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Email: dr_dick@drdicksexadvice.com

Mailing address:

Richard Wagner, Ph.D.
1122 E. Pike Street   #1133
Seattle, WA  98122

The Yin and Yang of Desire

Today I’d like to talk about: The Yin and Yang of Desire — Dopamine, Prolactin and Testosterone.

Let’s talk about love, lust and desire. But instead of looking at these things as social phenomena, let’s look at the chemical reactions going on inside our bodies that make us feel and behave the way we do.

sex-on-the-brainThere are clear links between certain chemicals and our most basic drives, which explains, for example, why we feel horny one moment and utterly disinterested the next. Or why our sex drive peaks after exercise. At the core of our sexual and affectional interests and behaviors lie the two chemicals — dopamine and prolactin. In many ways they are complimentary to one another; dopamine turns on desire and prolactin turns it off.

Dopamine is a neurotransmitter. This is basically your body’s pleasure and reward system. Our brains releases dopamine, to one degree or another, when we see, read or think about something sexy, taste something sweet, puff a cigarette, or come into skin-to-skin contact with another person. When dopamine levels are high, our libido goes into overdrive. Sometimes levels can be so dramatic that a person will neglect other essential bodily functions like eating and sleeping. Some “street” drugs —meth and coke among them — can mimic the body into thinking it’s dealing with dopamine.

Dopamine is critical to the way the brain controls our movements. If there’s not enough dopamine, we can’t move, or control our movements. If there’s too much dopamine, we are plagued with repetitive moments like jerking, tapping and twitching.

Get this; novel situations can increase dopamine releases. For example, hooking up with someone for the first time triggers especially high levels of dopamine. Curiously enough, these same high levels will not occur again during subsequent hookups with that same person. This is called the one-night-stand phenomenon; it’s why you can be attracted to someone at first encounter but not afterward.hormones and the brain

However, falling in love with someone can sustain high dopamine levels for a longer period of time. This explains why physical infatuation is at its peak in the beginning months of a relationship. Also dopamine floods the brain when we get drunk or take certain drugs, which is why drinking alcohol can make a potential partner look more attractive.

Prolactin is dopamine’s foil. It causes dopamine levels to plummet. Prolactin is a hormone, as opposed to a neurotransmitter, like dopamine. It floods the body during orgasm, virtually shutting down the sex drive, which is nature’s way of allowing us to attend to other essential bodily functions like eating and sleeping. Prolactin release in men will temporarily disable our ability to have an erection. This is called the refractory or recovery phase of our sexual response cycle. And prolactin is at least partially responsible for that happy, relaxed state after we cum. This is precisely the release women get while breastfeeding; in fact, the word “pro-lactin” directly indicates its role in milk production.

growing larger and largerProlactin primes the mind for long-term attachment — a role that helps the mother bond with her suckling child as well as lovers to each other. This means that if you stick around cuddling with your partner right after sex, you may actually start to like him/her more and more. This is called the pair-bonding effect. But prolactin’s dopamine-reducing action has a darker side. It cancels the tolerance you may have for your partner’s flaws.

While dopamine and prolactin are good indicators of the immediate workings of sexual pursuit, it is testosterone that best explains long-term changes in courtship. Testosterone is responsible for the masculinization of the adolescent male body during puberty. And it increases the dopamine levels that regulate our sex drive. But testosterone leaves its fingerprint on the body as much as the brain. It’s the catalyst for changes in skin tone, fat distribution, musculature and demeanor, which are signals to others that this individual male is sexually mature and in good health.

However, if you get a fever or become depressed, your testosterone levels can drop significantly. Malnutrition or high levels of anxiety or stress will also interfere with testosterone levels. The most immediate effect of this is a decrease in libido, and a noticeable drop-off in energy levels as well as confidence. There’s no doubt about it; testosterone levels will signal to potential mates that you are in the throws of depression, stress, anxiety or malnutrition. You will appear a little less attractive to people subconsciously. That’s why a confident, dominant male with high-testosterone levels generally enjoy more mating success.tits

Testosterone levels are highest in the morning, then wanes throughout the day. It’s also much higher in men in autumn and lowest in the spring.

