BECOME A MALE – TESTOSTERONE

The development of the foetus as a male happens because the ovum was fertilized by a Y-bearing sperm, because its gonads secreted testosterone and the female duct-inhibiting substance. But this is only part of the story of why a male becomes a male.

The physical changes in the genitals of the unborn male child, which are mediated by testosterone, may have a psychological component.

In small mammals, such as rats, monkeys, and sheep, testosterone made by the testicles of the foetus is known to modify the animal’s brain, imprinting on it a ‘maleness’ in its response to stimuli after it is born. In humans, this pre-natal brain conditioning has only a small effect, which is to modify or blur the child’s behaviour towards a male-type behaviour rather than to alter it considerably, as is the case of many other mammals.

The conditioning of the male child’s brain may enable the boy to identify more readily with his father (or some other significant male) and to model his behaviour on the way the adult male behaves. At the same time the modified brain response makes the boy treat his mother in a different, complementary way.

This means that, as far as the example of his father is concerned (or his mother’s interpretation of how a man behaves), the child responds positively by thinking, ‘This is how I am to behave’. In contrast, he responds negatively to the model of his mother by thinking, ‘This is how people of the other sex behave, and I must not imitate this behaviour but I must respond in a complementary way’.

*2/16/113*

HOW YOU BECOME A MALE – INTRODUCTION

Deep in the dark, moist, warm innermost recesses of the vagina, three hundred million spermatozoa (sperms) are ejaculated from the pulsing male penis at orgasm. One of these three hundred million will, with luck, succeed in making the 12-centimetre journey through the uterus of the woman and will penetrate the ‘shell’ of a single egg which lies waiting in her oviduct. The egg, or ovum, which has been expelled from the woman’s ovary at ovulation, has been gently propelled into her oviduct by the finger-like fronds which surround its internal opening.

The journey of the sperms is only possible within a period of two days on each side of ovulation, for it is only during this short time that the sperms can penetrate the mucus which fills the canal which leads into the uterus. Only at this time does the mucus alter from an impenetrable mesh to long strands through which twisting, turning channels form. Through these helical tunnels several million sperms pass, of the three hundred million ejaculated, propelled by the thrashing of their long threadlike tails. But only those sperms whose heads are of the right size can get through; sperms with abnormally big heads are trapped.

Of the several million which reach the uterus, only a few thousands will survive the journey through its cavity, and even fewer will survive the journey along the oviduct. One, and one alone, will penetrate the shell of the ovum. As its head fixes deeply into the substance of the egg cell, it loses its tail, and the free head fuses with the nucleus in the ovum. A new individual, male or female, has been formed.

Each of the sperms ejaculated into the vagina carries in its head in twisted material, like a bank of computer tapes, all the genetic information needed to make the new individual unique. The twisted material is separated into strands called chromosomes. This genetic inheritance from father and mother, and their father and mother, and their father and mother, combines in an almost infinite variety of ways, suppressing some inherited characteristics, exaggerating others, so that family resemblances appear in the new individual, but not so much that the individual is identical with its parents or ancestors.

The core genetic material in the head of each sperm fuses with the core genetic material in the ovum to make a new mix – a new individual who will be formed as the fertilized egg cell divides repeatedly in complex ways. Once the individual has been created, each cell in his or her body has the genetic material within it capable of forming another new individual, but through aeons of evolution this facility has been suppressed, and only two specialized cells are capable of this function. These are the female and the male cells, the ova and the spermatozoa. Each human body cell, except the sex cells, carries 46 chromosomes in its nucleus. Forty-four of these determine the individual’s appearance, 2 determine its sex. The sex cells contain only 23 chromosomes, half the human number, so that when the sperm head (containing 23 chromosomes) fuses with the ovum (also containing 23 chromosomes), the normal human number of 46 is restored. Each ovum carries one sex chromosome, called an X chromosome because of its shape. Each spermatozoon also carries one sex chromosome, but about half of the spermatozoa carry an X chromosome, and the other half carry a smaller chromosome which resembles a Y.

If an X-carrying spermatozoon fertilizes the ovum, the resulting new individual becomes a female. If a Y-carrying spermatozoon fertilizes the ovum the resulting individual is a male.

Since only spermatozoa carry either an X or a Y chromosome the sex of the unborn child – at this stage only the size of a pinpoint – is determined by the child’s father. So if a man sires many daughters but no son, he cannot blame his wife. The sex of each of his children is his responsibility!

