Neural Regulation of Ejaculation

Introduction Sexual function in men and women incorporates physiologic processes and regulation of the central and peripheral nervous systems, the vascular system, and the endocrine system. There is need for state-of-the-art information as there is an evolving research understanding of the underlying molecular biological factors and mechanisms governing sexual physiologic functions. Aim To develop an evidence-based, state-of-the-art consensus report on the current knowledge of the major cellular and molecular targets of biologic systems responsible for sexual physiologic function. Methods State-of-the-art knowledge representing the opinions of seven experts from four countries was developed in a consensus process over a 2-year period. Main Outcome Measures Expert opinion was based on the grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. Results Scientific investigation in this field is needed to increase knowledge and foster development of the future line of treatments for all forms of biological-based sexual dysfunction. This article addresses the current knowledge of the major cellular and molecular targets of biological systems responsible for sexual physiologic function. Future treatment targets include growth factor therapy, gene therapy, stem and cell-based therapies, and regenerative medicine. Conclusions Scientific discovery is critically important for developing new and increasingly effective treatments in sexual medicine. Broad physiologic directions should be vigorously explored and considered for future management of sexual disorders.

Section: Central Nervous System (Cns) Targets For Male Sexual Dysfuncsupporting

confidence: 61%

Future Sexual Medicine Physiological Treatment Targets

Burnett

Goldstein

Andersson

et al. 2010

“…Moreover, this neural activation of LSt cells is essential for ejaculatory reflexes induced by DPN stimulation as pharmacological blockade of ERK and NMDA receptor activation prevented BCM bursting characteristic of ejaculation following DPN stimulation [28,29]. Finally, LSt cells have direct axonal intraspinal connections with autonomic sympathetic (IML and CAN) and parasympathetic (SPN) neurons within the spinal cord [23,27,30–33] and project to pudendal motorneurons [34]. Thus, LSt cells have been demonstrated to form an essential component of the spinal ejaculation generator.…”

Section: Introductionmentioning

confidence: 99%

A Pivotal Role of Lumbar Spinothalamic Cells in the Regulation of Ejaculation via Intraspinal Connections

Staudt

Truitt

McKenna

et al. 2012

“…Ejaculation is a reflex mediated by a spinal ejaculation generator that consists of a population of interneurons at lumbar levels 3‐4 (lumbar spinothalamic cells; LSt) and their projections to autonomic and motor areas within the lumbosacral spinal cord [1–5]. Previous studies from our laboratory and others have indicated that LSt cells are essential for ejaculation as LSt cell lesions ablate ejaculatory behavior in intact mating animals [4].…”

Section: Introductionmentioning

confidence: 99%

Activation of NMDA Receptors in Lumbar Spinothalamic Cells is Required for Ejaculation

Staudt

Oliveira

Lehman

et al. 2011

Introduction The sexual reflex ejaculation is controlled by a spinal ejaculation generator located in the lumbosacral spinal cord. A population of spinothalamic (LSt) neurons forms a key component of this generator, as manipulations of LSt cells either block or trigger ejaculation. However, it is currently unknown which afferent signals contribute to the activation of LSt cells and ejaculation. Aim The current study tested the hypothesis that glutamate, via activation of N-Methyl-D-aspartic acid (NMDA) receptors in LSt cells, is a key regulator of ejaculation. Methods Expression of phosphorylated NMDA receptor subunit 1 (NR1) was investigated following mating, or following ejaculation induced by electrical stimulation of the dorsal penile nerve (DPN) in anesthetized, spinalized male rats. Next, the effects of intraspinal delivery of NMDA receptor antagonist AP-5 on DPN stimulation-induced ejaculation were examined. Moreover, the ability of intraspinal delivery of NMDA to trigger ejaculation was examined. Finally, the site of action of NMDA was determined by studying effects of NMDA in male rats with LSt cell-specific lesions. Main Outcome Measures Expression of NR1 and phosphorylated NR1 in LSt cells was analyzed. Electromyographic recordings of the bulbocavernosus muscle (BCM) were recorded in anesthetized, spinalized rats following stimulation of the DPN, and delivery of AP-5 or NMDA. Results Results indicate that the NR1 receptors are activated in LSt cells following ejaculation in mating animals or induced by DPN stimulation in anesthetized, spinalized animals. Moreover, NR1 activation in LSt cells is an essential trigger for rhythmic BCM bursting, as DPN stimulation-induced reflexes were absent following administration of NMDA receptor antagonist in the L3-L4 spinal area, and waere triggered by NMDA. NMDA effects were dependent on intact LSt cells and were absent in LSt-lesioned males. Conclusion These results demonstrate that glutamate, via activation of NMDA receptors in LSt cells, is a key afferent signal for ejaculation.