Monthly Archives: December 2021

sexologist in Lajpat Nagar

Sexual Problems Treatment

What are sexual problems?

Sexual problems or sexual dysfunctions refer to different pathologies or circumstances that do not allow pleasant sexual relations. Some of these problems include pain, trouble reaching orgasm, or loss of sexual arousal, says sexologist in Lajpat Nagar.

They can be presented by both women and men. In women, it manifests itself with the symptoms of pain during sexual intercourse, absence of orgasm and desire, or arousal problems. In men we find erectile dysfunction, reduction or loss of sexual interest, problems with premature or delayed ejaculation, or low testosterone.

Prognosis of the disease

Sexual problems are not a serious disease for which the patient puts his life at risk, but sexual health will be affected, also influencing his emotional health and quality of life. In many cases, according to the best sexologist in Lajpat Nagar patients with sexual problems experience a loss of self-confidence, low self-esteem, or even depression.

In addition, the particularity of sexual problems lies in that they not only affect the sexual health of the patient, but also influence that of their partner.

Symptoms of sexual problems

The symptoms of sexual problems are diverse, depending on the problem that occurs in each case:

Both men and women can experience the sexual disorders of anorgasmia and  lack of sexual desire, which refer to psychological disorders that do not allow the patient to enjoy sexual intercourse. The symptoms are usually anxiety, depression or stress.

The main sexual problems that affect only men are:

  • Erectile dysfunction : the man will feel the inability to have an erection or maintain it during intercourse.
  • Premature ejaculation : the man expels semen prematurely and is not able to retain it.
  • Delayed ejaculation : on the contrary, in this case the man needs a long time of stimulation to ejaculate, just as some of them do not finally ejaculate.
  • Low testosterone : This alteration in testosterone causes depression, anxiety, lack of sexual desire, erectile dysfunction, increased sweating, and fatigue or tiredness.

On the other hand, sexual problems that only affect women are:

  • Vaginismus : the patient will feel intense pain during sexual intercourse, to the point of making penetration impossible, due to the contraction of the vaginal muscles.
  • Dyspareunia : the patient feels intense and persistent pain in the pelvic area during or after penetration. Although it is more common in women, some men can suffer from it.

What are the causes of sexual problems?

The causes of sexual problems can be psychological or physical, and may be derived from stress, from some illness or injury suffered, side effects of some medication or emotional or physical problems, says sexologist in Lajpat Nagar.

Can they be prevented?

Prevention of many sexual problems can be established through good physical and emotional health. For example, erectile dysfunction can be caused by vascular causes, which could be prevented by avoiding obesity, high blood pressure, high cholesterol levels, or smoking.

On the other hand, education plays a very important role in sexual problems, since in many cases of anorgasmia, lack of sexual desire or dysfunction, the sexual education that the patient has received, their perception of sex and their self-esteem and confidence in itself.

Also treating stress and anxiety is useful to avoid sexual problems with psychological causes, explains sexologist in Delhi.

Treatments for sexual problems

The treatment for sexual problems will vary greatly depending on the sexual problem suffered and the cause that originated it.

Thus, many of the sexual disorders are dealt with with psychological therapy. In contrast, in cases caused by vascular, pelvic floor or hormonal problems , you will need personalized care and treatment by an expert gynecologist or sexologist in Lajpat Nagar.

 

Male Infertility of Testicular Origin

Male Infertility of Testicular Origin

According to the best sexologist in Delhi, there are numerous factors that can cause male infertility as a result of their effect on the generation and maturation of sperm in the testicles themselves, generating oligozoospermia (low concentration of sperm in semen), asthenozoospermia (low mobility of sperm), teratozoospermia (abnormal in sperm morphology) or secretory azoospermia (no sperm are produced in the testes).

The most common causes of male infertility of testicular origin include the following:

  • High testicular temperature: the normal temperature of the testicles should be between 35.5º and 36º. Any elevation above these figures has a negative impact on the sperm maturation process that begins in the seminiferous tubules.
  • Toxic agents: there are numerous environmental factors to whose exposure the testicles can see altered the activity of Sertoli cells, which play an essential role in the transformation of spermatidine into mature sperm: tobacco, environmental pollution, pesticides, consumption of meat from animals hormonalized with estrogens, use of certain drugs, radiotherapy, professional exposure to toxic substances, etc.
  • Klinefelter syndrome or XXY males: this is a chromosomal abnormality in which males have an extra X chromosome, causing a drop in testosterone that prevents sperm production (azoospermia). In addition, it causes anatomical alterations in the sexual organs, such as hypoganadism or micropenis.
  • Other genetic factors: in recent times, genetic alterations have been detected in areas of the Y chromosome that negatively affect the spermatogenesis process, causing oligospermia or azoospermia. This is the reason that in assisted reproduction clinics men with a sperm concentration of less than five million.
  • Trauma: strong blows to the testicles can affect the mechanisms of sperm production and maturation.
  • Testicular pathologies: there are different diseases that affect the testicle and that condition the correct production of sperm:

–  Varicocele: is responsible for 20% of cases of male infertility that are detected in assisted reproduction clinics. It is characterized by venous valve insufficiency of the spermatic veins and, depending on its severity, can cause teratozoospermia and oligozoospermia.
–  Cryptorchidism: It is a problem that occurs essentially in boys as one or both testicles do not descend into the scrotum, so, among other things, they are subjected to temperatures above 36º, which affects the quality of the sperm. It can also occur after puberty as a result of mumps.
–  Hydrocele: it is the accumulation of fluid around the testicle, which causes a significant increase in the overall volume of the scrotal bag that contains it. In principle, it may not compromise fertility, but there is a risk of complications that can cause infertility.
–  Genitourinary infections: they can cause testicular atrophy, obstruction of the seminal tract, generation of antisperm antibodies or compromise the accessory glands. They account for 5% of cases of male infertility, although some studies indicate that in 15% of men the semen analysis offers positive results.

