[may fluctuate abruptly] who require extra management in addition to nifedipine. Nitroglycerin tablets should not be administered routinely or casually, but only when indicated,” she cautions. “Ask your doctor before pursuing any kind of mechanical or electrical stimulation of your penis if you are prone to AD. Besides being very painful and taking away from your ejaculatory experience, it could leave you more disabled or dead.”

With that warning firmly in mind, it is safest to try your first vibrostimulation at a center or clinic where your blood pressure can be monitored. While this is ideal, it’s not practical for most. I encourage you to at least get a home blood pressure cuff to monitor yourself. AD is sometimes “silent” — as there are often no noticeable symptoms until it’s too late.

Over-the-counter vibrators are low-amplitude and work for maybe 30-40 percent of all men with SCI. The ideal vibrator is a high-amplitude medical model that works on 80-90 percent of men with injuries T10 or above and for about 70 percent of men with injuries at all levels. Until recently, the Ferticare by Multicept was your only option, priced at around $850. Now the Viberect X3 by Reflexonic is available and nearly as effective — for $299.

Try stimulating the shaft of the penis for about a minute, then focusing in on the frenulum on the underside of the penis next to the coronal ridge of the glans or head of the penis for another minute. Use the vibrator for only a couple of minutes at a time with at least a couple of minutes rest from the vibrator in between to avoid skin breakdown and excessive swelling. Some swelling is likely. It is very important not to stimulate yourself too long with the vibrator to maintain your skin integrity. When you are resting from the vibrator, you or your partner can continue to stimulate your penis manually or your partner can stimulate you orally. Massaging the perineum, the area between the base of your scrotum and your anus, while you are being stimulated with the vibrator may also help.

Erotic Electrostimulation: Proceed With Caution

In the February 2015 edition of NM, I saw a reference to erotic electrostimulation at the end of “Second Chances,” the cover story about Brian Kinney and his wife, Tiffany. In the story, Brad Stubblefield told Brian about using a transcutaneous electrical nerve stimulation (TENS) unit to evoke ejaculation. Brian’s story inspired me to do some experimentation and research of my own. I had an e-stim unit that had been used for neuromuscular electrical stimulation (NMES) of my abs and glutes, but I didn’t know exactly where to place the electrodes and what settings to use for ejaculation.

I went to the scientific literature, but there was nothing on men with SCI using e-stim at home for this purpose. There is a body of research on the use of electro-ejaculation stimulation, or more descriptively, rectal probe ejaculation, but my sense is that most men don’t want to go there outside of the medical setting. There’s also an interesting 2005 study by Dr. Lance Goetz on the addition of NMES of the abdomen to the vibrostimulation protocols, which increases the success rate of vibrostimulation significantly [http://bit.ly/1JUlx1S].

Fortunately, I found the Electro Nut Busting thread at CareCure. Based on my rough analysis, there were about 31 guys and one brave woman who experimented with either vibrostimulation or e-stim contributing to this wealth of knowledge.

One Woman’s Experience The “brave woman” who joined all the guys in the electro nut busting CareCure thread posted this encouraging response: “It worked for me! … I’m 50 and have trouble with my pudendal nerve and sciatica from my degenerative disc disease and L5-S1 herniated discs and have been two and a half years using a cane to walk for only a block, and I also have C6-7 nerve impinging. I have not been able to enjoy relations with my husband or have any desires by myself for over two years, and I used this first link with my Com-TENS unit with four pads and it did the trick, ladies!” To try this at home, here’s the link she’s referencing:

www.extremerestraints.com/male-e-stim-accessories_179/tens-pads-4-pack_30.html

From what I could discern from those who mentioned type of injury and level, about two-thirds were complete and most were cervical or upper thoracic. Of the group, 11 experimented with a vibrator and seven resulted in ejaculation. There was very little explicit discussion about pleasure and orgasm, with one person with a complete injury sharing they had both from vibrostimulation.

Of the 26 men in the discussion who tried e-stim, 22 reported ejaculation. That’s a remarkable 85 percent success rate. Five people specifically mentioned using this for fertility reasons. Ten explicitly noted that it was pleasurable, and two said it was not. Two, both with complete injuries, described the experience as orgasmic. The pioneer user who started the thread was one of them. He posted this raw response [edited lightly]: “The bottom line is: I did it! … Holy fuck! It does resemble an orgasm … it started to tighten, and it started to ‘spread.’ I was like, what the fu-aaaaahhhhhhhhhhhhh. The next moment, pump-pump-pump-pump … I have shot a load like in good old times. I have turned the EMS off and savored the feeling, a good, relaxed state, for a long while.”

Success sometimes came with a price, with six people reporting significant AD. Here is one typical story: “Ahhhh. I finally got it with four pads! Bad thing was I had it turned up too much and the AD was unbearable, I thought I was gonna croak! Had a headache for three days. Had to ice my head every night just to get it away … the AD was too much. Gonna try to go slower this time round.”

