Part Ten: Male Sexual Function Exercises and Diagnosis of Andrological Diseases

◇A Guide to Caring for Your Husband's Health as a Good Wife◇

Previous articleBAO JIAN ZHI SHI

Health knowledge

Six Methods for Male Sexual Function Exercise

◎Rubbing Yongquan Point: Sit cross-legged, rub your palms together until they are warm, then grasp your feet firmly with both hands and rub vigorously back and forth from the base of your toes along the line from the ankle joint to the Sanyinjiao point 20-30 times. Then rub the Yongquan point with each hand 81 times. Focus your mind on the Yongquan point while rubbing, and do so at a moderate pace with a slight rhythm.

◎ Massage the Kidney Shu Points: Place both palms on the Kidney Shu points, with the middle fingers of both hands aligned with the Mingmen point. Simultaneously massage in a circular motion from top to bottom and from the outside to the inside, for a total of 36 rotations. This is clockwise rotation, a tonifying method; counterclockwise rotation is a purging method. The Kidney Shu point is better tonified than purged. Pay attention to the clockwise and counterclockwise rotations. If you have kidney deficiency or lower back pain, you can start with 9 rotations and increase the number of rotations. Focus your mind on the Mingmen point during the rotations.

◎Shaking the scrotum: Stand with your legs apart and your back firmly against the ground in a semi-reclining position. Focus your mind on your lower abdomen (Dantian). Support your penis with one hand, and use the index, middle, and ring fingers of the other hand to support the lower part of the scrotum. Shake up and down 100-200 times, then switch hands and shake 100-200 times. Start with a light touch and gradually increase the force. Once you have a certain level of skill, you can switch to patting the scrotum with one hand 100-200 times.

◎Smoothing the Ren and Du Meridians: Place one hand on the perineum and the other on the pubic bone. Then, rub the testicles and penis vigorously with both hands about 100 times. Repeat with the other hand about 100 times. When starting out, use light pressure and gradually increase it. Focus your mind on the dantian (lower abdomen) while performing the exercise, breathe naturally, and remain calm and composed.

◎Lifting the Penis: Place the Laogong acupoint of one hand on the Dantian, and grasp the penis with the other hand, exposing the glans. Lift it up, down, left, and right 100 times each. Relax the area you are focusing on during the exercise, and do not think, think, or fixate on anything.

◎Strengthening the Spirit Whip: Hold the penis with both palms (with the glans exposed) and gradually increase the force, rubbing back and forth 100-200 times. Do not hold your breath during the operation. If you feel the urge to ejaculate, hold the penis with one hand and use the index and middle fingers of the other hand to press the perineum at the root of the vas deferens. At the same time, contract your abdomen and lift your anus (as if holding back a bowel movement). Use your mind to control ejaculation. After the urge to ejaculate has completely disappeared, lie on your side to rest.

Exercise methods for people with kidney deficiency

◎Tai Chi Chuan: Tai Chi Chuan is a slow exercise that uses the waist as the pivot point, making it very suitable for middle-aged and elderly people with weak constitutions.

◎Self-massage of the lower back: Rub your palms together until they are warm, then place them on your lower back and massage up and down until you feel a warm sensation. Do this once in the morning and once in the evening, about 200 times each time.

◎Stimulate the soles of the feet: The Yongquan acupoint on the sole of the foot is where turbid qi descends. Regularly massaging the Yongquan acupoint can benefit the kidneys, strengthen the body, and prevent premature aging. The method is as follows: Rub your palms together until they are warm, then rub the sole of your right foot with your left hand and the sole of your left foot with your right hand, once in the morning and once in the evening, rubbing 300 times each time.

◎ Kegel exercises: Relax your whole body and breathe naturally. While exhaling, contract your anal sphincter; while inhaling, relax. Repeat about 30 times. Kegel exercises promote blood circulation around the pelvic cavity, aid in the recovery of the sexual organs, and are effective in preventing and treating impotence and premature ejaculation caused by kidney deficiency.

Which organs are mainly involved in andrological diseases?

◎Scrotum: Located below and behind the base of the penis, between the groin of both thighs, it is sac-shaped. A longitudinal septum, called the scrotal septum, runs down the center of the scrotum, dividing the scrotal cavity into left and right parts, which serve as the "dormitory" for the testes, epididymis, and lower spermatic cord. The scrotum is soft, richly vascularized, and has the property of thermal expansion and contraction. Therefore, in addition to cushioning external mechanical impacts, it can effectively regulate the temperature of the "dormitory," keeping it 2-3°C lower than body temperature. This temperature difference between the testes and body temperature is one of the important conditions for ensuring spermatogenesis.

