commonly known that antidepressants can work as a PE "solution". The question is if the side effects on general mood and other life-actions are worth the tradeoff for taking a drug "off label".

 

My point was not that antidepressants can be used as a solution.
But many have questioned in these forums as to what causes PE in a pmo addict. And how can it be cured. The "how" has never been addressed or the common assumption that you have trained it your brain to ejaculate quickly (as one masturbated in a hurry more often during adolescence) and saying that it will get better on its own as you progress during nofap. While PIED has some explanation or scientific basis that it's because of dompamine D2 receptor down regulation/dysregulation.

 

I have dropped porn for a year now and diminished my M habits to what I think is a fairly healthy ammount and still struggle with PE, I haven't seen any signs of improving without the exception of isolated moments in which it had seem to dissapear completely with no explanation more than my psychological state.

However after reading your post, I have been playing dangerously with my bed time for the past decade and struggle with having a healthy sleep. So I think I should really get a grip on that.

 

Another research which has proved that prolactin in itself doesn't directly cause extended refractory periods but it's the neuromodulatory events that causes it and rise in prolactin could be a accompanying effect.

"PRL can affect peripheral and central pathways that have been implicated in sexual performance and motivation. Even though our manipulations indiscriminately affect both, our results refute the idea that PRL decreases sexual activity, the hallmark of the PERP-Post ejaculatory Refractory period. What could be the role of copulatory PRL? PRL release may be the “side-effect” of the neuromodulatory changes that occur during sexual behavior; this is merely the result of reduction in DA levels (DA inhibits PRL release) and/or the increase in oxytocin and serotonin (known stimulating factors of PRL release) instead of having the principal role in the establishment of PERP. The fact that PRL levels are already elevated during sexual interaction in BL6 and PWK males further suggests that PRL cannot promote by itself reduced sexual activity, at least in male mice.

So I could only hypothise that EVEN REFRACTORY PERIOD is damaged by the neurotransmitters in pmo addicts. And measuring prolactin levels could jus be in vain.
The only hope is to attain brain homeostatis by abstinence and follow other best practices like maintaing sleep schedule, exercise, learning a language or an instrument, socialising, eating clean, meditation. Not just for few months but for years to come to weed out the wrong neural pathways and restore damaged NT.

 

I came across this Inna site by Dr.Richards who seems to know well about pmo and the sexual exhaustion it causes and reasons for PE.

Premature Ejaculation
Chronic over-masturbation/over-ejaculation trains the prostate ejaculation control nerves to ejaculate as soon as the dopamine-sympathetic-sensory nervous circuits are stimulated. It is a reflexion training. Some of the sufferers get prostates nervous relexion training in response to any sexual stimulation from vision, hearing. kissing, to touching. They must de-train the prostate’s nervous plasticity.

Here is a list of the most common causes for premature ejaculation:

• Using Kegel Exercises to support the erection, which involves the PC muscles.
• Prostate PC muscles fatigue.
• Poor blood circulation, leading to trapped excessive DHT, norepinephrine, epinephrine, glutamate and histamine.
• Prostate abrasion and fast-ejaculation training.
• Excessive norepinephrine, epinephrine, histamine, and glutamate which lead to nervous toxicity, performance anxiety and penile hypersensitivity.
• Drug abuse – either street or medication drugs.
• Parasympathetic, Serotonin and GABA nervous control disorders.
• Erectile dysfunction.
• Penile, testicle or prostate surgery.
• Excessive inflammatory hormone prostaglandin E2 in the bloodstream, penis, semen, prostate or even your partners vagina.
• Excessive semen accumulation in the seminal vesicles, which exerts pressure against the prostate and induces pelvic congestion and pain.
• Long-term semen retention or abstinence, leading to excessive prostaglandin E2 and/or excessive testosterone.
• Excessive oxytocin in the bloodstream.
• Excessive or insufficient dopamine nervous excitation, associated with the hypothalamic-pituitary-testicular axis and thyroid functioning.
• Excessive or insufficient testosterone and DHT, associated with penile erectile nervous stimulation and inflammatory prostaglandin E2 production.
• Liver functional disorders, affecting the abnormal syntheses of the androgen hormones, thyroid hormones, and neurotransmitters.
• Excessive or insufficient testosterone and DHT, associated with penile erectile nervous stimulation and inflammatory prostaglandin E2 production.
• Pineal gland disorders or melatonin deficiency (sleeping disorder), associated with the recharging of the parasympathetic nervous system during sleeping, the pituitary hGH production, and the serotonin, GABA and norepinephrine nervous function.
• Neuro-endocrine disorders.
• Concentration of ions (Na-K, Cl) and permeability characteristics of the nervous cell membrane.
• Genetic Tetrahydrobiopterin (BH4) deficiency, which will lead to dopamine and serotonin nervous disorders.

