SEXUAL PROBLEMS AND IGNORANCE


SEXUAL PROBLEMS AND IGNORANCE

On the occasion of Sexual Health Day (4th September), Dr Atul Dhage, Psychiatrist, Sexologist, De-addiction Specialist and counsellor, Mindcare Hospital Ratnagiri, has written an article to draw attention to this sensitive topic


                                        
                              The words “sexual” or “sex” are enough to draw anybody’s attention to this article. I am sure almost all of us would be curious to read the article but it is still treated as some kind of pandora’s box in our society. It is rare to witness people talking freely about this subject. We see small kids being shushed when they ask about genitals. Kids are usually taught body parts in kindergarten, which includes head, eyes, nose, etc. But never about genitals. They are taught about these parts’ way after their school life in 12th class and that to in science stream only. Now, how many of them really study after tenth? And even if they study, are they science students? God knows how many of them actually study and understand it or they just mug it up for marks only to forget it later without any takeaway.

                                    So, the topic today, which is not really handled well by the parents or teachers. Most of the information that is gathered by the teenagers about this topic is from television, series, roadside books or magazines, sometimes from such bluff masters to claim to have excelled at this. Curious teenagers keen to know more try to use the above-mentioned techniques to get more information. They do get information, thanks to internet. But this isn’t the correct information, all they get is distorted, delusional and misleading information which is far from reality. And this my dear friends could be the beginning of sexual problems.

                                  Problems such as impotence, misunderstandings about first night, premature ejaculation, masturbation, menstrual problems, sexual problems after forties or lack of pleasure in a relationship are very common today. Most of these problems are mental and physical.  50% of these problems are caused by ignorance and misunderstanding. Also, life today has become more stressful. This not only leads to sexual problems but also weakens the communication between husband and wife. It may lead to increase or even new addiction of alcoholism, cigarettes and tobacco. The joy of married life and sex life is lost. And then there's diabetes and hypertension. Hormonal changes in the body after delivery, in women during menopause, or in men after forties or fifties. All of these factors may cause many sexual problems. To my surprise, the only solution people believe is a sex tonic. Ignorance ..... Ignorance ....... Ignorance ........ This ignorance creates problems, but it does not stop there; Because there is ignorance about how and from whom to get treatment and what is the treatment.


                                        In the beginning, one would not realize these problems and later on might be tempted to take self-medications. There are many fake medicines (with a poster of horse, bull) available in the market, but trust me, they would only harm you more. People sometimes order some medications online after seeing advertisements, they may buy medicines from pharmacy without any prescription, they might even visit a so called “ Guptrogtadnya visiting at lodge or hotels” who doesn’t have a degree or clinic but claims to have experience. Such doctors consult at some cheap hotels. There are even some “experts in the tents”. I am sure you must have seen such tents alongside highways or main roads. They claim to sell herbs which are rare to even find. I am sure they find such herbs right outside their tents. All diseases cured by the same powder. Does this sound familiar??? I sometimes pity on such patients. Sometimes, I just don’t understand whether to laugh or cry when I hear such incidents. I would like to mention a case of a patient who had troubles with erection, where the exact words of the “tent so called doctor” was “Bhaiya nas band ho gayi hai, current nahi ata” (brother your nerves/vessles are not working because of pressure of hand on penis while masturbation). He asked the patient to lie down and used some bulb which had a switch at the bottom. He kept the bulb on his head, chest and stomach, the bulb lit all three times. But when he kept it on his genitals, the bulb did not lit as he didn’t switch on the button. And then he said “Bhaiya current nahi ata, nase dab gayi he”. You might laugh at it but such people do exist and many of us might go through situation similar to this if we are not aware about sexual problem, why are its causes and whom should one consult for sexual problems.