With the fusion of the nucleus of the sperm head and that of the ovum, a new life has begun. Quite rapidly the single cell accumulates energy and divides, and then divides again, so that 2, then 4, then 8, then 16, then 32, then 64 cells are formed. Each of these cells contains in its nucleus a chromosome count of 46 of which two are sex chromosomes, one X and one Y. In genetic shorthand this is written as 46XY or 46XX.

Occasionally, for incompletely understood reasons, something goes wrong to upset this seemingly simple system and extra X or Y chromosomes are added, or are taken away, or otherwise distorted. Such cell lines may continue and the individual, when born, may be sexually abnormal.

The dividing cells form a sphere, which looks rather like a mulberry within 3 days, and a day later the sphere has entered the cavity of the uterus and has become attached to its lining.

Growth occurs rapidly, and the sphere changes shape. One part of it, where several layers of cells collect, forms the embryo and, later, the foetus, while another part forms the placenta.

Three weeks after fertilization, the embryo, which now looks reptilian, has developed a gut cavity. Along its back surface, two ridges appear, one each side of the midline. These ridges will form the sex glands, or gonads. Into these ridges sex cells migrate from a nearby area, and rapidly divide and divide again.

At this stage of development it is impossible to tell the sex of the embryo by looking at the sex glands, but the cells of the sex glands have been programmed by the sex chromosome they have inherited. If the cells contain a Y sex chromosome, the gonads develop into testes and, provided the embryonic testes function properly, the remainder of the sexual anatomy will develop as a male. This is because the Y chromosomes in each of the cells which make up the embryonic testes induce it to manufacture quantities of the male sex hormone, testosterone, and a much smaller quantity of the female sex hormone, oestrogen. If the sperm which fertilized the egg carried an X chromosome, not a Y chromosome, the gonads will become ovaries, which produce quantities of oestrogen and a much smaller quantity of testosterone. In other words, the testes and the ovaries produce both male and female sex hormones, but in different quantities. The embryonic testes also produce another substance called the female duct-inhibiting substance which is important in determining the sex of the embryo.

There is, of course, more to the sexual apparatus of a male than testes. From each testis, on each side of the body, a twisted, hollow tube runs to join a similar tube from the other testis, at what will eventually become the prostate gland, and opens into a pit at the rear end of the embryo called the cloaca. By now, about 7 weeks after conception, the embryo also has a set of female ducts -oviducts, uterus, and upper vagina. Under the influence of testosterone, the male ducts grow and the female duct-inhibiting substance-causes the female ducts to wither away. If it so happens, as occurs rarely, that the embryo has a testis on one side and an ovary on the other, the side with the testis will produce a male duct and that with the ovary will produce a female duct. The child will be born a hermaphrodite.

Normally, testosterone and the female duct-inhibiting substance secreted by the testes make the male ducts grow and the female ducts wither. The embryo is well on the way to becoming a male.

He has to go through another stage of development before he does. The male ducts, at this period of development, terminate in the cloaca where the gut also ends. Just in front of the cloacal pit (that is on the embryo’s front side) a small lump appears, and two swellings grow backwards to make a raised edge to the pit. Looking from the outside, it is impossible to tell if the embryo is a female with a big clitoris, or a male with a small penis and a split behind it.

Quite soon the sex of the embryo becomes clear. If the embryo is a male, the cloacal cells absorb the testosterone which is circulating in the blood and convert it into a new product called dihydrotestos-terone. This, in turn, converts the tissues of the cloaca into male genitals. By the 14th week after conception, the lump at the front has become a tiny penis, and the folds at each side of the pit have joined together to form a scrotum. At this stage of development it is empty. Much later in pregnancy the testes are drawn down into the empty scrotum from their previous position in the foetus’s abdomen, and at birth the baby is obviously a boy.

After birth only small amounts of the sex hormones are produced by the gonads – testes in males and ovaries in females – until puberty occurs.

*1/16/113*

SLEEP WITHOUT DREAMS: DID WE SLEEP?

But everyone seems to know that they have slept, even though there is a blank in the memory during NREM sleep. How do we know that we have slept? We depend on two cues:

* Dreams, which are an inside cue

* The clock, which is an outside cue

When we wake from our dreams, we can recall the contents of the dream and we know that the dream is part of our normal sleep. Hence we are convinced that we have in fact slept. There are people who need to recall that they have dreamt before they are convinced that they have slept. Without dreams as a marker in the blank space in the NREM sleep, we are unable to give an account of what follows after the thought of ‘the wonderful lunch’.