Thyroid Disease And Sexual Dysfunction

Thyroid Disease And Sexual Dysfunction

Thyroid diseases and their impact on male and female sexual function is an issue that has not been historically given greater importance in sexual medicine, in relation to -for example- the impact of diabetes or high blood pressure. But fortunately, the trend is beginning to reverse, as in the last decade we found an increase in the number of well-designed studies exploring this relationship. Considering that thyroid diseases are quite common in the general population, it is reasonable and desirable that this is happening.

Let’s start by defining these pathologies. Hypothyroidism is characterized by the fact that the thyroid gland does not produce the amount of thyroid hormones that are needed for the normal functioning of the body, while hyperthyroidism is the excess production of these hormones.

In this sense, we found an article published in 2018 in Sexual Medicine Reviews entitled The impact of thyroid disease on sexual dysfunction in men and women. In this work, thyroid disease, sexual dysfunction, the relationship between the two conditions, and their treatments are reviewed in depth.

Hypothyroidism and hyperthyroidism are common medical disorders that manifest in a wide variety of ways that have been well described in the medical literature. Primary hypothyroidism accounts for 95% of all forms of hypothyroidism. In contrast, hyperthyroidism has a larger and larger number of etiologies. Regarding symptoms, hypothyroidism manifests itself with symptoms such as weight gain, fatigue, constipation, cold intolerance, cognitive slowness, dry skin, edema, myalgia, and also menstrual irregularities. For its part, hyperthyroidism occurs in both sexes with a combination of increased appetite and weight loss, heat intolerance, tremors, palpitations, emotional lability, and anxiety.

The primary treatment for hypothyroidism is replacement therapy in the form of synthetic T4. Modalities for the treatment of hyperthyroidism include radioactive iodine, various antithyroid medications, and thyroidectomy.

Thyroid disorders have been associated, as we will see below, with significant disturbances in male and female sexual function.

Hypothyroidism and sexual dysfunction

The limited number of studies available on the prevalence of the dysfunction in patients with hypothyroidism has shown that more than 60% of men with this condition experience erectile dysfunction. With regard to female sexual dysfunction, studies show figures ranging from 21% to 46%.

In relation to the mechanisms through which thyroid deficiency can exert direct and indirect effects on sexual function, in the case of men it is the alteration of the regulation of the hypothalamic-pituitary-gonadal axis, which leads to a reduction in circulating sex hormone levels. In women, studies have shown that low circulating thyroid hormone is the single most important factor driving sexual dysfunction. Studies have also revealed that prolonged primary hypothyroidism can lead to hyperprolactinemia, which is another potential mechanism for sexual dysfunction that applies to both men and women. On the other hand, hypothyroidism is associated with fatigue,

There are several reports that demonstrate an association between sexual dysfunction in male patients with hypothyroidism, especially in the form of erectile dysfunction, ejaculatory dysfunction, low sexual desire, and alterations in sperm characteristics and fertility. The relationship between hypothyroidism and erectile dysfunction has been particularly documented, but we also have studies that link it to the other sexual dysfunctions mentioned.

The association between hypothyroidism and female sexual dysfunction has also been documented, although fewer studies are available compared to men. Special attention has been paid to the link between hypothyroidism and changes in sexual desire, vaginal arousal/lubrication, and orgasm. Considering that the incidence of hypothyroidism also peaks in the menopausal age, perimenopausal symptoms can overlap with hypothyroid symptoms and also contribute to sexual dysfunction.

Hyperthyroidism and sexual dysfunction

In men, the prevalence of sexual dysfunction in patients with hyperthyroidism has been estimated to be 48% to 77%, and in women, it is 44% to 60%.

Similar to mechanisms seen in patients with hypothyroidism, studies have shown that hyperthyroidism can, directly and indirectly, modulate sexual function. Although the exact mechanism remains a matter of debate, three pathways have been implicated: sympathetic, endocrine, and psychiatric.

The most common sexual sequelae of hyperthyroidism in men are erectile dysfunction and premature ejaculation. Regarding women, different studies found significantly lower scores in all domains of the Female Sexual Function Index (FSFI): desire, arousal, lubrication, orgasm, satisfaction, and pain, compared to age-matched controls.

In relation to the treatment, the correction of hypothyroidism in men and women produced positive effects on sexual function, normalizing the phases of desire, arousal, and increasing levels of sexual satisfaction. Studies also show a significant improvement in sexual function in hyperthyroid patients treated with antithyroid medications.

In conclusion, the recent evidence presented in this review suggests that thyroid axis dysregulation plays an important role in sexual dysfunction that cannot be overlooked. Correction of thyroid hormone deficiency or excess was associated with an evident resolution of sexual dysfunction in male and female patients with hypothyroidism or hyperthyroidism.

By deepening the understanding of the relationship between thyroid disease and sexual dysfunction, sexologist in Delhi working in the field of sexual medicine can more accurately and rapidly identify patients with these conditions, as well as resolve associated sexual symptoms through treating the underlying thyroid disorder.