Tag Archives: sexual dysfunction

Thyroid Disease And Sexual Dysfunction

January 10, 2021erectile dysfunction, sexual dysfunction, Thyroid Disease

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.

Sexual Dysfunction – A Silent Killer of Relationship

August 30, 2020erectile dysfunction, premature ejaculation, Sexologist in Delhi, sexual dysfunction

We call sexual dysfunctions the set of disorders in which psychological and / or physiological problems make it difficult for the person to enjoy their sexual activity as they would like. It is a disorder in some phase of the sexual response – excitement, plateau, orgasm, resolution.

Sexual dysfunctions are frequent and it is estimated that 40% of men and women can present them at some point in their lives. The most frequent among women is a lack of interest in sex and arousal problems, and premature ejaculation and impotence appear more frequently among men.

In the diagnosis and treatment of each dysfunction, the sexologist in Delhi analyzes whether the symptoms are primary or secondary, absolute or situational, or if the severity is total or partial.

The physical changes that occur in the four stages of sexual response (excitement, plateau, orgasm, and resolution) serve as the basis for analyzing at what stage sexual dysfunction occurs.

Thus, when the person is mentally and physically excited, the following physical changes appear:

In women: In men:

EXCITEMENT		EXCITEMENT
Vaginal lubrication		Penile erection
Clitoral erection		Scrotal size increases
Swollen lips		Increases the size of the testicles
PLATEAU		PLATEAU
Lip coloration		Cowper gland discharge
Vaginal tightening		Prostate gland contraction
Vaginal tightening		Prostate gland contraction
Elevation of the uterus and retraction of the clitoris		Terminal vesicle contractions
ORGASM		ORGASM
Contractions of the uterus		Ejaculation
Rhythmic contractions on the orgasmic platform		Contractions of the penis, urethra, and sphincter
Rectal sphincter contraction		Rectal sphincter contraction
RESOLUTION		RESOLUTION
The uterus and vagina return to their initial state		The penis and scrotum recover their initial state

We can classify the dysfunctions related to the sexual response cycle:

	WOMEN	MENS
Disorders of desire	Excess Deficit	Excess Deficit
Sexual arousal disorder	Lack of general excitement	Problem of starting an erection Problem of maintaining an erection
Orgasm disorder	Difficulty reaching orgasm Lack of orgasm Premature orgasm Delayed orgasm	Absence of ejaculation Premature ejaculation Delayed ejaculation
Sexual resolution disorder		Delayed resolution
Others	Dyspareunia Vaginismus Sexual phobias Socio- sexual anxiety	Dyspareunia Sexual phobias Sexual partner anxiety

Among the psychological causes of dysfunctions we find the following factors:

Predisposing factors:

Lack of information and sexual formation or inadequate information received.
Moral education devalues sexual activity.
Insecurity in the psychosexual role.
Traumatic sexual experiences.

Precipitating factors:

Relationship problems (poor communication, fights, infidelity).
The appearance of a sporadic problem (excessive tiredness, alcohol, stressful work or family situation).
Organic special moments (after a heart attack, after childbirth, anxiety disorder or depression, etc.).

Maintenance factors:

Non-existent or inadequate sexual formation.
Anxiety associated with sexual interactions.
Inappropriate personal or partner performance in sexual relations.
General problems in the couple relationship.
Specific fears or phobias.

Physiological causes of dysfunctions:

Diseases or injuries: of the cardiovascular system, endocrine system, genitourinary tract, nervous system.

Effects of drugs: sedatives, antiandrogens, anticholinergics and antiadrenergics, psychotropic.

(The most frequent physical disorders are: diabetes, hypertension, hypogonadism, spinal disorders, etc .; at the drug level they are antihypertensive, antidepressant, alcohol, barbiturate, etc.).

Female sexual dysfunctions:

Hypoactive sexual desire (“sexual apathy”, “lack of sexual desire”, “lack of interest in sex”).
Lack of interest in sex, absence of fantasy, dreams or thoughts of sexual content, difficulty engaging in autoerotic or partner sexual activity.

Aversion to sex
Intense feelings of disgust, displeasure, repulsion or fear of situations of a sexual nature (concrete or thought). Sexual contact is usually avoided.

Sexual arousal disorder
Loss of arousal levels, physical and emotional disconnection from sexual intercourse. Inability to respond to caresses, sexual physiological responses are not experienced.

Orgasmic disorder
Difficulty reaching orgasm after an adequate level of arousal.
Dyspareunia
Pain during intercourse.

