EXTERNAL male sexual development begins in the fetal stage inside the womb.
After birth, the male sexual organs develop very slowly due to low androgen levels.
However, even in young boys, androgens play a role in "masculinizing" the brain to influence boys to behave like boys, and to prefer more male-oriented activities and toys.
And they do enable young boys to have spontaneous erections.
By the time of adolescence, a boy's upbringing would have shaped his masculine role and preferences, while the hormonal changes of puberty would have reinforced his external male characteristics (facial and body hair, voice change, testicular and penile growth, etc) and masculine behaviour.
Spontaneous nocturnal and morning erections (due to the testosterone surge and sexy dreams), and daytime erections (due to sexy thoughts, pictures or movies) become frequent.
Wet dreams and sexual "exploration" and "adventures" are common as the testosterone surges to prepare him for the biological function of finding a mate, mating (copulating), and becoming a father and protector of the family.
So, it is not surprising that testosterone not only causes male sexual development and male sexual behaviour, but also, aggressiveness.
However, the effects of hormones on sexual preference is complicated and poorly understood, because many macho men loaded with testosterone are gays, who prefer other men instead of women!
In the majority of boys, however, the surge of testosterone causes them to be interested in the opposite sex, and there is the natural tendency to mate.
In civilized society, this translates to finding potential candidates for marriage and starting a family.
However, as we all know, there is plenty of sex going on outside of marriage, purely for its own pleasure.
After all, prostitution is said to be the oldest profession. And even Kings and Presidents have risked everything for sex.
This just goes to show that humanity is heavily sex-driven, thanks to androgens.
Note that even in women, it is the androgens that are the main drivers of their sexual urge.
Oestrogen is essential for female sexual development and female sexuality, but it is testosterone, working on the oestrogen-primed mind, that gives women their healthy libido.
Likewise, in men, healthy levels of both androgens and oestradiol are necessary for a good libido.
The male sex life
I have five rules on male sexual function that can serve as simple indicators of the health of your sex life.
These rules indicate if you have:
- healthy androgen levels (and other hormones like oestradiol, human growth hormone (HGH), gonadotrophins, prolactin, oxytocin, melanocyte-stimulating hormone, pheromones, and precursor hormones like pregnenolone that all influence male sexuality and sexual function in some way);
- healthy levels of nitric oxide (the messenger molecule necessary for vasodilation - to dilate the coronary arteries for healthy heart function, and the penile vessels for a good erection, among others);
- a healthy heart and lungs;
- good stamina; and sufficient qi (life-force).
Rule #1: If you are not thinking of sex every day, you don't have enough androgens (and some of the other hormones mentioned above) to produce a healthy sex drive (libido).
Thinking of sex daily (but not all the time) does not mean having sex every day.
In humans, the biological urge to have sex is modulated by many other factors like religious and moral issues, and work.
In contrast, for example, the lion can do "it" up to 50 times a day without bothering who is watching!
Rule #2:: If you are not having erections at least twice daily (a spontaneous one in the morning, and at least once again in the day due to a sexual urge), you don't have enough androgens (plus possibly several other hormones) and nitric oxide.
Spontaneous early morning erections are due to surges in testosterone levels, and are regular in healthy boys and young men.
Unfortunately, due to poor health and low androgen levels, many men stop having spontaneous morning erections after reaching 40. Their ability to achieve erections at other times also declines.
If you are really healthy, you will still have spontaneous erections even beyond 60.
Rule #3: If you are not having sex at least three times a week, you are not having enough sex!
Of course, many out there may disagree with me, but I am just indicating what those who are fit and healthy, and have optimum hormone levels, are enjoying.
Many couples have resigned themselves to having minimal sex because they fail to seek proper medical advice to recover their lost libido and sexual ability.
They tell people they are living happily with little or no sex, when in fact, they wish it was otherwise.
They should not continue fooling themselves, when (in most cases) their condition can be easily improved or reversed.
