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Revista Sexología y Sociedad. 2013; Vol. 19, No. 1
ISSN 1682-0045
Versión electrónica
ARTÍCULO DE REVISIÓN
Ejaculation and Sexual Pleasure in males:
A complex relation with multiple determinants
MsC. Loraine Ledón Llanes,* Dr. Gustavo L. Acosta Ballester,** Dra. Lizet Castelo Elías-Calle***
National Institute of Endocrinology
*Bachelor in Psychology, Master Degree in Gender, Sexuality, and Reproductive Health, assistant researcher, works at the Psychosocial Division of the Institute of Endocrinology, Havana. **General Practitioner, Master Degree in Medical Education and Bio-energy Medicine, Assistant Professor. Works at the Luis de la Puente Uceda Policlinic, Havana.
***Medical doctor specialized in Endocrinology, Master Degree in Satisfactory Longevity, assistant professor and associate researcher. She works at the Care for the Diabetic Patient Division in the National Institute of Endocrinology, Havana.
ABSTRACT
Reflections on the supposed relationship between the volume of ejaculated semen and sexual pleasure, originally established by Masters and Johnson. For this purpose, a revision of classic texts and current scientific articles about topics of human sexual response, sexuality and sexology, with emphasis on the ejaculation process is made. The article is structured in sections that show the fundamental aspects concerning ejaculation and some related dimensions or factors: general descriptive aspects, and comprehensive perspectives on the masculine orgasmic experience that include ejaculation, sexual techniques, ejaculatory dysfunctions, orgasm and sexual pleasure. The position of the authors regarding this topic is discussed.
Key words: volume of ejaculated semen, ejaculation, orgasm, sexual pleasure
Introduction
Ejaculation is one of the male sexual expressions less dealt with in scientific literature unless there is some kind of ejaculation “disorder” or is “differently” expressed according to medical and social criteria. As R. J. Levin puts it: “Out of the four E’s of the male sexual function –excitement, erection, emission, and ejaculation-- the least studied mechanism is the latter: ejaculation” that which the author considers “the Cinderella of male mechanisms, with a very poor catalogue of experimental studies” (1:123).
Ejaculation is a physiological process expressed in the male sexual response of the orgasm and is related to biological, psychological and social factors. Though it has been clearly established that ejaculation and orgasm are two different phenomena, parallelisms between the two have been occasionally established, one of them affirming a link between the amount of ejaculated semen with the sexual pleasure experienced by males. This relation, originally described W. Masters and V. Johnson, has been perpetuated in some texts and subsequent articles.
The objective of this study is to reflect on this alleged relation and for this purpose a review of classic texts and topical scientific articles on human sexual response, sexuality and sexology, with emphasis on the ejaculation process was carried out. The study is structured in sections on fundamental aspects concerning ejaculation and some related dimensions or factors. There is a final debate stating the view of the authors on the subject.
General Descriptive Aspects of Ejaculation
Ejaculation of seminal fluid has no analogy in female sexual response (2). It is the result of a set of neuromuscular phenomena enabling the advance of semen during the sexual response cycle and its expulsion through the urethral duct at the end of the cycle (3). Though ejaculation takes place in the third stage of the human sexual response (orgasm), pre-orgasmic emission of a clear and transparent mucous fluid can be observed during the plateau stage, produced by the Cowper glands, involuntarily released from the urethral meatus and can contain active sperm (2, 4-6).
Though ejaculation and orgasm are almost always experienced simultaneously they are not one and the same process (3, 5). Orgasm is a global psychophysical response (7) associated with rhythmic muscular contractions in the pelvic region and other areas of the body liberating accumulated sexual tension and with secondary subjective sensations (5)as a result of erotic messages received from receptors located all over the body (8). Male orgasm can vary (2, 5). Ejaculation is a physiological response, an objective phenomenon (7) specifically related to the expulsion of semen, sometimes even without experiencing an orgasm (5).
Approaches to understand male orgasmic experience with ejaculation
For Masters and Johnson, male orgasm with ejaculation can be studied following physiological, psychological, and sociological approaches (2).
Physiological Approach
The physiology of male orgasm includes the physical conditions and reactions during the development of sexual tension. Physiologically speaking, ejaculation can be divided into two stages (2, 3, 7): emission and ejaculation as such (4).
