Healthy living With Dr. Nanchak Nimzing
Pone No: 08036787758, 09052597025
Normal sexual function is a complex interaction involving both the mind (i.e. thoughts, memories and emotions) and the body. The nervous, circulatory and endocrine (hormonal) systems all interact with the mind to produce a sexual response.
In men, sexual dysfunction refers to difficulties in engaging in sexual intercourse. This involves a variety of disorders such as:
(1) Sex drive (also known as libido)
(2) The ability to achieve or maintain erection (erectile dysfunction or impotence).
(3) Ejaculation (either premature or retrograde).
Generally, sexual dysfunction may result from either physical or psychologic factors, or a combination of both. A physical problem may lead to psychologic problems (such as anxiety and fear) which can in turn aggravate the physical problem. Men sometimes pressure themselves or feel pressured by a partner to perform well sexually and become distressed when they cannot (this is PERFORMANCE ANXIETY). Performance anxiety can be troublesome and further worsen a man’s ability to enjoy sexual relations.
(1) ERECTILE DYSFUNCTION
Erectile dysfunction (or impotence) is the inability to achieve or maintain an erection. This is the most common sexual dysfunction in men.
Every man is occasionally unable to achieve an erection, this is normal. Erectile dysfunction occurs when the problem is FREQUENT or CONTINUOUS.
– This can be MILD (i.e. sometimes he can achieve a full erection, but most other times, it is not adequate for penetration, or no erection at all).
– A man with SEVERE erectile dysfunction is rarely able to achieve an erection.
– Erectile dysfunction becomes more common with age but is not part of the normal aging process. About ½ of men 65 years and ¾ of men 80 years of age have erectile dysfunction.
(i) Disorders that narrow arteries or decrease blood inflow (e.g. atherosclerosis, DIABETES or blood clot).
(ii) Neurologic damage such as the nerve leading to or from the penis.
(iii) Hormonal disturbance – testosterone.
(iiii) Drugs can interfere with the ability to achieve erection – antihypertensives, antidepressants, some sedatives or antipsychotics.
(v) Psychologic issues (a depression, performance anxiety, guilt, fear of intimacy, ambivalence about sexual orientation). This is more common in younger men.
(vi) Miscellaneous – problems with relationships, problems at work, factors like stress, illness, fatigue etc.
2. DECREASED LIBIDO
Decreased libido is a reduction in sex drive. Sex drive (libido) varies greatly among men. Different men find different degrees of libido satisfactory. Libido maybe decreased temporarily by condition such as fatigue or anxiety. Libido also tends to decrease gradually as a man ages. Persistent low libido may cause distress to a man and his sex partner.
Life long low libido can result from:
(a) Traumatic childhood sexual experiences or from learned suppression of sexual thoughts.
(b) Most often however, low libido develops after years of normal sexual desire. Psychologic factors such as:
– Anxiety are often the cause.
– Relationship problems
(c) Some drugs such as those used to treat hypertension, depression or anxiety as well as.
(d) Decreased levels of testosterone can also lower libido.
A man with decreased libido thinks less about sex. He losses interest in sexual activity. Even sexual stimulation by sights, words or touch, may fail to provoke interest.
The man often retains the capacity for sexual function as some men continue to engage in sexual activity just to satisfy their partner.
– The diagnosis is usually based on the man’s description of his symptoms – even though a blood test can measure the level of testosterone in the blood.
– If due to psychologic factors, various psychologic therapies – including behavioural therapies, such as SENSATE FOCUS TECHNIC can help.
– Acupuncture therapy, especially needling at tonification points to lift up the man’s energy level, and regulatory points are very useful. After this, counseling and diet advice in addition to supplements such as natural testosterone boosters have been useful. If the cause appears to be a drug, his doctor can often try treating the man with a different drug.
3. PREMATURE EJACULATION
This is ejaculation that occurs too early, usually before, upon or shortly after penetration. This is not just ejaculation that occurs before a man wants it to but rather ejaculation that occurs very soon – often within a minute or two.
(i) It is rarely caused by a disease, although inflammation of the prostate gland or a nervous system disorder can cause the condition.
(ii) It is thought mainly to result from anxiety or other psychologic causes.
(iii) Also, it is thought that unusually sensitive penile skin may be a cause.
(1) Specific acupuncture points are used as well as behavior modification therapy can help most men in addition to natural supplements.
4. RETROGRADE EJACULATION
Retrograde ejaculation is a condition in which semen is ejaculated backward into the bladder rather than through the normal outlet.
In this condition, the part of the bladder that normally closes during ejaculation (i.e. the bladder neck) remains open, causing ejaculatory fluid to travel backward into the bladder.
-Spinal cord injuries
-Certain drugs and some
-Surgical operations (including TURP-transurethral resection of the prostate).
Men with retrograde ejaculation can still have orgasms. However, it reduces the amount of fluid coming out, sometimes no fluid comes out. The condition can cause infertility but is otherwise not harmful.
-The diagnosis is made by finding a large amount of sperm in a urine sample.
Most men need no treatment, but more than one third of men with the condition improve after acupuncture treatment.