Chronic stimulation of sex organs can lead to over-production of a-MSH. It also traps excessive a-MSH in certain areas of the skin, which may result in extra skin darkness, particularly in eye cycles, labia minors, and penile foreskin. Chronic over-masturbation also leads to over-reactive or also called over-trained prostate, PC muscles, and bulbourethral glands.

Destruction of serotonin and GABA nervous control, exhaustion of the hypothalamus-pituitary-adrenal and testicular axis and liver system results in an unbalanced release of pro-opinomelanocotin (POMC) peptides, such as AdrenoCorticoTropic Hormone (ACTH), endorphins, a-Melanocyte-Stimulating Hormone (a-MSH), and Lipotropin Hormone (LPH). Also, prostate abrasion, excessive inflammatory hormone prostaglandin E2 production, excessive stress hormones cortisol and epinephrine for performance anxiety, parasympathetic and sympathetic erectile nervous disorders, excessive use of PC muscles, and precum/semen leakage will be observed. When the serotonin, GABA, endorphrin, cortisol, and/or a-MSH fail to modulate the dopamine – norepinphrine conversion and the psychological stressors norepinephrine/epinephrine-induced inflammatory hormone prostaglandin E2 production, one may observe more than one of the following responses to sexual stimulation:

• Excessive dopamine-norepinephrine induced prostaglandin E2 for a core temperature rise (over-heating or “sex fever”) in the brain, spine, adrenal glands and prostate – the sympathetic nervous “Fight and Flight” responses.
• Prostaglandin E2 over-excited penile and prostate nerves for penile and prostate hypersensitivity.
• Excessive prostaglandin E2 induced prostate and bulbourethral inflammatory responses and over-heating for precum and semen leakage, plus instant ejaculation.

Premature-ejaculation’s most common causes, including drugs, surgery, genetic disorders, and other organ functional disorders.

 

And his diagnosis of a pmo addict and treatment plan. He seemed to know well about the effects on the body. I am unable to post the link here. I will copy past the whole thread. And there are numerous posts like this.

"SHORT STORY:
1. I kept masturbating daily, sometimes a few more times a day, max probably 3 times a day but that’s very rare.
2. Always to porn usually, sometimes no porn, death-grip, long edging sessions that went maybe a few hours sometimes, normally when Id wake up in the morning or before I went to sleep.
3. Did it for 5 years. Tastes started at plain vanilla stuff and over the years got more intense. Some videos stopped appealing to me towards the end of the 5 year period. I always looked for more arousing stuff.
4. Searching for videos and waking up and thinking lets have a porn session use to give me a massive adrenaline rush always.
5. Orgasm/Ejaculation never used to give me any issues 6. Symptoms gradually crept up on me without me noticing after each orgasm/ejaculation/porn session.
7. for about 2 months symptoms got worse and worse after each PMO.



8. Then one day I did as usual another PMO and this time got severe anxiety, extreme fatigue, headaches, brain-fog, changing moods, social anxiety, higher more trembly voice, insomnia, no appetite, weak muscles, little bits of depression, all symptoms of adrenal fatigue negative thoughts started entering my head which never used to like how will I get a job, how will I get a girl, how am I gonna live life etc etc I never used to think stuff like this but they just started all of a sudden.



9. Read YBOP so thought I need to reboot. so did cold turkey 90 days off PMO. FELT AMAZING, a lot of the symptoms gone in that time.