As you can see, for those prone to AD, there is ample reason to proceed with caution. This experience can be a blessing and a curse.

Together this online community worked to share and refine protocol for unit selection, electrode choice and placement, settings, and timing.

What About Equipment?

So what do you need to get started? A TENS, EMS, or NMES? What’s the difference? What brand? What size and type of electrodes?

Historically a TENS unit was prescribed for pain-related issues and a neuromuscular electrical stimulator (NEMS or EMS) for muscle strengthening. However, many units marketed today come pre-programmed with modes for both. Based on the various experiences shared, it doesn’t seem to matter what type of unit you use as long as you can adjust the pulse rate, pulse width, pulse amplitude and have a continuous setting.

I purchased a basic two-channel TENS unit muscle stimulator — TENS 7000 — complete with one set of four electrodes, lead wires, 9-volt battery, instructions, and carrying case for under $30, delivered via Amazon.

This is everything you need to get started.

Some people reported better success using rings or bands rather than square electrodes. These come in single pole and bi-pole. For help in this area I turned to Gary, the owner of happystim-usa.com. I could not find much on Amazon, and there are a lot of confusing options on specialty sites. Gary was generous with his time and gave me a lesson in basic electronics and e-stim.

Gary told me to think of a tubular fluorescent light bulb. There’s a negative charge on one end and a positive charge on the other end. Your penis is like the gas in the tube. The electrical charge runs through it with the negative attracting the positive.

A TENS pad is considered a single pole electrode because you plug one wire into a single electrode. It takes two single pole electrodes to complete the circuit, one charged by the negative branch of the lead wire and the other by the positive (red) branch. A bi-polar electrode is technically an electrode that has two single pole electrodes fixed on one unit. The closer two electrodes are to each other, the more intense the stim.

Electro nut busting has the potential to be orgasmic, but most are doing this just because they can. There are the guys who experience physiological sexual pleasure, some not as good as before, some the same. Then there is the pleasure that the majority have in the fact that they can achieve ejaculation, even if they don’t have any sensation associated with it — and even when there is significant risk and pain.

Resources

• Viberect X3, medicalvibrator.com/product/viberect-x3 or www.urologyhealthstore.com

• TENS 7000, www.medi-stim.com/stims/tens/tens7000.html

• E-stim supplies, www.happystim-usa.com

• Miami Project guide to male fertility following SCI, bit.ly/1JYpZwq

Electrode Placement for Ejaculation

[Editor’s note: To ensure proper placement of electrodes, it would be wise to contact someone with experience in erotic electrostimulation — such as an experienced CareCure Forum member, SCI nurse, or other person familiar with the process — before “flipping the switch.”]

When selecting between bi-polar and single pole electrodes, remember the bi-polar will be more intense. However, they are useful if you want to stimulate multiple sites on your anatomy. You can always start with your settings lower. I purchased the bi-polar Choker conductive loop to put around the head of the penis ($15.95) and Strangler to put around the base of the penis and scrotum ($24.95) — Oh, what I wouldn’t do for science! Note: It is recommended to use electrode gel with accessories other than TENS pads to avoid stinging or burning. I purchased the Spectra 360 Electrode Gel by Parker Labs (8 ounces for $7.50).

Once you have all your equipment, you are ready for placement. CareCure contributors often started with two sets of TENS pads (four electrodes). They placed the electrodes attached to the negative lead from each channel to the left and right of the base of the penis in the pubic area. It is recommended to trim closely or shave for best conductivity. They placed the electrodes from the positive lead of each to the left and right side of the shaft of the penis, each close to the head or overlapping. From there, individuals experimented with their own placement of the negative and positive leads.

I consulted with my colleague, Dr. Barry Komisaruk, a world-renowned sex researcher with expertise in neuroanatomy and physiology, to determine the theoretically best placement to facilitate ejaculation. Skipping the technicalities, he thinks you would definitely want to include stimulation of the scrotum in addition to the underside (ventral) of the penis, along the urethral sponge and on the top (dorsal) of the penis, to stimulate the nerves necessary for emission and propulsion, the two phases of ejaculation.

With regard to settings, the guys from CareCure were using a pulse rate between 2 and 150 Hz, a pulse width between 50 and 300 µs (microseconds), and a pulse amplitude between 0 and 100 mA (milliamps). Most would set the pulse width at 300 µs, warm up at lower levels of Hz, and ramp up the mAs during stim sessions.

Gary, owner of happystim-usa.com, always shares these three points of advice when coaching people on the art of electro sex:

• PPP — practice, patience, placement

• Retaining body water is a good thing, especially electrolytes.

• Mental state at time is important for sexual arousal

— Mitchell Tepper