Why We Need To talk About Sex

Love+Medicine Pillows

The Pelvic Health Collaborative invited me to present a lecture about the importance of talking about sex with patients. I passionately believe it should be an integral part of an evaluation of an individuals’ overall health and well-being. Any discussion with adult patients tends to be site/disease specific, i.e., after prostate surgery or heart attack. But what about patients with Crohn’s disease, arthritis, anxiety or obesity that are not considered directly related to sex? Are we asking these patients about their sex lives? We need to be. Because everything can affect sex and sex can affect everything.

An article was published in the New York Times entitled “When Did Porn Become Sex Ed?” Kids are not talking to their parents, their friends, or their doctors, so they turn to the Internet. The access is so easy and anonymous – straight from the smart phone. This is where they are learning how it is done. Is it any wonder performance anxiety is on the rise? What happens to expectations after watching internet porn? While some strides were made during the last administration in promoting comprehensive sex education, it was removed from the 2018 federal budget.

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The Chosen People?

TEVYE: I know, I know. We are Your chosen people. But, once in awhile, can’t You choose someone else?

Jewish people are roughly divided into two main groups; Ashkenazic and Sephardic. Simply stated, Ashkenazic Jews are from Central or Eastern Europe while Sephardic Jews are from Spain and the Middle East. While people from any ethnic group can develop genetic disease, Ashkenazic Jews are at higher risk of certain diseases because of specific genetic mutations. They are, in general, a more genetically homogenous group compared to the Sephardic Jews.

A study done in 2014 and published in Nature Communications found that today’s population of 10 million Ashkenazic Jews descended from a core group of 350 people 600-800 years back. This small group, referred to as a population “bottleneck”, passed on the same genes to the next generations, putting them at higher risk of certain genetic mutations. Scary thought. 75-90% of American Jews are Ashkenazic. The Ashkenazic Jewish population are at a higher risk of over 100 different diseases. 

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HAIR YOGA: Yes, It’s a Thing

Love+Medicine Hair Yoga

We all want to have better hair. Our hair reflects our health, genetics, age, hormone levels and priorities. I, unfortunately inherited my mom’s fine, wispy hair. I bring my stylist a picture of a killer hairstyle from a magazine – only to be told I need product. Lots of product. I have tossed hundreds of bottles of ‘product’ that I swore I would use after seeing how great my hair looked at the shop. In truth hair has never been a priority for me. I’ve heard it’s a Koplin trait but I hardly ever brush my hair. Or blow dry, or really do anything.

Some things get better with age, hair is not one of them.

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Ask Dr. Annie K: Sex and Aging

My husband, who is 78, can’t climax. He has the desire but loses the urge after a short time. He has had ed for several years but could still finish up to the last year or so. Is this age related? Any hope?
– Anonymous

Love+Medicine

 

Thank you for this great question. I assure you that many of my readers are interested.

This is a condition called Delayed Ejaculation (DE) or Anorgasmia. The erection is there but no climax. The answer to your first question, whether it is age related is yes. About 1/3 of men your husband’s age have problems reaching climax.

Let’s take a look at the science behind the male sexual response to understand what is going on. It is a cascade of events originating in the brain but involving the entire body. One system relaxes the body allowing for blood flow to the penis (erection), the other follows up with contractions necessary for ejaculation. These processes are sweetly choreographed to reach the big O.

What can cause DE?

Drugs – It is well known that antidepressants cause sexual dysfunction. Here are some others:
Alcohol
Diphenhydramine (Benedryl)
H2 blockers (Tagamet, Zantac, Pepcid)
Hydrochlorothiazide
Atenolol
Opiates
Furosemide (Lasix)
Triamterine (Maxzide)
Estrogen
NSAIDs (Ibuprofen)
Pseudoephedrine (Sudafed)
Finasteride (Propecia, Proscar)
Lipid-lowering agents
Digoxin
Levodopa (Sinemet)

Heart Disease – The arteries of the penis are often the first to show atherosclerosis.

Weak Pelvic Floor – These muscles weaken as we age.

Infection – Urinary tract infections, STDs and prostatitis.

Endocrine Conditions – Diabetes, hypothyroidism, low testosterone levels.

Psychological and Spiritual Factors – Anxiety, depression, relationship issues.

Consultation with a primary care physician AND a urologist are recommended to rule out these and other medical conditions. They may provide treatment options as well. Studies are limited but there are promising reports of acupuncture as a treatment for DE.

Sex is different as we age – biology we have to accept. I like to describe it as a quieter sex. Just as hot but more simmering than full boil. Pleasure comes equally from giving and receiving. Orgasm may not be the goal every time. Going through the natural changes and seeing them as normal may bring you closer as a couple.

 This is advice for all my sexually active seniors:

  1. Get in shape.
  2. Make love early in the day, when testosterone levels are highest.
  3. Eat healthy – What is good for your heart is good for your penis.
  4. Maximize oral stimulation.
  5. Fantasize about sex.
  6. Do Kegel exercises.
  7. Use your imagination.

Age is not a disease. Do everything you can to OPTIMIZE the functioning of your body and mind. In answer to your second question, there is definitely hope!

Are You Due For A Tune-Up?

Dr. Annie K’s Spring Sex Tune-up

 

The human body is an absolute wonder. The way it bends and stretches, responds to pain and pleasure, protects us. It is upon us to take the time to honor and respect our bodies – by both daily words of gratitude and royal treatment. Like any intricate machine, our bodies require maintenance.

Here is my proposed sexual health checklist for men and women. My guess is that your doctor isn’t asking these questions (but should).

 

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