However, sexual desire is still more complicated than is known to science, and there may be multiple archetypes of partners we’re drawn to — there is evidence that aggressive high-testosterone men appear sexier to women and gay men for a one-night stand. But softer, more sensitive balanced men are more likely to tug at our heartstrings in a relationship. Scientists reason that the bulkier mate is more likely to be physically powerful and carry good genes to create strong children. While the slimmer guy is a more loving, reliable partner likely to help raise the kids so they survive to adulthood. The effect of this strange contradiction seems to be a biological predisposition against monogamy and sexual exclusivity.

But none of this is carved in stone. A man’s hormone’s levels increase when he is in a competitive environment or carries out acts of aggression, which can explain how guys seem to bulk up quickly when they go to prison or join sports teams. These levels decrease when he feels intimidated or humiliated, which might explain why those who get picked on at school stay skinny and mild-mannered compared to their peers. This in turn made them easier targets and only increased the likelihood of them being bullied.

butt shakeThis is not uncommon behavior among primate colonies that have huge alpha males looming over a population of smaller, submissive males and females. While this is not a perfect parallel to human social groups, it does go a long way in explaining how a social environment can be a precursor to physical body changes. And just so you know, our testosterone levels also drop during long-term relationships, giving the male brain a sense of stability and mellowness, easing off the drive to forage for new sexual partners.

Science alone lacks a moral element, and fails to explain, in a modern context, why we should desire to be masculine, aggressive, potent or dominant in the first place. In nature, the alpha-male is the most likely to enjoy reproductive success, but that isn’t what gives our lives value today. We might have more success being an average male that falls in love and becomes a good provider. And in the modern world it’s probably the more stable and sensitive man who is most likely to sire children.

Still, science gives important clues to what’s going on in our minds and bodies and that of our potential partners. A lot of our basic inclinations are out of our control, but when we know what causes them or what to expect, we can work with them for the best outcome.

One Of The Willie Worrisome

Name: lup92
Gender: Male
Age: 15
Location: England
I’m 15 and masturbate often but have had no form of sex although my girlfriend wants to start. However my penis and scrotum have extremely small lumps all over. I also have a purple red large lump on the rim of my bellend. What do I do? Should I start? Or do I risk giving something to my girlfriend?

A quick note before we begin. I’m a Ph.D. kind of doctor. not MD type of doctor. You know that, right? While I know my way around the human body, I never offer medical advice of any sort. And, just so you know, no self-respecting physician, MD kind of doctor, is gonna offer you medical advice online either without seeing you in person first. Which, if you ask me, is a real good thing.

teen intimacy

Here’s the thing about lumps and bumps and discolorations of the skin anywhere on your body, especially on your precious willie, pup. They are signs that all is not well. Do us all a big favor and have your johnson looked at by a physician. Your health is nothing to fool around with. Everything you describe could be completely harmless, but you don’t want to take the chance that it isn’t, right? And here’s a tip: don’t do it for your girlfriend. DO IT FOR YOU! It’s your dick, you gotta lean how to take care of it. And there’s no time like the present to start properly lookin’ after it.

willy_worryJust so you know, I’m not suggesting that your have a STI (Sexually Transmitted Infection). I mean, how could you? You’ve only been wanking, right? Still, if you’re concerned enough to write to me about it, you should take yourself in for a look-see. Since you are underage, you’ll probably need one of your parents to arrange the appointment. But if you are typical teenager, you’ll probably be embarrassed to discuss this with your parents. Still, there’s no getting around this. I think your parents will be proud of you for being proactive about your health and wellbeing. Besides, there’s nothing to be ashamed about.