Emission is the expulsion of the seminal fluid released by supportive reproductive organs (prostate, seminal vesicle) through ejaculate ducts (efferent vessels of the testicle, epididymis, and vas deferens) and deposited in the prostatic urethra (2, 6, 7) due to the reflex contraction of such organs (9). Emission takes place a split second before ejaculation and is controlled by the autonomous nervous system (4). As the semen is collected in the prostatic urethra, the urethral bulb is expanded twice or thrice its normal size, anticipating the second stage. When the urethra’s striate sphincter closes it increases intra-urethral pressure associated with the sensation of imminent ejaculation (7) or «inevitable ejaculation» (4), initiating the ejaculation by pressure changes and subsequent distension of the urethra (10).
The second phase of ejaculation begins when collection of genital discharges in the prostatic urethra has ended (1). This phase includes propelling of the semen to the urethral meatus through the membranous portions and relaxation of the striate sphincter or urethra, the contraction of the smooth sphincter and the rhythmic contractions of the prostatic urethra, the penile urethra, and the muscles at the base of the penis (2, 7, 11, 12). These movements end when semen is expulsed through the urinary meatus by cyclic contractions of the last part of the penile urethra at 0.8 seconds intervals (2, 5-7, 9). Contractions are the driving force of the ejaculatory reflex, applying pressure on the base of the penis expulsing the semen in three to seven spouts (4). The internal sphincter of the urinary bladder neck remains closed so that the seminal fluid can make it to the penis (6). After the first three or four penile contractions, they begin to space out declining in intensity (5).
In the resolution phase, after ejaculating, the male enters into a refractory period, when another ejaculation is impossible. The duration of this period can range from minutes to several hours and becomes more prolonged with age and after repeated ejaculations (4, 6).
Mechanisms of ejaculation.
There is still no complete understanding of the general neurophysiology of ejaculation. It is known, though, that it is associated to many neurophysiological events involving nervous, hormonal, and vascular interactions (13, 14), and also to a learning process (15).
Ejaculation involves an activity of the superior cortical centers and is also a reflex act (2): seemingly there is no one brain center but several interconnected areas sending the final message to the spinal cord to provoke the ejaculation (1, 4, 16). Visceral aspects are governed by the sympathetic nervous system. In the brain, the centers of emission and ejaculation have dopamine as the exciting neurotransmitter and serotonin as the inhibiting neurotransmitter. The propelling mechanism of the seminal bolus in the urethra is covered by somatic nerves from the pudendum nerve, originating at S2-S4 (7).
Ejaculation is also related to the limbic system (17). The ejaculation areas are located along the spinal-thalamic tract and its reception station in the thalamus, as well as in certain areas of thalamic projection of the limbic system (18). Evidence shows that ejaculation is affected by hormone-regulating mechanisms (7). Experiments in rodents suggest the influence of hormones such as prolactin (PRL), the follicle stimulating hormone (FSH) and the luteinizing hormone (LH) (17).
Ejaculation and age.
Ejaculation changes with age (7). The refractory period increases and ejaculation strength and frequency as well as its biphasic characteristic markedly decline towards the end of adolescence (4,19). Kaplan describes the ejaculation experience in man throughout the different life stages (19). Both this author and Masters and Johnson are of the view that this change does not necessarily limit pleasure and that getting rid of the need for a quick ejaculatory discharge can foster a more satisfactory and imaginative sexual intercourse, good health and opportunities provided (4, 19).
Psychological Approach
For Masters and Johnson, the physiological process of ejaculation can be correlated with subjective progression towards orgasm (2).
In the emission phase, man experiences the sensation of inevitable ejaculation (2) in the form of intense heat or pressure, sometimes accompanied by shudder and tremors (5). In the ejaculation phase, male subjectivity progresses in two phases. The first one is associated with the contractions of the urethral sphincter, stimulating a contractile sensation and varying in intensity and subjective appreciation (2). These contractions are very pleasant and can be described as a pumping sensation (5). The second stage is associated with the semen passing under pressure through the distended and elongated urethra, providing the male with a subjective appreciation of the seminal volume (2) and can experience contractions differently: as a warm spout of fluid or as a stabbing sensation (5). For Masters and Johnson, an example of subjective appreciation of seminal volume is when males refer they perceive a more intense orgasm after a period of abstinence (when seminal volume increases) compared with a situation where they ejaculate shortly after a first ejaculation (and therefore the seminal volume decreases) (2).
