Manthan Clinic

Sexual Health

 

Human sexuality is a vital and integral part of behavior and personality. Sexual dysfunction is a source of great distress to individuals and couples. Sexual dysfunction may lead to a failure to form relationships or the breakup of existing relationships and families, because it is frequently under-recognized and under-diagnosed in clinical practice. 

Sexual dysfunctions are highly prevalent, affecting about 43% of women and 31% of men.  

 

Male Sexual Problems

 

Problems of desire

The sexual drive or libido is inherent in all human beings. Usually the sexual drive is directed towards appropriate sexual partners, but sometimes there can be problems with the drive in terms of its amount or direction.

 

Loss of libido implies a diminution in the sexual drive and can be caused by psychological disorders such as depression, marital discord leading to desire deficiency, performance anxiety leading to excitement inhibition.

CNS disease like Partial epilepsy, Parkinson’s disease, Androgen deficiency, alcoholism, drugs like anti-hypertensive and anorexia nervosa.

 

Physical illnesses such as carcinomatosis or heart failure may also lead to loss of libido.

 

Excess libido can be associated with psychological disorders such as hypomania or frontal lobe syndrome, addictive sexuality, sex impulsivity or rarely physical illnesses such as tuberculosis.

 

Disorders of Arousal

Erectile Dysfunction

Psychogenic cause, Androgen deficiency, hyperthyroidism or hypothyroidism, vascular insufficiency causes like atherosclerosis, penile Raynaud’s, venous leakage, spinal cord or nerve injury may also lead to erectile dysfunction in males.

 

Problems of performance

Because of social taboos, the sexual act is shrouded in a certain aura of mystery. The sexual naïve individual or couple may lack the necessary knowledge and skills to perform sex.

Lacking the confidence that experience can bring, a young man may suffer with premature ejaculation, where semen is ejaculated before entering the vagina, or before sex has properly got underway. The problem may lead to avoidance of sexual act (a bit like avoidance associated with a phobia) and problems in relationship.   

 

Case History

Rahul went to his family doctor twice before he said what he wanted to say. The first time he spoke to the female partner in the general practice and came away red faced, clutching a prescription for a sore throat. The second time Rahul visited me and I spent some time trying to understand Rahul’s anxiety. Rahul told me that he was having problems with his wife and that she had told me to ‘get it sorted out, because there must be something wrong with you’. Amidst some embarrassment the young man told me that when he tried to have sex with his wife ‘it didn’t last very long’. On careful examination and questioning about what Rahul meant, it transpired that Rahul always ejaculated during foreplay. He had never managed to penetrate his partner. The closest that they had both got to intercourse was when he managed to put a condom on. Unfortunately, he ejaculated immediately.

 

Absent  Ejaculation

 

Post Ejaculation Pain

 

Delayed Ejaculation

 

Problems of gender

Apart from biological intersex conditions, gender is generally appropriately assigned to society according to the normal male’s genitalia. The social gender given to the new-born male is usually followed by a core male gender. In other words, the male looks and feels that he is a male.

In male transsexuals, although male genitalia are fully developed, the core gender is female. So although phenotypically male, the male transsexual feels that he is female and should have female genitalia. There is a fundamental difference from male homosexuals who both look male and feel that they are males. Male transsexuals may cross dress and seek hormonal and surgical means of adopting feminine attributes.

 

Dhat Syndrome

It is culture bound clinical condition where there is guilt in young men about loss of semen affecting their physical and psychological health. It is also associated with anxiety and depressive symptoms. The core feature is concern with passage of semen during micturition or while staining to pass stool.

 

Apprehension about potency

It is a common belief that masturbation and night emission before marriage result in loss of potency in marital relations. Masturbation is considered to be responsible for shrinkage or sideward curvature of penis and watery semen.

Female Sexual Problems

 

Problems of Desire

The most common female sexual problem presenting to specialist clinics is one of low sexual interest. This problem is relatively difficult to treat. It may require intensive psychotherapy looking for reasons for ambivalence about sexual behavior caused, say, by childhood sexual abuse. Organic causes such as endocrine disturbance (hypothyroidism, hyperthyroidism, pituitary adenomas and others) need to be excluded as do psychiatric disorders like depression. 

 

Disorders of arousal

Subjective Sexual Arousal Disorder

• Relationship issues 

• Sexual trauma in childhood

Genital Sexual Arousal Disorder

• Stress

• Fatigue

• Endocrine or hormonal problems

Orgasmic Disorders

• Strong feeling of losing control over feelings and behavior

Vaginismus

• Involuntary muscle spasm

• Physical or sexual abuse

• Painful first sexual intercourse

• Relationship problems

• Fear of pregnancy

• Religious orthodoxy

• Poor sexual education

• Sexual inhibition

• Fear of intimacy

• Psychological conflict

Treatment of Sexual Dysfunctions is provided at our Niramaya - The Mind Centre which is specialized in providing  

• Sex Education

• Relaxation Exercises

• Homework assignments for couples

• Oral Herbal Medications for Erectile Dysfunctions

• Oral Herbal Medications for Premature Ejaculation

• Oral Herbal Medications for Leucorrhea in Women

• Herbal Medications for Vaginal pains

• Herbal Topical/local Therapy