Another option is to contact a sex-positive resource near you. Check out the folks at FPA. Surely they’ll have a resource for you.

Please take care of this ASAP.

There is one more thing. And I’m gonna be as blunt as I know how. If you think you’re old enough to fuck, you’re old enough to know all about condoms and how to use them. If ya don’t, you’re just a dumb kid who may function like a grown-up, but doesn’t know how to behave like one. And I don’t want to believe that about you.

What it is with young people (old people too) who are still fuckin’ clueless about unprotected sex in this day and age? I have nothing against younger people being sexual. That pretty much is to be expected. But I am totally opposed to kids having kids! Like I said, if you’re old enough to swing it around, you’re old enough to know how to swing it responsibly.

Good luck

An (extremely long) Tale Of Woe

First Name: Sam
Age: 22
Gender: Male
Location: North Carolina, USA
Wow, where do I even begin….

I am a 22-year-old gay male and believe that I may have SOME form of erectile dysfunction. I emphasize “some” because it is possible for me to get hard, firm erections, but I’m ALWAYS by myself when I do.

I have been able to give myself orgasms since I was in preschool. I did not masturbate the “traditional” way that men do (or ejaculate) until I was in 6th grade. Before that, I would lay down with my hands cupped around my crotch area and would “hump” into them until I felt an orgasm sensation and would then stop. In 6th grade I began to look at gay internet porn, and, seeing how most of those men masturbated, began to emulate the process. I even practiced “edging” often, beginning in 6th grade, as I had read on the internet at that time that it built up sexual stamina and led to powerful orgasms.PERFORMANCE_ANXIETY_pic_02_3

I would say that since I’ve been able to have orgasms (beginning in preschool), I would have one usually at least once a day. There were days here and there where I wouldn’t, but I guess an average would be 6 out of 7 days per week, with an average of twice per day. Of course, it’s hard to average them out since I’ve been having them for so long.

I did not start having sexual intercourse until my freshman year of college when I was 18, with my roommate at that time. Even that first time, I had problems maintaining my erection. I also had to use my hand and masturbate in order to have the orgasm, which took much longer than when I’m by myself. My roommate and I engaged in sexual intercourse regularly for the latter 2 and a half months of my freshman year, and every time, I had to have an orgasm by masturbating. Oral sex would not work, his hand would not work, and we did not engage in anal sex.

From ages 19-20, I had very little intercourse, but regularly masturbated (almost always to porn), and had no problems maintaining an erection and achieving orgasms. I hooked up with older men occasionally during this time, and again, could not have an orgasm unless I masturbated. It was also slightly more difficult to get an erection than by myself watching porn, and always took me longer to achieve orgasm than by myself. I had my first experience with anal sex (as a “top”) during this time as well, and could not ever reach orgasm, same with oral sex and hand-jobs.

When I was 20 I met and began dating my first boyfriend. We were together for 10 months, and while I enjoyed my time with him, our sex life was poor. We did not engage in anal sex except once, because we both considered ourselves tops. The one time we engaged in anal sex I tried to be the bottom, but did not enjoy it at all and had to stop. We did engage in oral sex, but I could never achieve orgasm that way. Again, I had to masturbate in order to have an orgasm. Not only that, but I began to have significant trouble sometimes to get an erection. Also, it took a lot longer for me to reach orgasm when I masturbated with him. By myself with porn, I could reach orgasm as quickly as 5-7 minutes. With him, it often took me at least 20 minutes, and it was usually 25-35 minutes.

loving legsAfter we broke up, I began to hookup a little more frequently then I had in the past, but it was not that often. Whenever I did, again, I always had to masturbate to achieve orgasm, and it took me a long time to do so. AND, during some of these hookups, I simply could not even achieve orgasm myself, as I started to have difficulty maintaining or even getting an erection. I highly doubt it was because of my sexual partners, because I would not hookup with someone I was not sexually attracted to. Also, I usually could have erections during foreplay, but when it came to the “big finish” my erection would start to wane or just become completely soft, and nothing I did or thought about changed that. Once, I achieved orgasm from barebacking (which I have not done since and luckily did not contract HIV or an STD), and there was also only one time where I hooked up with a guy and achieved orgasm from him giving me oral sex, although I believe this was because I refrained from masturbating for the past few days beforehand.