These authors found in their study sample that “the more seminal volume ejaculated, the greater the subjective sensation of pleasure” (2:194) due to the capacity of the volume of seminal fluid emitted to distend the urethra (7). When men included in the study had had multiple ejaculations, they referred that the most pleasant experience had been the first ejaculation (7).
In a recent article, Levin critically reviews eight physiological aspects of the sexual arousal process described in Master and Johnson’s original report (1966, first edition, cited by Levin) (20), which --in light of increasing lab studies available-- require correction, modification or additional explanation. Item 7 of his review deals with the relation between the volume of semen ejaculated and sexual pleasure experienced by males. The author questions the following aspects of the research methodology used by Masters and Johnson to arrive to the abovementioned conclusion (20):
1) there is no data about the number of male subjects studied;
2) to obtain “more fluid volume” the subjects did not ejaculate in at least five days, which leads to confusion in ascertaining if the appreciation of greater sexual pleasure was due to a higher volume of fluid or to the possibility of ejaculating after a period of abstinence;
3) in his view, it is extremely difficult to design an experiment allowing to analyze and describe the influence of such factors.
To these we may add the possibility that studying sexual response under lab conditions may influence the fact that experience reference be focused more on anatomic and physiological aspects.
In a second stage, Levin analyzes the findings of studies which do no confirm the relation between volume of ejaculated semen and sexual placer (20):
1) The author (1) himself reports that when no semen volume has been ejaculated (“dry” ejaculation) the pleasure referred has been as good as the pleasure experienced in ejaculations with an adequate volume of semen. .
2) Gerstenberg, Levin and Wagner (11) studied a group of subjects that had been administered a drug to interrupt emission and ejaculation, and still experienced an orgasm. The subjects reported that the orgasm had been as pleasant as those experienced with a complete ejaculated volume.
3) M. T. Rosenberg et al (21) conducted a study with around five hundred men aged 18 to 89 years old and, significantly, most of them reported that the sexual pleasure experienced with ejaculation was more associated with the strength of their ejaculations than with the ejaculated volume.
For Levin, neither the research methodology used by Masters and Johnson nor available studies support the theory of a “simple relation between the volume of ejaculated semen and the sexual pleasure involved” (20:397).
A relevant aspect for the subjective experience of pleasure during ejaculation is the contractile experience. In Masters and Johnson on sex and human loving (Boston: Little Brown and Company; 1985) by Masters, Johnson, and Kolodny, cited by Haning et al. (22), spasmodic muscular contractions expelling the semen is the most reliable proof that an orgasm has been experienced. However, Levin is particularly emphatic in making clear that though “with every contraction there is an ecstatic pulsatile pleasure, the voluntary contractions of the striate bulbocavernosus muscle do not generate this pleasure. The exact location where ejaculatory pleasure generates remains a mystery” (1:125). Masters, Johnson, and Kolodny state that:
Detection of intense contractions during an orgasm does not necessarily means it is perceived “better” than another orgasm in which body alterations are less vivid. A more moderate physiological orgasm can be more intensely, pleasantly and satisfactorily experienced than a more active physiological orgasm [5:101].
Though the reflex mechanisms of the orgasmic response are quite uniform, the intensity of the experience varies according to the physical state of the person, the ejaculatory frequency (23, 24); mood changes (23); cognitive aspects (9); psychosocial factors such as activity, expectations and feelings regarding sexual intercourse (5); timing and circumstances surrounding the sexual experience (23) and the general conditions in the relationship, erotic link, attitude towards sexuality, level of desire and respect (25).
Sociological approach
Masters and Johnson mention the existence of environmental, cultural, and social factors that influence orgasm (2). They acknowledge, ever, the poor literature on this matter due to the fact that male ejaculation is structured as a need for the life cycle, thus being less controlled (compared to female orgasm, for example) and greater interest in other areas of male sexual response, like erection. For them, sexual adaptation failure in man and the cultural issue of male sexual performance is not associated with experiencing an orgasm (2) but rather with being able to maintain an erection within scientifically established limits. Levin mentions the existence of some difficulties for scientifically exploring ejaculation related to current insufficient technological development to grasp some specificities of the ejaculatory process such as the speed of muscular movements and the location of this physiological activity “hidden” in the pelvis (1).
Sexual techniques, ejaculation, and pleasure.
