Penile Sensitivity, Erectile Dysfunction and Delayed Ejaculation

In the extreme reduced penile sensitivity can inhibit the ability to get an erection.

But delayed ejaculation and erectile dysfunction are closely linked to reduced sensitivity. These conditions can be responsible for causing delayed ejaculation, and indeed sometimes they occur together.

Nerve damage, depending on where it occurs can be responsible for either or both conditions, as can diseases and circulatory disorders. With RPS, you may not be able to get an erection from physical stimulation alone.

If you wish to try to determine if you have a penile sensitivity problem or erectile dysfunction, there are several ways which can usually answer the question.

• Your urologist can perform a test with a device which momentarily pops a tiny needle into your penis which injects a drug to simulate arousal to cause an erection. If your vascular system or neural pathways are sufficiently damaged, no erection will occur. If you simply have RPS, the erection will occur.
• You can very simply test whether you get nocturnal erections, an indication whether or not you have ED. If you have nocturnal erections, you do not have ED, and your inability to gain an erection from physical stimulation is likely due to reduced sensitivity in your penis.
• You can perform a modern version of the “stamp test”. The test name originated in a day when postage stamps came in rolls with perforations between them and with a glue which had to be licked to attach them.
• Several of these stamps from a roll could be wrapped snugly around your flaccid penis before bedtime with the stamp glue holding the ends together in order test if you got nocturnal erections. In the morning, if the stamps were still snugly in place, it indicated no nocturnal erections.
• If the stamps have torn along the perforations, you have likely had nocturnal erections (or maybe you just move around a lot.)
• A modern version requires fabrication of a strip of paper about 1 inch wide, and long enough to wrap completely around your flaccid penis. Trim an area in the middle to about 1/8 inch wide, wrap it around your flaccid penis and tape the ends in place before bedtime. If you have nocturnal erections, the narrow area will tear.
• A third indication to separate ED and RPS is to determine when you can get erections. If you cannot get an erection from physical stimulation, but you can get a significant erection from visual stimulus (such as pornographic videos, pictures or stories), you probably have a problem with your penile sensitivity.

If you determine that you simply have erectile dysfunction, you are lucky: there are many effective medications and treatment options available for ED.

Effect of reduced sensitivity on delayed ejaculation

The process of sexual stimulation, erection, continuing sexual stimulation and eventually ejaculation may seem to be quite simple, but on the contrary, different neural pathways are utilized, linked to different response centers in the spinal cord and brain.

Some of the responses are from the parasympathetic division of the autonomic nervous system (ANS), and others are from the cortex of the brain.

The ANS connects to and responds to an area of the spinal cord called intermediolateral cell column and operates without the intervention of conscious thought or any input from the brain.

Stimulation of normal penile nerves – those with normal sensitivity, at least – with a normal circulatory system will automatically cause an erection.

Stimulation of the brain from other sexual sensory input is also capable of initiating an erection, just as negative stimulation from the brain can terminate an erection.

With continued physical stimulation of a normal penis there will be a build up of sensation and pleasurable feelings peaking at orgasm. Ejaculation normally occurs at or near the point of orgasm.

The initial step in ejaculation, the emission phase, begins with a “point of no return” wherein the ejaculation response will automatically follow through to the emission of semen.

The complex process includes sperm from the testes, which passes through ejaculatory ducts and mixes with fluids from seminal vesicles, the prostrate gland, and the bulbourethral glands to make up the final ejaculatory fluid. All these coordinated neural responses are a part of the autonomic ANS.

In the final phase, ejaculation proper, the semen is ejected through the urethra with rhythmic contractions by the bulbospongiosus muscle under the control of a spinal reflex at the level of the spinal nerves S2-4 via the pudendal nerve.

The typical male orgasm lasts several seconds, typically with 8-10 contractions. If any part of the ejaculation process does not proceed as normal, there may be limited or no ejaculation at all.

If there is insufficient arousal for any reason, including a low level of penile sensitivity, the triggering of the ejaculation response will be delayed or may not occur at all (anejaculation).