10. Thought I was cured, started edging for 10 days, 11th day PMO’d and bam all symptoms returned at full force the following day. (not during or after orgasm, the symptoms start the following day)



11. Now in second reboot (its now 65 days into second reboot have noticed much faster to start recovering and for the symptoms to go away compared with the first reboot about 25 days or so compared to some 70 days in the first reboot) in saying this the fatigue and headaches are still there and I notice I always seem to feel better during the evening for some reason. my headaches go away and I feel like normal at night time.



Questions:
What is cause of these symptoms?
Is this Sexual Exhaustion from too much orgasm ejaculation, overstimulation and inability for the body to cope with such high demands?



HOW DO I FIX MYSELF?



I am taking a supplements, Organic Greens Super Food that has lots of good stuff in it herbs etc in the morning. Amino Acid complex during mid day, sometimes fish oil. sometimes protein shakes, a multivitamin at night time. What are your thoughts on this? I have changed the lifestyle, eliminated porn forever and started being more positive.



please reply me, im struggling to cope with the thought that I will never be able to have an orgasm again without getting such severe symptoms.



please help me fix this, im so worried



ur thoughts are greatly appreciated



I already asked once but I received no reply from you



Doc: Hour long edging sessions can be extremely taxing on one’s neuroendoctine balance and proper organism functioning. Edging, as a practice, is definitely a more harmful variation of conventional masturbation. I would say that it is not uncommon to experience similar severity of the symptoms after years of consistent edging.



External pressure and stress can definitely be a contributing factor.



As you have noticed yourself then, increased sympathetic response to even minor triggers is quite common and usually very related to sexual exhaustion (in cases where similar lifestyle is observed).



Similar symptoms are almost definitely related to improper serotonin-GABA nervous modulation on excitatory and inflammatory response. Excessive sympathetic activity and inflammation will basically lead to all of the described symptoms and more. I will additionally expand on the phenomenon down my post.



It definitely sounds like a moderate to severe case of sexual exhaustion.



You definitely did well to endure 90 days and also avoided going over the “three month mark” I’ve mentioned in some of my previous answers as the safe limit for such. The flatline was to be expected and served to provide you with an accurate representation of the actual state of your condition.



The unfortunate fact is that addiction is not so easily removed from one’s brain. It can stay dormant for months or even years, waiting for a suitable trigger to reveal itself.



This is actually very common with people who experience any form of anxiety disorder. It is most likely related to the way our bodies utilize certain neurostransmitters (in particular serotonin) during the natural circadian rhythm. During the evenings and at night the body becomes much more reliant on melatonin for its functioning, and serotonin abnormalities (such as low levels or certain receptor alterations) are less prone to be detected while under “lighter load”.



Certain cortisol abnormalities are to be expected but they are usually a result of the excessive sympathetic functioning for increased anxiety, stress, and inflammation. Hypothalamic-pituitary-adrenal-testicular axis is usually severely affected with sexual exhaustion, so there’s the possibility of suffering from a mild manifestation of such. However, taking in account the time needed to develop and your age, I would not suspect any permanent or severe abnormalities as of yet.



You will get those with normal sex too, predominantly through dopamine-norepinephrine-epinephrine conversions and increased demands on your cardiovascular system. The difference is that it is much more aggressive in its occurrence in people who have weakened modulation on serotonin-GABA nervous modulation (masturbation or not). Artery constriction can make it even worse.



The symptoms are definitely indicative of a moderate to severe stage of sexual exhaustion. PMO Addiction combined with individual genetic makeup and lifestyle can definitely lead to it.



You were generally on the right track. The way to go is to transform the negative neuroplasticity you’ve developed over the years into a positive one. The interneuronal connections have been developed and ordered to process information in a specific manner and it usually takes much conscious effort into rewiring them to induce the desired response.



It depends on the individual specialist. However, based on the symptoms you’ve described you are very correct in your expectation. I would strongly advise against any SSRIs / SNRIs as they can worsen the condition even further.



Nocturnal emissions are both shorter and notably less intensive as far as neuroendocrine load goes. They are also well timed with hGH / androgen spikes.



That being said, some people would still observe negative side effects and experience slower recovery (not nearly as bad as from PMO, though), especially if the emissions are excitatory / inflammatory in nature.



Similar generalized tests are usually quite ineffective in detecting the imbalanced state through the inability to monitor neurotransmitter levels in the brain, the wide range of acceptable results, and the flat ratio of hormone-neurohormone-neurotransmitter interactions monitored.