Sexual experience and progression also depend on physical and mechanical aspects that can have a greater or lesser stimulating bearing on arousal, orgasm, ejaculation, and sexual pleasure. Clinical studies indicate that, under normal circumstances, tactile stimulation in general and rhythmic stimulation of the glans and penis in particular, are a fundamental requirement for ejaculation (4, 18, 26).
Sexual intercourse positions also merit some considerations. Those allowing easier penetration of the penis and more freedom of movement («missionary»), can reduce control over the ejaculatory reflex; those allowing more ejaculatory control (couple on top) can be considered as threatening (27) taking into consideration some “hegemonic masculinity” definitions (28). They make pelvic thrust more difficult or are very erotic, and can trigger the orgasmic and ejaculatory response; anal penetration can be very arousing because of the brushing sensation in his genitals and the visualization of areas with a high erotic meaning, but can limit the emotional intimacy and makes deep pelvic movements more difficult (27).
This shows that the position as such is not the most relevant factor for ejaculation or sexual pleasure and that both concepts not necessarily go hand in hand. Masters, Johnson, Kolodny (27), and Schnabl (25) believe that sex pleasure does not depend so much on proven mechanical efficiency but rather on the way in which two persons relate and communicate between each other.
Ejaculatory Disorders
This section deals with the general characteristics of ejaculatory disorder and certain specificities that can shed light on the existing relation between volume of semen ejaculated and sexual pleasure.
Premature Ejaculation (PE)
What has propelled research on ejaculation is premature ejaculation (1), the most frequent ejaculatory disorder with a reference value of prevalence of 29% (3), affecting 75% of men some time in their lives (29) and most common in young males (7, 30).
Currently there is no clinically satisfactory concrete concept on PE because it is part of the sexual response dynamic of the couple (7, 15) and is associated with social, cultural, and personality (15). According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) premature ejaculation is characterized by an ejaculation than in over 75% of the cases takes place before, during or shortly after beginning sexual intercourse and before desired by the man, due to the perceived incapacity to delay ejaculation, having negative personal effects in the man himself (31). For authors such as Waldinger (32) there is no particular pathophysiology or etiology for this entity.
Premature ejaculation was not always considered a male sexual response disorder. During many years it was considered acceptable, a proof of “male biological superiority” (6). Some authors consider it a legacy from the primitive man allowing the insemination of a larger number of females and greater dissemination of his genetic material (33).
The etiology of premature ejaculation can be organic and psychological (7). The organic etiology is less frequent (34) though not less important (35-37). Psychological causes have a greater bearing (38) and varied (7). Though PE is not correlated with sexual conflicts, psychopathology, marital relations or socioeconomic level (39) it is commonly associated to distress (30), loss of sexual self-confidence, and less satisfaction and pleasure in sexual and couple relations due to male’s concern regarding control over his orgasms (40).
Symonds, et al studied how PE had impacted the lives of twenty-eight men and found that the disorder had caused low self-esteem and concern regarding the couple relation (38). Corretti found that being exposed to evaluation by the sexual partner can cause anxiety, which negatively affects control over the ejaculation reflex and reduces the latency period (30). According to these findings, pleasure and sexual satisfactions in men with premature ejaculation are seemingly not affected so much by ejaculation and orgasm per se but rather by the fact that speed and the sensation of not being in control generates distress, uneasiness and insatisfaction in the couple.
Delayed Ejaculation (DE)
As a result of exercising an excessive involuntary control over the ejaculation reflex (4, 9, 34), man’s ejaculatory and orgasmic reflex is inhibited (41, 42) blocking the sexual sequence in the plateau stage (4, 42). Ejaculating requires a prolonged time and stimulation and sexual arousal sometimes is delayed (34). This disorder is observed in all age groups (34) and is associated with psycho-traumatic factors (41).
For a man free of conflicts, the high degree of arousal preceding orgasm is characterized by a sensation of sexual “abandonment” that becomes a very pleasant experience (4). However, prolonged periods of penile thrust required for ejaculating, can be physically and psychologically uncomfortable for the couple (34).
Partial ejaculation incompetence
This is a variant of delayed ejaculation that sometimes is confused with retrograde ejaculation. According to Kaplan (42), patients find it difficult to abandon themselves to sexual experience and are concerned with their performance. The ejaculatory response is only partially inhibited. The emission phase remains intact but the ejaculation phase is missing. Subjects perceive the sensation of inevitable ejaculation but feel no genuine orgasmic sensations because it does not happen. Semen drips because the pleasant pulsatile component is inhibited (4, 42). In reaching the climax, the male only feels the emission but perceives no orgasmic pleasure (42).
