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November 17, 1962

Spontaneous Ejaculations

Author Affiliations

University of North Carolina, Chapel Hill

JAMA. 1962;182(7):820. doi:10.1001/jama.1962.03050460112020

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To the Editor:—  The expert's answer to the question regarding distressing spontaneous ejaculations which appeared in the Questions and Answers section of The Journal (181:69 [July 7] 1962) is open to serious objection, as the advice given is likely to result in iatrogenic aggravation of the symptom. In my experience, I have found that patients who complain of distress because of spontaneous ejaculations have displaced feelings of distress related to the anxiety which is produced as a result of a threat to their masculine identification. Further physical examination, as indicated in the answer, will probably arouse more anxiety and should be avoided until psychiatric consultation and treatment are attempted. Such psychiatric measures will, in all probability, make further physical examinations unnecessary.The "side effects" of diethylstilbestrol will further threaten the masculine identification of this patient, thus worsening his emotional condition, even if it stops the spontaneous ejaculations. These may,