◎Testes: Located within the scrotum, there are two testes, one on each side, oval in shape, approximately 4-5 cm long and 3-4 cm thick, each weighing about 10-15 grams. They are the main organs of the male reproductive system, possessing the dual functions of sperm production and androgen secretion. The germ cells of the testes develop into sperm. Interstitial cells primarily produce androgens, which not only promote spermatogenesis but also stimulate the development and maintenance of secondary sexual characteristics, the development of external genitalia and accessory glands, and the emergence of libido. Sertoli cells have a decisive influence on the spermatogenesis process. The site of sperm production is the seminiferous tubules of the testes. These tubules combine to form straight tubules, which then converge into 15-20 efferent ducts, finally merging into a single duct that enters the head of the epididymis.

◎Epidilate: Slender and flattened, shaped like a crescent moon, one on each side, about 5 cm long, attached to the posterior surface of the testis, divided into three parts: head, body, and tail. The epididymis is mainly composed of the epididymal duct, an irregularly tortuous tubule 4-6 cm long, forming the body and tail of the epididymis. At the tail, the epididymal duct turns posterosuperiorly and gradually merges into the vas deferens. The physiological function of the epididymis is to promote sperm maturation and to store and release sperm. It accomplishes these functions through the absorption, secretion, and concentration functions of the epididymal epithelial cells.

◎Spermatic cord and vas deferens: There is one spermatic cord on each side, originating from the internal inguinal ring, running obliquely downward within the inguinal canal, passing through the subcutaneous ring into the scrotum, and terminating at the posterior border of the testis. The total length is about 11.5~15 cm. The spermatic cord is composed of blood vessels, lymphatic vessels, nerves, vas deferens, part of the cremaster muscle, and fascia including the above tissues, which enter and exit the testis. The vas deferens is the main structure within the spermatic cord, originating at the tail of the epididymis and terminating at the ejaculatory duct. It is approximately 40 cm long and directly continuous with the epididymal duct. It enters the inguinal canal through the external inguinal ring, then proceeds posteroinferiorly along the lateral wall of the lesser pelvis after entering the internal inguinal ring. It then turns medially, crossing above the distal end of the ureter, passing between the bladder and rectum to the base of the bladder. At the upper end of the seminal vesicle, it dilates in a fusiform shape along the medial side of the seminal vesicle, forming the ampulla of the vas deferens. The lower end of the ampulla tapers, merging with the seminal vesicle excretory duct above and behind the base of the prostate to form the ejaculatory duct. The spermatic cord is the essential pathway for blood circulation and lymphatic drainage from the testes, epididymis, and vas deferens. Its main function is to ensure spermatogenesis and the transport of mature sperm. The vas deferens is the only passageway transporting sperm from the epididymis to the prostatic urethra.

◎Prostate gland: There is only one prostate gland, chestnut-shaped, located in the lower part of the bladder, in front of the rectum and below the seminal vesicles. It weighs about 18 grams (25 cm long, about 35 cm in diameter at the base, and about 25 cm thick), and is divided into several regions: the central zone, the peripheral zone, and the transitional zone. The urethra passes through its center. The prostate gland secretes prostatic fluid, which contains various trace elements and hydrolytic proteases, and is one of the components of seminal plasma. The prostatic fluid secreted by the prostate gland can be discharged into the urethra through 16-32 prostatic ducts that open into the posterior urethra, and is mainly discharged during ejaculation.

◎Seminal vesicles and ejaculatory ducts: There are two seminal vesicles, one on each side, located lateral to the ampulla of the vas deferens. They are elongated oval sacs, about 3-5 cm long, and appear milky white and transparent to the naked eye. They secrete seminal vesicle fluid, which accounts for about 70% of the semen volume. The lower end of the seminal vesicle is thin and straight, forming an excretory duct that merges with the end of the ampulla of the vas deferens to form the ejaculatory duct. The ejaculatory duct is about 2 cm long, penetrating the prostate gland from its base and opening onto the verumontanum, which is also the channel for transporting semen.

◎Urethra: The male urethra serves a dual function, controlling both urination and ejaculation. It is 16-20 cm long and divided into four segments: the prostatic portion, the membranous portion, the bulbous portion, and the penile portion. The bulbous urethra contains bulbourethral glands that secrete fluid that contributes to the composition of semen and lubricates the glans penis during intercourse.