Ejaculation inhibition (or ejaculatory disability
according to Kolodny, Masters and Johnson) (5) (EI)
This is one of the most challenging male sexual disorders to which less attention has been devoted (43). It is the disability to ejaculate during penetration despite high degree of sexual arousal (15, 34). It is less frequent among clinical population (15) and has an incidence of 5% to 11% among the general population (44) among men under 35 years old (34). Its causes can be of an organic nature (15, 17, 34), though a neurobiological understanding model considers it part of the biological variability of the arousal threshold required prior to an orgasm (45). Most causes are psychogenic (15, 17, 46).
This dysfunction brings about emotional and practical problems for both members of the couple (46), though it can also cause intense sexual pleasure as it allows prolonged sexual intercourse (1-2 hours) (34). In a qualitative study conducted with men suffering from ejaculation inhibition, Robbins-Cherry, et al found 4 key topics, one of them being “perception of the situation” (46): for some of the men studied, disability to ejaculate was not perceived as a problem.
Retrograde Ejaculation (RE)
In this disorder, the neck of the bladder is not hermetically closed during orgasm as a result of a disease or the use of anticholinergic drugs altering the anatomic integrity of the vesicle neck and interfering in its neurological potential. Semen is thus expulsed into the bladder (5, 42, 47). According to Masters, Johnson, and Kolodny, the man with this disorder experiences a different sensation during ejaculation. Though he perceives the orgasm he is also aware that the sensation produced by the seminal fluid while travelling through the distal urethra is missing (5). He experiences a pleasant but “dry” orgasm. There is no external emission of fluids (42), which could result embarrassing for some men, while representing no concern whatsoever for others (47).
According to anecdotes referred by men suffering from long term and complicated diabetes mellitus as well as from retrograde ejaculation and have been treated for sexual dysfunction at the National Institute of Endocrinology, there is no difference between orgasmic pleasure experienced with or without retrograde ejaculation. Their discomfort begins when they start planning a family, in the cases where retrograde ejaculation is accompanied by erectile dysfunction and when the couple is concerned with no visualization of the semen, considered as the climax and end of male sexual exercise.
Orgasm and pleasure: amid physiology and subjectivity
The orgasm is a peak subjective phenomenon showing objective manifestations (contractions) that have been considered as its sine qua non proof (48). Most of the body changes taking place during the orgasm were observed by Masters and Johnson —Human sexual response, Boston: Little Brown; 1966, quoted by Levin (48)— throughout their twelve-year lab studies with 382 women and 312 men. Their studies were essentially physiological descriptions.
The orgasm is one of the most intangible functions of the human brain, including a wide range of transitions during the sexual conduct termination. It implies the progression of both sexual desire and arousal (49), as well as physiological and mental aspects which are not necessarily synergic (14, 48, 49). Experiences resulting from orgasmic pleasure and satisfaction in men have been poorly considered, but the anecdotic evidence suggests that they depend on psychosocial influences like it happens in women (50). One of the alleged influencing factors contributing to the orgasmic pleasure and satisfaction is the one associated with the perceived intensity and the anatomic location of orgasmic sensations: the masturbation orgasm has been considered more physically intense and localized than the coital orgasm, though the latter provokes more pleasure and satisfaction (51). Other authors state that the orgasmic pleasure and satisfaction depend more on the psychological intensity of the orgasmic experience, associated with the experimented feelings and emotions (50).
Some pieces of evidence have stressed the importance of the relationship quality in male orgasmic experiences (22, 50). McCarthy and Fucito believe that, from a theoretical and clinical perspective, intimate and interactive sexuality is what men and couples consider first, since sexuality is mainly an interpersonal process in which the final goal is to stimulate the couple´s satisfaction and relationship (52). In older men, Schiavi found that sexual functioning and satisfaction were more influenced by psychological, relational and psychosexual factors than by vascular, neurological, and hormonal factors (53).