                             There are different sorts of sexual problems. So obviously, there are different medications to treat them. With the advancement in research in this field relating to anatomy and the psychological aspect in this process, many new and effective medicines are available (not just the tonic!). Getting the treatment has become much easier these days. What we need now is a proper treatment and counselling to handle such circumstances, proper consultation from experts. Problems generated because of mere misunderstandings can be fixed with minor medication and by giving complete knowledge about sex and sexual therapy. So, let’s dam up the river of ignorance!!! Otherwise we will be doomed to face the consequences.
                   Now let us see what are the various problems, what tests are to be done, how each of these problems are different and what are different ways of treatment. There is a difference between the problems faced by men and women. This is because the nature of sexual process differs.

Sexual problems in men:
1. Impotence
2. Erectile dysfunction
3. Premature ejaculation
4. Lack of desire
5. Retarded ejaculation / Delayed ejaculation
6. Dhat Syndrome
7. Misconceptions about masturbation
8. Misconceptions about nocturnal Ejaculation/wet dreams
9. Performance anxiety and problems due to lack of knowledge

Sexual Problems in Women:
1. Frigidity/ Lack of desire
2. Vaginismus
3. Anorgasmia
4. Problems due to lack of knowledge
5. Dyspareunia
6. Post-menopausal sexual problems
7. Misconceptions about masturbation


Causes:
    As we can see that the problems differ, the reasons for the same differs as well. The reason can be one of the following:
Psychological:
1. Ignorance, hesitation and fear about love making and sexual act
2. Acute or longstanding traumatic experiences during childhood
3. Lack of love / problems in relationship
4. Mental stress and fatigue
5. Mental illness - depression, anxiety, schizophrenia, etc.

Physical reasons:
1. Pathological problems of Pituitary gland or testicular disease
2. Hormone deficiency
3. Chronic illness like Diabetes, high blood pressure, cancer, liver disease etc.
4. Excessive drinking, smoking, excessive addictions of other drugs
5. Diseases related to senses, nervous system and  blood vessels
6. Obesity
7. Medications used for certain ailments

Treatment:
In order to give proper treatment, it is necessary to understand the problem accurately and the reasons too. For this, there are various things and tests that may be needed.
1 Complete information about sexuality
2 Physiological tests if needed
3 Complete physical examination
4 Hormone levels
5 Thyroid
6 Colour Doppler
7 Papaverine injection test
8 Nocturnal Penile Tumescence and Rigidity (NPTR)
9 EMG (electromyogram)

Treatment methods:
           We have seen that there are different types of diseases and the causes are different. Treatments also vary accordingly. Treatment depends on the disease and the cause. It is important to seek treatment from a sexual therapist, not just by ordering medication over the phone or taking a sex tonic.
1. Sexuality counselling / education
2. Supportive Psychotherapy / Cognitive Behaviour Therapy.
3. Rational Emotive Behaviour Therapy.
4. Medication
5. Various sex therapies depending on the illness.
6. Papaverine injection.
7. Vacuum pump device
8. Various operations
9. Sex Stimulation Therapy Using Machines (MBT)

Remember the following:
1. Be informed and aware about sex. Anyone above the age of 10, or about to get married or about to have sex must get complete knowledge about it. It will prevent you from further problems. Remember it is not the treatment but a prevention.
2. Don’t be shy or fearful to discuss about it with your partner.
3. In case of visit a therapist, avoid going alone. Visit with your partner as this is a process involving both the parties.
4. While talking to the therapist be open and be frank. It is important that the real cause is discovered and only then it can be treated well. The disease may become severe if not treated on time but timely medication will help to get rid of it.
5. Lastly, there is nothing mysterious about sexual organs. They should be treated as any other organ in the body. It needs attention and treatment as and when required. So, hiding about sexual problems must be avoided.


Wishing you all a healthy and happy sexual life. Happy Sexual Health Day to all!

Dr. Atul Dhage
Neuro-Psychiatrist & Sexologist, deaddiction specialist and counsellor
Mindcare Hospital For Mental & Sexual health, Ratnagiri.

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