I am 22 now, and am starting to worry that I will not be able to ever have any good sex with someone else other than myself. In almost all of my most recent hookups, I have had to use a cockring to get an erection, and even then sometimes it doesn’t even help. Also, in almost all of my most recent hookups, it either takes me around 30 minutes to masturbate to orgasm, or I simply can’t have an orgasm because of lack of an erection. However, if I am by myself watching porn, I do not have any trouble getting and maintaining “rock-hard” erections and reaching orgasm.

I have become particularly concerned about this problem now, because I have begun to date someone and engage in sex with him for the past few weeks. When we first had sex I topped him anally and had a good erection. But we still masturbated together to completion. Ever since the first time though, I have had a LOT of difficulty just getting an erection period. Cockrings do not help, and oral sex and foreplay don’t really help either. Sometimes when we make out for a while I’ll start to get kind of hard, but then when I try to get ready to penetrate him or simply masturbate with him, I’ll go soft again. I’ve been able to reach orgasms sometimes when I masturbate with him, but my penis is usually semi-soft when I reach orgasm, and again, it takes more effort and certainly more time to do so then when I’m alone watching porn. He is incredibly good FleshJacklooking, good at sex, and very passionate, so I know it is not him. Luckily, he does not mind when I cannot perform, he says he likes me for me and that everything is fine, and he thinks that I shouldn’t worry about it. But at this point, I really can’t help but worry about it…

The last time this problem happened I had willingly decided to not have an orgasm for three days beforehand, hoping that it would help the issue. But unfortunately, it did not help or change anything. I’ve decided to completely stop viewing or watching any pornography whatsoever, and have also decided that when I masturbate I will avoid as much contact with my hand and, instead, use my FleshJack (the gay version of FleshLight) with the “Squeeze” texture (their most “realistic” anal texture). I have not had sex with him since I decided this (which is the day I’ve written this question, May 27, 2015).

I apologize for this EXTREMELY long inquiry, but I didn’t want to leave out any details of my sexual history in case they were important. I’m wondering if masturbating regularly since preschool has anything to do with my poor performance. And I’ve considered that I’m “overthinking everything” when I engage in sex and maybe that’s preventing me from getting erections with other men, but I’m such a sexual person that I can’t think of anything but dirty, sexual thoughts when I’m with another man, yet it just doesn’t seem to work. I do start to focus on not being able to get an erection if I’m not getting one for 5-10 minutes, but during that time beforehand, I’m not thinking about anything other than the pleasure, so I don’t see what I’m doing wrong. The problem is beginning to be REALLY embarrassing and I’m concerned that if I’m already having these problems at only 22 years of age, I’ll likely have the worst of erectile dysfunction problems in the future.

I suppose my main questions are:
1) What could be causing this to happen?
2) Is my proposed method of completely avoiding porn and masturbation via my hand an appropriate solution?
3) Do you have any specific suggestions or general advice that can help me with this problem and/or my sex life?

Again, I apologize if this is way too long; I’ve just never been so concerned about it before. I’m 22, I should be able to get rock hard erections easily, but I feel like a 70 year old man who just “can’t get it up.” ANY advice you can give me will be sincerely appreciated.

Whew, Sam, that was like the War And Peace of sex advice questions.