Rule #4: If your erection is not Grade 4 on the Erection Hardness Score (EHS, see below), you are unhealthy, and lack androgens, HGH (and possibly other hormones too) and nitric oxide.
The EHS grades are based on a scale of one to four.
Grade 1: Penis is larger, but not hard.
Grade 2: Penis is hard, but not hard enough for penetration.
Grade 3: Penis is hard enough for penetration, but not completely hard.
Grade 4: Penis is completely hard and fully rigid.
Erection hardness and duration correlate with sexual satisfaction, self-esteem and confidence.
They also correlate with hormonal and cardiovascular health, and qi.
Obesity and statin drug therapy (to reduce high cholesterol) are also associated with poor erections.
While a woman may achieve climax through non-penetrative sex, a man's climax is achieved through ejaculation, which is impossible without a good erection (necessary even for masturbation).
However, premature ejaculation (ejaculating too early, before there is sufficient pleasure), leads to frustration instead.
The penis invariably becomes limp after orgasm. The refractory period (time lapse before erection is possible again) varies between minutes for healthy young men, to hours and days for unhealthy older men.
Achieving Grade 4 is easy for qigong masters who practice hard qigong.
Through qigong exercises, we are able to achieve and sustain completely rigid erections. You may have read reports of some qigong masters carrying weights or even pulling trucks using their penis.
Sexual energy is qi.
One of the signs of having enough qi is the ability to sustain solid erections for long durations.
Qigong masters can also have multiple orgasms, with zero or minimal refractory period.
Rule #5: If your Grade 4 erection - don't bother about this rule if you don't even achieve Grade 4 - cannot be sustained for at least five minutes, then you are still not sexually fit.
And you should also produce about five millilitres of ejaculate to have a really good orgasm (two to six millilitres is considered normal).
The volume of ejaculate is correlated with sexual satisfaction.
However, as much of the ejaculate is seminal fluid (the sperm makes up only about 10 per cent of the volume), even those who have undergone a vasectomy (where the sperm is blocked from entering the seminal fluid) can still enjoy good orgasms.
Get yourself checked
It is desirable for the sex act, including foreplay, to continue for some time to achieve sufficient pleasure.
Healthy young men may continue the sex act for much longer, but after age 40, most men slow down, especially if they are unhealthy or unfit.
By age 50, very few can still sustain rigid erections for more than five minutes, unless of course, they use Viagra or its clones. And when they ejaculate, they only produce a few drops!
Surveys in many countries show that about 45 per cent of men above 40 years old have some degree of erectile dysfunction (ED - the inability to achieve a good erection). The percentages are higher with the older age groups, and in diabetics.
About 10 years ago, it was reported that Malaysians had the world's highest per capita consumption of Viagra, which tells us that our men "Tak Boleh" (Cannot), although they always shout "Malaysia Boleh!" (Malaysia can!).
We are indeed an unhealthy lot. The latest reports show that the rates of hypertension, obesity and diabetes are steadily rising.
It also means that the rate of ED must be rising, although this was not surveyed.
If this is not addressed, there will be many frustrated men (old and not-so-old) and their frustrated partners among us.
And the sale of Viagra and related drugs will continue to boom.
If you fail on the above rules, you should consider getting medical advice to have your cardiovascular fitness and sex hormone levels checked.
To achieve full marks, you need to be physically healthy and fit, have optimum hormone levels, and have the ability to produce sufficient nitric oxide.
I know there are many men out there who are plodding along feeling tired on most days, have poor libido and even poorer erections, and are frustrated with their sex lives.
I hope reading this article (and the previous one) will make them realise that such a situation is not normal, and that they can, and should, do something about it.
If you (or your spouse/partner) are one of them, talk to your doctor.
Dr Amir Farid Isahak is a medical specialist who practises holistic, aesthetic and anti-ageing medicine. He is a qigong master and founder of SuperQigong. The views expressed are those of the writer and readers are advised to always consult expert advice before undertaking any changes to their lifestyles.