It is possible. However, it is not likely. And even so – the root issue is probably not the thyroid or adrenals. Naturally, the statement would be true only if you’ve not reached a breaking point, which is still unlikely since you’ve managed to restore quite a bit of your proper organism functioning for 90 days.



Yes, I’ve seen quite a few very similar cases.



It’s usually caused by a combination of factors, most of them related to self-abusing pattern of activities, individual gene expression, and general lifestyle. Let me mention some of the causes for your symptoms:



* Excessive masturbation usually leads to imbalances in acetylcholine, serotonin, dopamine, GABA levels and their respective receptor count, which in turn leads to a wide set of symptoms. However, one of the most notable consequences is the impaired serotonin-GABA nervous control on neuronal activity and excitatory / inflammatory response. As a result, excessive cortisol, prostaglandin E2, and other inflammatory factors are observed in blood, tissues, and brain. This creates a negative neuroplasticity extremely fast since excitatory factors have always played a part and been important for behavioral modulation in times of acute external stressor exposure.



* Artery constriction for increased inflammation and lessened blood flow to tissues.



* Adrenal gland adjustments to chronically create more stress and inflammatory hormones, such as cortisol and epinephrine, at the expense of DHEA and other androgens. This is closely related to the negative neuroplasticity loop I mentioned.



* The lowered androgens as a result of the varicocele you mentioned.



* The increased levels of cortisol, prostaglandin E2, norepinephrine, epinephrine, and especially prolactin to negatively affect the levels of GnRH, LH and FSH, and together with the arterial inflammation and constriction kill testicular function as well as hypothalamic-pituitary-adrenal-testicular axis’ proper functioning. Matters only get worse by the possibility of your testicles not functioning at their full potential from the start due to the mentioned varicocele. Less androgens to modulate inflammatory response, testicular insulin resistance, energy levels, tissue and testicular health, hormonal conversions, and neurotransmitter homeostasis, will result in even more vicious cycle of inflammation to suppress them even further through low dopamine levels and chronically heightened prolactin.



I am taking a supplements, Organic Greens Super Food that has lots of good stuff in it herbs etc in the morning. Amino Acid complex during mid day, sometimes fish oil. sometimes protein shakes, a multivitamin at night time. What are your thoughts on this? I have changed the lifestyle, eliminated porn forever and started being more positive.”



You’re definitely on the right track there. However, you’ve missed addressing the mentioned serotonin-GABA nervous modulation, which is usually of extreme importance. Rewriting a negative neuroplasticity usually takes time and is a tricky thing to do if one is unaware of what he’s doing. It can support itself through feedback reactions so ideally you’d have to address each and every issue simultaneously. That’s why just a random set of supplements frequently prove ineffective.



There are some general things and practices you should consider. Such as:



* Exercise
Running is very beneficial for Nitric Oxide-hGH boosts, as well as for improved neurogenesis.



* Proper diet.
Much fiber, fruits, avoid milk with prostaglandin E2 analogs, avoid empty calories and much red meat.



* Negative ion exposure
The general rule is wherever there is water, there are negative ions: rivers, lakes, oceans and ponds, even your own shower.



* Massages
Similar practices definitely have a positive effect on local inflammatory processes and proper blood circulation restoration.



* PMO discontinuation
It’s definitely a good thing that you’re already on it. You’ll need to discontinue sexual activities for 1 to 2 months (several times if you have to) and then limit masturbation as well as other similar in nature activities to 1-3 times a week for 3 to 5 months.
Additionally, edging has to be completely discontinued.



Also, a combination of Alpha-Amino, Multi-Alpha, 5HTP-Nettle (should be gradually discontinued 3rd to 4th month), GRB6-GABA (should be gradually discontinued 3rd to 4th month), Alpha-HGH, and Ultra-Purified-FishOil for the specific case, will improve nervous and endocrine functioning, stabilize acetylcholine, serotonin, dopamine, GABA levels, aid hypothalamic-pituitary-adrenal-testicular axis proper functioning, restore proper serotonin-GABA nervous modulation on excitatory and inflammatory response, increase androgens, increase elasticity prostaglandin E1 E3 and Nitric Oxide, alter numerous gene expressions, and eventually rewrite the negative neuroplasticity developed.