It’s perfectly clear that you are worried about your sexual response. But I’m gonna guess that your worry is actually making things worse. Before I respond to your three questions, I want to say; get thee to a therapist! You need to sit down with a sex-positive therapist and work through this stuff with him/her. This is super important, don’t just blow it off. If you need a referral, see the Directory of the American College of Sexologists to find someone in your neck of the woods. I also offer remote therapy via Skype or phone. See my Therapy Available page.

whewNow to your questions in the order you asked them…
1) What could be causing this to happen?
Everything you tell me points to performance anxiety. I’ve written and spoken a great deal about this issue over the years. Use the CATEGORIES pull down menu in the sidebar to your right. Scroll down till you find the main category, Sex Therapy. Under it you will find the sub category, Performance Anxiety.  You’ll find tons of information.

2) Is my proposed method of completely avoiding porn and masturbation via my hand an appropriate solution?
It might be, but not for the reason you suspect. Again, you need to discuss this with a therapist. It’s important and more involved than I have time and space to lay it out for you.

3) Do you have any specific suggestions or general advice that can help me with this problem and/or my sex life?
Yeah, chill the fuck out! Honesty, that’s the best thing you can do right now. Then, with the help of a therapist, work through your problems, put in place a program to rebuild your partnered psychosexual response one step at a time. You’ll probably begin with sensate focus training, stress reduction, and relaxation exercises.

HPV, WTF?

Here’s an exchange I had with a fellow named Angel. He writes:

I have a friend that has HPV. We spoke about being together but I’m nervous about this because I don’t know enough about HPV. Like how safe would I be if we were to mess around and or have sex? I wait to here back from you. Thank you for your time.

Here’s what I know, Angel…

  • HPV (human papillomavirus) is a common virus that infects the skin and mucous membranes.
  • There are about 100 types of HPV. Approximately 30 of those are spread through genital contact (typically fucking). Around 12 of these types are called “low-risk” types of HPV, which can cause genital warts.
  • In addition, there are approximately 15 “high-risk” types of HPV that can cause cervical cancer.
  • It is estimated that 80 percent of all women – and 50 percent of men and women combined – will get one or more types of “genital” HPV at some point in their lives.

As you can see, this is a very widespread virus. However, it’s relatively easy to protect yourself. Use a condom. You were gonna do that anyway, right?stis-1

And, as you probably know, there is a human papillomavirus vaccine is used to prevent infection by HPV strains 16 and 18, which causes most cancers of the cervix, as well as some cancers of the vulva, vagina and penis. Infection with HPV strain 16 also causes most anal cancers and some throat cancers.

This vaccine, given to young men and women ages 9 through 26, prevents pre-cancerous changes that may become cancer. HPV vaccination is currently recommended by the Centers for Disease Control and Prevention for all boys and girls ages 11 or 12, and for men and women ages 13 through 26 who have not already received the vaccine or have not completed booster shots.

Depending on the specific vaccine used, it may also prevent genital warts caused by other strains of HPV. This vaccine will not cure an HPV infection that is already present, and does not prevent other sexually transmitted diseases.

condom_STI_titlesThe HPV vaccine is given as a series of three injections into the muscle in the upper arm or thigh. The first shot may be given any time beginning at 9 years of age. The second dose is given 2 months after the first shot, and the third dose is given 6 months after the first shot. The protective effects of the vaccine last for approximately 5 years. Whether or not a booster is needed after five years is not yet known.

Angel writes back with:

Yes ok then sorry I just figured it’s easier to be safe and just not go there. We are really good friends and don’t want to wreck that by worrying about what I may, or may not catch. He doesn’t want me to use condoms for oral sex.

I don’t suppose you happen to know what kind of HPV this person has, do you? That makes a big difference, ya know.

Many people are unclear on the risks associated with oral sex and HPV. It can be passed during oral sex, but it is rare. To reduce the risk of infection during unprotected oral sex, limit exposure to sexual fluids and ensure that no cuts or lesions are present in your mouth or on your partner’s genitals. But, in the end, your safest bet is use a condom. If he doesn’t want you to use a condom, tell him to such his own dick.

Good luck

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