◎Pension: Its primary function is to enable sexual intercourse. It consists of two corpora cavernosa on the dorsal side and one corpus spongiosum on the ventral side, and is divided into three parts: the glans penis, the shaft of the penis, and the root of the penis. In an adult, the penis is approximately 7-10 cm long when flaccid; when fully erect, its length and volume can more than double. The corpora cavernosa are composed of numerous trabeculae and the spaces between them. The trabeculae are connective tissue, elastic fibers, and smooth muscle; the spaces are spongy and directly connect to blood vessels. The spiral arteries have smooth muscle walls that function as valves. These unique structures make the corpora cavernosa the erectile tissue, and penile erection is a prerequisite for sexual intercourse.

Diagnosis of male diseases

The diagnostic principles for male diseases are similar to those for urinary system diseases, but the focus should be on marital, sexual, and reproductive history. The basic diagnostic methods are symptom analysis and physical examination, followed by necessary physical and chemical examinations and special tests. A comprehensive assessment and inductive analysis are essential to distinguish the true from the false and arrive at a correct diagnosis.

◎Medical History: Due to the unique and social nature of male diseases, collecting a medical history is both important and complex. A detailed inquiry should be conducted based on the individual patient, and sometimes it is necessary to seek supplementary information from their spouse. The history must be detailed and reliable.

⊙Personal History: Growth and development, education and culture, occupation, hobbies, lifestyle, economic conditions, smoking and drinking habits, mental state, etc.

⊙Marital history: Age at marriage, marital relationship, sexual activity and its frequency, whether or not children were born and whether contraception was used, etc.

⊙Past medical history: History of any diseases, injuries, surgeries, or medications related to the onset of the disease.

⊙Present medical history: Onset of illness, suspected precipitating factors, presence of emotional fluctuations or impact on mental state, presence of physical trauma, possible iatrogenic effects, urgency of treatment, confidence in treatment, any remaining concerns, and whether the spouse actively cooperates with treatment, etc.

◎Common symptoms: The most common symptoms of male diseases are changes in sexual and reproductive function, namely male sexual dysfunction and male infertility. Other symptoms include changes in urination, changes in urine and semen, pain, and lumps.

⊙Changes in libido: Primarily, it manifests as a lack of libido or low libido, with a minority experiencing hypersexuality. Libido is closely related to age, gradually declining after age 50 and essentially disappearing by age 65. Systemic diseases, decreased male hormones, endocrine disorders, erectile dysfunction, and premature ejaculation can all lead to decreased or absent libido.

Erectile dysfunction (ED): ED is the inability of the penis to achieve a normal erection in response to sexual stimulation. It is primarily a functional disorder: increased inhibition of erection by the cerebral cortex and dysfunction of the spinal erection center; secondly, it can be organic: malformations of the reproductive system, trauma, inflammation, and in addition, chronic diseases and poor overall health can all cause it.

Premature ejaculation: Ejaculation occurring too soon after intercourse is called premature ejaculation. It is often caused by pathological excitation of the brain or excessive burden and increased excitation of the spinal ejaculation center. It is related to long-term masturbation, excessive sexual activity or abstinence, as well as chronic prostatitis, seminal vesiculitis, etc.

Nocturnal emission: Irregular nocturnal emission during sleep is a physiological phenomenon in unmarried young and middle-aged men. However, if nocturnal emission still occurs frequently after marriage with regular sexual activity, and is triggered by sexual desire or mild sexual stimulation, it is considered pathological. The causes are often similar to those of premature ejaculation, or related to hypersexuality or excessive physical and mental fatigue.

⊙Anejaculation: The inability to ejaculate during intercourse, without experiencing orgasm. This is primarily due to increased inhibition of ejaculation by the cerebral cortex, a sluggish response of the male genitalia to sexual stimulation, and difficulty in exciting the spinal ejaculation center. Anejaculation is mainly psychogenic, but other causes include lack of sexual knowledge and skills, spinal cord transection/paraplegia, removal of the L1-L4 sympathetic ganglia, post-prostatectomy, and use of medications such as guanethidine.

Infertility: There are primary and secondary infertility; based on the presence and quantity of sperm, it is further divided into absolute and relative infertility. Congenital malformations of the reproductive organs and acquired injuries or diseases affecting the whole body or specific areas, causing impaired sperm production, obstruction of the vas deferens, inability of the penis to penetrate the vagina for ejaculation, or abnormal semen, all result in the inability to conceive, leading to male infertility.