Mah and Binik assessed the orgasmic experience in youngsters and found that: a) sexual and orgasmic satisfaction was significantly higher during the couple´s sexual intercourse in comparison with solitary masturbation, and a closer relationship with the cognitive-affective characteristics of the orgasmic experience than with the sensorial ones; b) emotional intimacy was crucial for the orgasm; c) the psychological and affective intensity of the orgasmic experience was more significant for experiencing pleasure than the anatomic location of orgasmic sensations; and d) the orgasmic sensations beyond the genital-pelvic region were more pleasant (50). Haning et al found that general intimacy, the couple´s sexual intimacy and the tendency to experience an orgasm were positively correlated with sexual satisfaction in males (22).
An important aspect of the orgasmic experience is the one associated with sexual pleasure representations, which «have a specific meaning for each man and should therefore be more specifically defined», according to Fink, Carson and DeVellis in «Adult circumcision outcomes study: Effect on erectile function, penile sensitivity, sexual activity and satisfaction» (Journal of Urology 2002; 167:2113-2116), quoted by Richters (54). Pleasure goes beyond the orgasmic experience, which drew a greater attention perhaps due to the existence of physiological correlates, evidenced in both reproductive and sexual organs. However, the subjective expression of orgasm is more difficult to understand for its «deeply personal», nature associated with the concepts of pleasure and satisfaction, though different at the same time, the analysis of which demands the combined skills of physiologists, psychologists, endocrinologists, as well as images of both the brain and the subject (48).
Discussion
The views contained in this article derive from the review conducted and the biological, psychological and social paradigm of human sexuality promoted by Masters and Johnson (55) –pioneers in this field- when defending its «extremely personal» nature (27) and its comprehensive biological, psychological, interpersonal and cultural influence in every sexual act (13, 31, 56).
Ejaculation is still an understudied process. Therefore, evidence is insufficient and poorly enlightening, especially concerning the relation between ejaculated volume and sexual pleasure. The perpetuation of this relationship is associated with the revolutionary nature of Masters’ and Johnson´s findings and their impact when restructuring the concept of human sexuality, providing a more objective platform for action, and using scientific research methods. In all likelihood, that is why some groundless assertions were taken for granted. However, a more detailed analysis of findings, further pieces of evidence and progress made in understanding both sexuality and pleasure can provide new standpoints.
Originally, the positive relationship established between ejaculated semen volume and sexual pleasure stemmed out from the existing «confusional» variable (sexual abstinence of boys studied) which moderates this alleged relationship. Seemingly, such relationship shows some signs of generalization, though the literature on sexual response and ejaculation (even articles published by Masters and Johnson themselves) refer to different forms of experiencing them which are not necessarily pleasant.
The determinism of physiological factors associated with sexual experience in general, and on the ejaculatory, orgasmic and sexual pleasure process must be a crucial reflection to bear in mind. Masters, Johnson and followers affirm that the intensity of anatomical and physiological aspects involved in sexual experience can affect, but not determine, sexual pleasure and satisfaction. Besides, the physiological aspects, in turn, are integrated into a wide range of factors (physical, psychological, transactional, environmental, circumstantial and socio-cultural factors) acting upon the ejaculatory and orgasmic process in males. This complex interaction moderates the construction of a direct relationship between the ejaculated semen volume and sexual pleasure.
The concept of sexual pleasure is another important aspect. As has been described, the anatomical and physiological changes taking place in each sexual response phase, including ejaculation, show a subjective correlate: in terms of experiences and sensations. However, these changes are not equally perceived by every individual, nor are equally construed, and they are not enough to cover the concept of pleasure derived from sensations, senses, exchanges, fantasies, expectations and representations within the concrete and symbolic framework of interactions. Assuming that sexuality is diverse, variable and transformable is like assuming these attributes for sexual pleasure.
Based on the previous assessment and discussion, we can conclude that:
• There is no linear relationship between the ejaculated semen volume and sexual pleasure in males.
• The ejaculated semen volume is a physiological aspect of male ejaculation that might lead, or not, to a subjective perception when experiencing more intense physical sensations within the ejaculatory process.
• The subjective perception of physical sensations within the ejaculatory process can contribute, or not, to experience a greater sexual pleasure.
• Sexual pleasure is the unyielding dimension of a physiological aspect (semen volume), of one of the processes (ejaculation) within one of the phases (orgasm) of human sexual response which, in turn, is merely one among all sexuality expressions.
• A more comprehensive scientific research, with an interdisciplinary perspective, is needed both in the ejaculation field and in the structuring of sexual pleasure.
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Fecha de recepción de original: 27 de octubre de 2012
Fecha de aprobación para su publicación: 3 de abril de 2013
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