Vaginismus
Involuntary contraction of the outer third of the vagina upon penetration.

Sexual dysfunctions due to medical illnesses
Some illnesses can influence sexual functioning due to the physiological alterations they produce or the medication they require; These include: diabetes, arthritis, multiple sclerosis, spinal cord injury, thyroid, endometriosis, vaginal infections.

Substance-Induced Sexual Dysfunctions
The use of some drugs or drugs can affect sexual response.

Male sexual dysfunctions:

Impotence, erectile dysfunction:
Inability to obtain or maintain an erection sufficient to perform intercourse satisfactorily.

Premature ejaculation:
Inability to exercise voluntary control over the ejaculatory reflex.

Delayed ejaculation:
The man cannot ejaculate due to excessive involuntary control of the ejaculatory reflex.

Anorgasmia
There is no sensation of pleasure, but the semen does come out.

Dyspareunia
Pain during intercourse, which can be during or after sexual intercourse.

Sexual Dysfunctions Treatment

July 25, 2020sexual dysfunction

What are Sexual Dysfunctions?

You can talk about sexual dysfunction when you experience difficulties regarding desire, arousal, orgasm, or resolution during any stage of the sexual act. The appearance of pain at any time of the act is also considered a dysfunction, says sexologist in Dwarka.

When we refer to the sexual response of people, we must know that it normally follows a progression common in all individuals and that it is divided into desire, excitement or plateau, orgasm, and resolution. When problems or disorders occur in one or more stages of this progression, we would be facing sexual dysfunction.

The appearance of sexual dysfunctions can have harmful effects on people who suffer from them since they often experience difficulties in their relationships with their partner and their self-esteem is reduced, explains the best sexologist in Dwarka.

Anyone can occasionally present small abnormalities in their sexual response, although we would be talking about dysfunction when the problem lasts for a certain time, at least three months, and which also occurs persistently.

What is the reason for Sexual Dysfunction?

If we ask ourselves the reason or the possible origin of sexual dysfunctions, we can distinguish three types of main factors:

Predisposing factors, which increase the chances of the appearance of a dysfunction:

A restrictive religious or moral education
Living a traumatic experience in childhood
Presence of parents with problems in their relationship
Sexual myths
Feeling insecure with one’s gender

Precipitating factors, which can cause dysfunction:

Relationship problems
Sexual dysfunction in the couple
Adverse situations in the social, work or family environment
Inappropriate interaction with the partner in the sexual sphere
Inappropriate sexual experiences
Pregnancy or childbirth
Focus on a previous sporadic failure

Maintaining factors, which lead to the dysfunction not disappearing and therefore recurring on other occasions:

Lack of information on dysfunction
The anticipation of sexual failure or failure
Anxiety and/or fear of the sexual act
Communication problems and/or attraction with the partner
Feeling of responsibility or guilt with the partner
Depression
Substance use (alcoholism)
Anorexia
Anxiety

What are the main symptoms of Sexual Dysfunction?

Although the causes of sexual dysfunction can be very varied, its symptoms are common. In general, we find elements such as a lack of interest in sex, little receptivity to sexual activity, or lack of fantasies or sexual thoughts, says sexologist doctor in Dwarka.

We can analyze the symptoms in more detail depending on whether the person suffering from the dysfunction is a man or a woman, which would allow us to make the following classification:

Symptoms in men

Impossibility of achieving an erection
Premature ejaculation
Problems ejaculating, delayed ejaculation or inability to ejaculate
Difficulty maintaining proper erection and having satisfying sex

Symptoms in women

Vaginismus, or difficulty achieving painless or uncomfortable penetration, due to involuntary muscle contraction of the vagina
Lack or insufficiency of vaginal lubrication
Pain, stinging, or burning sensation in the vulva or vagina while having sex
Anorgasmia or inability to reach orgasm

Symptoms common to men and women

Inability to get excited
Lack of sexual desire or interest
Pain in sexual relations (more frequent in women than in men)

What types of Sexual Dysfunctions are there?

There are four categories of sexual dysfunction, depending on the factor that is related in each case:

Sexual desire disorders

This disorder is the most frequent and is characterized by the deficiency or absence of sexual appetite, fantasies, or erotic thoughts, as well as lack of receptivity to have sexual relations. It is more frequent in women than in men, since it can affect about a third of women between 18 and 59 years of age, and even close to half of the women once menopause begins.

This type of desire disorder has various causes, both cognitive and biological or affective, so its diagnosis and treatment can be complex, explains b.