The other cue is the clock. We look at the clock before we go to bed; it is 10.30 p.m. at night. We may wake up and go to the toilet, it is 2 a.m. When we wake up again and look at the clock it is 7 a.m. in the morning. Hence we are convinced that we must have slept about eight hours. Have you ever had the experience of the clock, for some mechanical reason, stopping at 6 a.m. in the morning, letting you believe that there was still an hour to sleep before your normal wake-up time. You go back to sleep, and later discover that the clock never went to 7 a.m.; the clock was not working! Too late, it was already 9 a.m. At night we are depending on the clock as an external cue, for during the NREM sleep our mind is blank.

A number of people constantly complain of chronic insomnia and always seek treatment. When they are placed in the sleep laboratory, however, the EEG and other recordings all confirm that I’ve been sleeping soundly. Yet, when they wake up, they insist they have not slept at all. These people cannot remember any dreams, and hence they do not have the inside cue to convince themselves that they have in fact been sleeping.

Most of us believe that we do in fact sleep. But this belief is not easily held in the absence of the dream experience or a visible clock. Those people who believe they do not sleep at night do so because they cannot experience sleep itself. All they can experience is the distress they feel while awake. I believe the blank period of NREM sleep is very important in understanding insomnia and overcoming it. People who suffer from insomnia nearly always underestimate the amount of sleep they really have. This is because individual’s own view of how much sleep he has is always inaccurate, as no one can recall how much NREM sleep he actually has.

*21/23/6*

SLEEP WITHOUT DREAMS: NREM SLEEP

Biology of NREM sleep

We know there are two different kinds of sleep, and they alternate with each other throughout the night. During REM sleep dream are experienced, and during NREM sleep there are few or no dream at all. When we fall asleep we go through NREM sleep, then RE” sleep; these two combine to form one sleep cycle and we have few sleep cycles throughout the night. In this chapter we are going to study NREM sleep in detail.

In NREM or non-REM sleep there is an absence of rapid e movement as recorded by the electro-oculogram or EOG. The brain waves are also calmer, in contrast to those of REM sleep. During REM sleep, the brain waves are not much different from those the awake state. However, during NREM sleep the brain wav are slow and big and are divided into four stages according to the frequency.

During NREM sleep the mind is in complete rest, and is passive peaceful, and calm. In REM sleep, in contrast, the mind is active’ and explosive, and the whole brain is working to capacity. Some experts report a 40 per cent increase in the blood flow to the brain during REM sleep.

During NREM sleep, the breathing is slow and regular. The blood pressure is lower than when we are awake, and the heart rate also slower as if we are in complete rest. On the other hand, du ‘ REM sleep the breathing is very heavy, and irregular. The blood pressure can be sky-high and the heart rate can be as fast as we had just finished a 100 m race. It has been observed that a heart attack or stroke takes place during sleep at night, it occurs during the REM stage. However, the peak incidence of heart attacks is between 7 a.m. and 11 a.m. in the morning and not during sleep. So you can sleep easy.

What about the muscular system during sleep? During NREM •km the muscles are active and the muscular system is fully engaged with the brain. There are spontaneous movements in the body during NREM sleep. We turn over many times during the night. This movement is important. People who cannot move because of illness such as quadriplegia suffer from bedsores. They need to be turned by nursing staff continuously throughout the 24 hours. The reason is that if the body is not moving during sleep, the skin which is under pressure from the weight of the body will be blanched and the blood supply to that part of the skin will be insufficient. That area of skin will break down and slough off to form a bedsore. So it is important that the body turns automatically during sleep, turning and moving of the limbs prevents the stiff neck and joint pain that most people experience the morning after they en drunk the night before.

REM sleep the muscular system is disengaged, as if a mechanism is preventing the body from moving. This I the physical acting out of dreams. REM sleep is also called ‘paradoxical sleep’; the brain is so active and yet, paradoxically, the body is completely paralysed.

Is NREM sleep unconscious?

