A man who is sexually satisfied is truly happy: What to do about erectile dysfunction and anejaculation caused by smoking?

A man who is sexually satisfied is truly happy.

**Smoking causes erectile dysfunction**

Some people believe that smoking can demonstrate a man's masculinity and is a symbol of male prowess.

Some even claim that smoking two or three cigarettes before sex can prolong orgasm and enhance sexual pleasure. The reasoning is that smoking can increase the body's higher nervous activity, excite the brain, and thus promote libido and enhance sexual pleasure. In reality, this is nonsense.

While cigarettes can stimulate the brain and excite it, they often cause an imbalance and incoordination between excitation and inhibition, resulting in short-term excitement and long-term inhibition. Long-term smoking stimulates the sympathetic nervous system, producing excessive adrenaline and noradrenaline, which causes the smooth muscles in the corpora cavernosa of the penis to contract, preventing the penis from filling with blood and causing erectile dysfunction, thus affecting normal sexual life.

There are many causes of erectile dysfunction, but the most important is insufficient blood supply to the penis. The penis is mainly composed of three corpora cavernosa, which are filled with blood sinuses connected to branching arteries. During penile erection, under the control of nerves, the arteries dilate, and a large amount of blood enters the blood sinuses, increasing the size and firmness of the penis. Harmful substances such as nicotine and carbon monoxide in tobacco and rutin protein in tar can cause atherosclerosis of the penile arteries, increase blood viscosity, and impair microcirculation, resulting in narrowing and constriction of the blood vessel lumen, thus making it difficult to achieve or maintain an erection.

On the other hand, tobacco toxins have an inhibitory effect on the synthesis of sex hormones in testicular interstitial cells.

The testes are the primary male sex organs. Their interstitial cells synthesize androgens, which promote the development of accessory sex organs such as the penis, epididymis, and vas deferens, and maintain their maturity. Reduced androgen synthesis and decreased blood levels can affect normal libido.

Numerous studies have confirmed that the proportion of smokers among patients with erectile dysfunction is significantly higher than that of the general population of the same age, and the more one smokes, the higher the incidence of erectile dysfunction. Large-scale studies have found that more than two-thirds of patients with erectile dysfunction are smokers.

Among people's bad habits, smoking is the most important factor causing erectile dysfunction, leading to the most important pathological basis of erectile dysfunction-poor blood circulation. Therefore, smoking not only fails to bring masculinity but also causes erectile dysfunction. Currently, many divorced couples cite "incompatibility" as the reason, but in reality, "incompatibility" is merely a convenient excuse; the real reason is "sexual incompatibility." Cigarettes act as a "third party" in the breakdown of marriages. Therefore, quitting smoking is the simplest and most effective way to treat erectile dysfunction, restore male virility, maintain marital stability, and preserve masculinity.

Author: Du Changming, Second Affiliated Hospital of Xuzhou Medical College

**What to do if you can't ejaculate**

Anejaculation refers to the inability of a man to ejaculate during sexual intercourse, preventing him from reaching orgasm. The causes are varied, and each person's situation is different.

Anejaculation causes unimaginable pain and confusion for men. Clinically, all treatments for anejaculation focus on enhancing sexual stimulation and increasing direct sexual sensation in the male reproductive organs. The following methods may be tried: ① Create a romantic and comfortable setting for intercourse, avoiding any disturbances and allowing for complete mental relaxation. ② Schedule sexual activity in the morning or after sufficient sleep to restore energy and stamina, ensuring optimal physical and mental condition. ③ Reducing the frequency of intercourse or abstaining from intercourse for a certain period can promote ejaculation. Reduced frequency allows the ejaculation center to rest and adjust, increasing semen reserves and resulting in faster and more intense ejaculation. ④ Enhance foreplay and induction. ⑤ Increase the frequency of thrusting during intercourse; this is the final push towards ejaculation, and changing sexual positions can further enhance sexual sensation.

Sexual disharmony is often unavoidable in remarried couples, and the process of mutual adjustment and adaptation is complex and requires time rather than haste. Overcoming concerns requires not only open communication about sex but also mutual care and consideration. Therefore, learning about sex together after marriage can be beneficial for achieving harmony and adaptation in the relationship.

It's important to note that remarried couples shouldn't constantly "revisit old memories," especially during sex. Remarried couples often consciously or unconsciously compare and contrast their past sexual experiences, causing one partner to recall the differences. This "changed flavor" of sex often makes it difficult to achieve sexual harmony and satisfaction. While not ejaculating is understandable, such comparisons are very harmful. For remarried men, completely erasing their memories of their ex-wives is unlikely. The wise approach is to cherish the love they've regained and try to overcome any psychological barriers.

If the above methods still do not work, you can consider going to the hospital for medical help, including necessary examinations and treatments.

Author: Li Hongjun, Deputy Chief Physician of the Department of Urology, Peking Union Medical College Hospital