Hypoactive sexual desire disorder: occurs when sexual desire persistently and continuously decreases, lasting at least six months, experiencing a lack of sexual fantasies as well as little or no interest in having erotic relationships. In this type of case, the origin may be associated with factors such as anguish, anxiety, or problems in maintaining interpersonal relationships.

Sex aversion disorder: Also called sexual rejection, it is characterized by an extreme or irrational fear of sex. It is a relatively rare disorder and occurs in both men and women. It resembles phobias in that the person suffering from this disorder experiences physiological reactions such as sweating, increased heart rate, nausea, etc., when witnessing some type of sexual behaviour or, sometimes, even at the mere thought of it.

Sexual arousal disorders

We speak of disorders of arousal in those cases in which the people who suffer them experience difficulties in the second stage of sexual response, that of excitement or plateau. Traditionally, this type of disorder was known with derogatory names, such as “impotence” or “frigidity”, although nowadays its motives and causes are much better known and are more de-stigmatized.

These types of disorders are usually related to medical or physiological causes, in addition to psychological ones, such as, for example, a lack of blood flow in men or vaginal lubrication problems in women, explains sexologist doctor in Dwarka.

Sexual arousal disorders are more frequent in men than in women, although the latter also experience them.

Male Erection Disorder: Also known as erectile dysfunction, it consists of the inability to obtain or maintain a satisfactory erection. This entails, therefore, the inability to develop sexual relations, especially those that involve penetration. In order to really be an erection disorder, this problem must be maintained for a minimum of six months, and also must not be caused by other causes, such as substance use (medications, drugs, etc.)

Disorder of female sexual arousal: it consists of the total or partial failure of vaginal lubrication, and which consequently makes intercourse difficult or impossible. The causes of this type of disorder can be both psychological (depression, low self-esteem, anxiety, stress, etc.) and physical (lack of estrogens, infections, etc.)

Orgasm disorders

Also known as anorgasmia, it is the inability to reach orgasm even when there is great sexual desire or appropriate stimulation is being received. We can speak of orgasm disorders when we find persistent absence or delay of orgasm after having successfully developed the excitement or plateau phase, says the best sexologist in Dwarka.

Although it is more frequent in women, this disorder also occurs in men; in any case, in both cases, the psychological component is of great importance. In addition, this disorder can severely affect the self-esteem of people who suffer from it.

Male Orgasmic Dysfunction: This disorder consists of the absence or abnormal delay of orgasm in the male. However, it is important to note that this absence of an orgasm does not imply the absence of excitement or pleasure, but only the inability to reach the culmination of the sexual act.

Female Orgasmic Dysfunction: Like men, women may also experience orgasmic dysfunction disorders; they, to reach orgasm, can experience different types and intensities of stimulation. Despite this, many women have never experienced an orgasm. And there are even some others who have stopped experiencing it after having sexual intercourse normally during a period.

Premature ejaculation: This is the most frequent sexual disorder in men; however, there is still a certain taboo on this. It consists of the sudden and early expulsion of semen, earlier than desired, and which cannot be controlled. It affects almost a third of men; however, it is estimated that at least 70% of them have experienced it at some point in their lives. It does not imply any risk to the health of those who suffer it, but it can lead to problems related to self-esteem, warns sexologist in Delhi.

Pain disorders

The sexual pain disorders consist of suffering genital pain during intercourse affected person. It is much more frequent in women than in men, although the latter can also suffer from it. Thus, while dyspareunia affects both men and women, vaginismus affects only the latter.

Dyspareunia: This is a disorder that affects both men and women, although it is much more frequent in these. This disorder can range from simple genital irritation after intercourse, to experiencing deep pain. Dyspareunia is usually defined as discomfort or pain before, during, or after intercourse.

Vaginismus: Unlike dyspareunia, vaginismus affects only women. This disorder consists of the difficulty to have sexual relations, due to an involuntary muscular contraction of the vagina. Therefore, although vaginismus makes intercourse very difficult or impossible, women who suffer from it can practice other types of games or sexual practices, and even achieve orgasm through them.

How is Sexual Dysfunction treated?

Today the most effective treatment is sex therapy. This has the main objective of creating or restoring the sexual well-being and satisfaction of both members of the couple.

The first objective will always be an evaluation to establish a diagnosis of dysfunction. It is important after the diagnosis that there is adequate information about the dysfunction that is suffered and about sexuality. Then the sex treatment in Delhi will focus on sexual objectives. This part is the most important, where different very effective programs have a place. Finally, prevention and possible relapses will be worked on, suggests sexologist in Delhi.