NREM sleep represents three-quarters of the time spent in sleep. Although a great deal of study has been carried out on the psychology is, no one has yet studied the psychology of NREM sleep, try to make amends here. Biologists and physiologists classify our state of awareness into two main types, the conscious state and the unconscious state. This grouping should not I with Freud’s concept of the conscious and unconsciouscious state is a state in which we are not aware of anything and from which we are not easily aroused. It includes such experiences as a black-out after a head injury, the complete blank while under general anaesthetic, and so on.

The conscious state, on the other hand, is a state in which we are continuously aware of what goes on around us or of what we are thinking. We can account for all events continuously. So we how we got out of bed in the morning, got dressed, t, went to work, said hello to the pretty secretary, worked hard, had a wonderful lunch with the secretary, went back to the office to work even harder, came home, had dinner, watched to bed (still thinking about the wonderful

lunch) … and then there is a blank, until we get out of bed again the next morning. (For the lady readers, please change ‘pretty secretary’ to ‘handsome assistant’, but note that the pretty secretary here just happens to be my wife!)

An interesting feature of the above is that we are able to give a continuous account until after our thoughts of ‘the wonderful lunch’. A blank follows. We are not unconscious, as we can be aroused easily. However, we are not conscious either, as there is a blank in the continuous account of the day’s event. This blank is NREM sleep, during which there is no thinking, no memory, and no account of what goes on, very much like the blankness we have when undergoing general anaesthetic. NREM sleep is classified under the conscious state because it is arousable, but it is much more like the unconscious state, as we have no thinking or memory and cannot give a continuous account of what goes on.

*20/23/6*

SEX AND DREAMS: THE PENIS IMPLANT

The discovery of erection during REM sleep has helped progress the treatment of impotence. There are two main types of impotence. The first type arises for psychological reasons. It is well known that some men can have sex with their wives but are unable to with their mistresses, or vice versa. A variety of psychological reasons are involved, such as anxiety over the fear of being discovered an a sense of guilt, fear of catching venereal disease, etc. This psychological impotence is best treated by psychological means. The second type results from physical illness; after a bad accident or a major operation in the pelvic area, a man may not be able to have an erection at any time. A penis implant has now bee developed that can help those who are impotent because of physic illness. To sort out who is eligible for this implant, the impotent candidate has to spend a few nights in the sleep laboratory.

With the impotent candidate in the sleep laboratory, a gadget can be placed around the penis to record any erection occurring during REM sleep. This recording is called nocturnal penile tumescence or NPT, and a positive reading is a reliable indicator of psychological causes of impotence. In Melbourne, at the Cabrini Hospital, two strain gauges are placed around the penis and recordings are made on a scroll of graph paper running throughout the night. Patients who have positive NPT readings are having erections and are suffering from psychological impotence. Some times they can be woken up during an episode of REM sleep while they are having a dream erection. The mere demonstration of the ability to have an erection can give them tremendous confidence and their condition can sometimes be cured spontaneously as t’ now know that they are in fact potent.

Before the discovery of dream erections and the ability to measure NPT, most experts believed that 90 per cent of impotence resulted from psychological causes, and most impotent patients were s to see the psychiatrist. However, since the discovery of dream erections, there has been a complete change of attitude. The experts now believe that only about 50 per cent of cases of impotence arise from psychological causes, with the other 50 per cent being result of physical illness.

Patients who are impotent because of physical illness do not h positive NPT readings, and an implant may be able to reverse t’ status. There are now a variety of implants that can be surgically placed in the flaccid penis. One ingenious technique from the USA is to implant a long inflatable double sausage made of polyurethane into the penis. This is connected by thin tubes to a small bag ac as a reservoir of fluid and situated in the abdominal muscle is also connected by similar tubes to a small pump, rather like third testicle, in the scrotum. When the patient wants to have he can give his third testicle a squeeze, and the fluid is transferred from the reservoir to the inflatable implant in the penis to achieve a good erection. He can maintain this erection as long as his partner desires. When they have finished, all he has to do is give the third testicle another squeeze and a special valve allows the fluid to be transferred out of the penis. Nowadays these operations are performed all over the world.

What about women? The clitoris, the most sensitive part of the female genitalia, is the equivalent of the male penis. Developmentally, parts of the body undergo involution if they serve no purpose. An example is breasts in men, as they are not required to feed babies. During REM sleep, the clitoris goes into engorgement and hardening -penis in men. So for the lady reader, do not think – that dream erections refer only to men. Next time you wake up from a dream, feel your clitoris.

*19/23/6*