Of course, you did mention that you are taking a similar combination so if you have found that it works for you I will suggest just adding L-Tryptophan or 5HTP-Nettle and GRB6-GABA.



Note that the primary goal for the first 3 to 4 months is to restore the proper acetylcholine-dopamine-serotonin-GABA levels / ratio and modulation on inflammatory and excitatory response, as well as proper dopamine-norepinephrine-epinephrine conversions and dopamine-prolactin ratio. You would then need to monitor your overall stress levels (both physical and mental) for some months to make sure you’re keeping the neuroplasticity that has been developed.



Please, keep me updated on the case.



Hi Dr Richards,



thank you for the reply. just a quick note, im a little confused with the supplementation guide you suggest.



currently im taking the following supplements:



Multivitamins



Fish oil



PRE LUNCH – PURIFIED FISH OIL
Each 5ml Provides:
•EPA 825mg
•DHA 550mg
•Other Omega-3s 350mg
•Oleic Acid (Omega-9) 290mg
•Vitamin E (d-alpha tocopherol) 30IU



3. ANYTIME – Protein Shake –
contains:
—-11 grams of Essential Amino Acids (EAA’s):
Tryptophan, Valine, Threonine, Isoleucine, Leucine, Lysine, Phenylalanine, Methionine
—-7.7 grams of Conditionally Essential Amino Acids (CAA’s):
Arginine, Cystine, Tyrosine, Histidine, Proline, Glutamine and Glutamic Acid
—-5.5 grams of Non Essential Amino Acids (NAA’s):
Aspartic Acid, Serine, Glycine, Alanine



3. AFTERNOON – Amino Complex
Contains:
L-Lysine (as L-Lysine HCI) 75mg
L-Histidine 75mg
L-Isoleucine 75mg
L-Leucine 75mg
L-Methionine 75mg
L-Phenylalanine 75mg
L-Threonine 75mg
L-Valine 75mg
Hydroxypropylmethyl cellulose, microcrystalline cellulose, hydroxypropyl cellulose, magnesium stearate, cellulose gum.



also have 5-HTP (5-Hydroxy-L-Tryptophan) 50mg available but im not too sure if I should use it because I have read that it can lower dopamine, is nettle a necessity with the 5-htp as mine doesn’t include nettle.



what do you suggest? also what other supplements do you recommend?



how much dosage of GABA do I require?



also is this order of taking the supplements okay. if you can advise when to take each supplement that would be great.



also I have improved the diet immensely to ensure im eating healthy foods.



Look forward to your reply.



It’s a pleasure. I apologise for the late reply. Let’s get straight to it:



Thank you for being so thorough with the report. Let me say that your supplementation definitely seems very adequate and on point, with the exception I mentioned in my previous post. Additional and balanced 5HTP-Nettle and a “Picamilon” quality GABA supplementation (where the GABA has been combined with Niacin to pass the Blood–brain barrier) are essential to serotonin-GABA nervous modulation on inflammatory / excitatory response.



It is true, however, the effect is very mild at best and is basically required to diminish any excessive inflammatory / excitatory response, excessive dopamine-norepinephrine-epinephrine conversions, and to prevent “abstinence anxiety” caused by such on day 30 and above. Sexual activities discontinuation will actually increase dopamine above its usual range, even with heavy 5HTP supplementation.



I won’t go as far as saying that nettle root is absolutely necessary but it adds a very positive and thought out effect to the mix by addressing numerous inflammatory, anaemia, hair-loss, benign prostatic hyperplasia (BPH), osteoarthritis, and digestive related problems in a quite effective manner.



If it’s not combined with niacin, I won’t recommend taking any since you’d have to rely on particularly large numbers to be somewhat effective. Standard GRB6-7-GABA dosage applies otherwise.

 

Thank you for the posts. Though I don't really understand chemical talk.

 

Very helpful thread. Unique content

 

Any update brother @Cyberpunk3000

 

Am still abstaining and recovering. Am thinking of rewiring only after Dec. So can't say much until then about premature ejaculation brother.

 

Hi @Cyberpunk3000,

Your counter says 500+ days, can you update on PE situation?