Tuesday, March 19, 2024
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Ask the Doctor: Dr Deepak K Jumani

Q.1.  Dr Deepak Jumani, I am 56 years old I don’t have any medical problems like Diabetes, High BP or cholesterol issues. I drink on weekends with my friends may be couple of pegs of whisky, I don’t smoke, I don’t chew tobacco. I am facing a funny problem. I have lost my confidence in bedroom when I am with my partner and whenever I am intimate, I want to finish it of fast.  At times I avoid also. My partner is really unhappy with this behaviour of mine.  How do I solve my issue?

 

A.1.   Everyone in his trek of life does face this issue sometimes. We all are living in these testing times of stress, uncertainty, and anxiety. We are living in a state of war with the invisible creature.” The Corona Virus “Most of us want to be prepared with the attack of this invisible enemy in our war. The only hathiyaar we have to fight with this invisible enemy is keep distancing from each other, wash our hands all the time and cover our face which includes nose and mouth. Having said that we have internalised a feeling in ourselves that everyone else whom we meet may be infected with Covid unless proven otherwise, so we try to be cautious. This is the wisest behaviour to adopt and adapt.

       Though sex is a part of our quality of life we have given it a back seat and have been keeping survival of our life on the steering wheel.  This is understandable in the challenging times today. So, coming to your question to solve the issue of your partner being unhappy with you I suggest the following.

  • Periodically tell your partner you find them attractive—and in what ways.
  • Touch your partner casually—shoulder, hair, hand—at least once on most days.
  • Recall and share an enjoyable sexual encounter you two had—preferably in the last couple of years.
  • Tell your partner how you feel after enjoyable sex with them—close, alive, graceful, feminine, etc.
  • Suggest a specific time to get together, and a specific non-genital activity. For most people kissing is a highly intimate activity, so you may want to start with cuddling, holding, naked rubbing, or undressing each other. When you feel “OK, now we’ve done that,” do it more.

         And a couple of don’ts:

  • Don’t criticize the sex you have, or whine about the low frequency. Instead, talk about the kind of sex you’d like to have (e.g., “When we take plenty of time,” or “Orgasm isn’t the goal,” or “We talk to each other while we’re doing things”).
  • Don’t tell your partner to stop watching porn or to stop masturbating. You can even buy some sex toys like vibrators or dildos etc. as the use of such accessories add a variety.

Many a times I have seen women getting dissatisfied because of inadequate foreplay. Let me clarify certain facts about this. First and foremost please make it clear that please remove the idea that intercourse is the real sex and rest of it isn’t. This myth needs to be busted.  The other acts of intimacy before and after intercourse are equally and more enjoyable, be it foreplay and after play. Many men rush through the foreplay because do don’t enjoy it much as they feel it’s a pre functionary ritual they have to do and they have distracted concerns like erection, lubrication or orgasm and they are too anxious about succeeding the act. Here men forget that foreplay is an adventure to explore each other body parts as though you are seeing it for the first time. Some parts of our body are erogenous zones though but it can be any part as flesh doesn’t think it waits for the brain to code and experience as erotic or annoying.  In fact foreplay is a period of relaxation and not as a stage of duty or preparatory.  Trust me these phases are more enjoyable and pleasurable so my advice to you is not to prioritize intercourse as a winning fort.  So de-emphasizing intercourse is the great step and encourage yourself and your partner to do what they like during erotic activity rather than just jumping in for intercourse. This will reduce anxiety and promote communication. Be vocal in a soft tone ask your partner how does this feel, do you like more of this , do you want a little different and believe me these are the most sexiest words  on earth.  So to sum up as we age we need to spend more time on foreplay and after play rather than interplay. This will add variety to activities in your love play and make sex life more pleasurable.

 

Q2. Doctor I am 56 yrs.,   I have been suffering from a chronic skin disease like psoriasis since the last 18 years I have tried all sort of medications be it allopathy, ayurvedic homeopathy etc but still get itching and have to take steroids to relieve my itching and these skin lesions turns me off and I also do not get adequate erections. Will I ever be able to have good enough sex? 

 

A.2 Psoriasis has been associated with numerous psychological disorders such as low self‐esteem, depression, anxiety, sexual dysfunction or suicidal ideation. Recently, there has been a progressive increase in studies examining the impact of psoriasis on sexual function. It does affect our quality of life. 

Several studies suggest that depression plays a significant role in increased morbidity among patients with psoriasis. Stigmatization is what makes one feel to avoid having sex and this avoidance coupled with depression leads to erectile dysfunction in men. The detrimental effect of the condition on the individual’s physical appearance, decreased libido, and the inconvenience caused both by skin desquamation and by topical treatment also makes one feel to avoid having sexual intimacy.

Most of the patients whom I see with psoriasis have other co morbid conditions as diabetes, hypertension, obesity, dyslipidaemia, or are smokers or alcoholics Psoriasis also leads to arthritis and poor dental conditions such as periodontitis. 

Certain medications use to treat psoriasis have also been known to cause erectile dysfunction

All these medical conditions coupled with depression make men feel less attractive to their partners and we are aware that Psoriasis is a stigmatizing disease that impairs quality of sex life.  

The solution is that you need to modify your life style, correct your metabolic disorders, talk to your dermatologist to give you medications with less sexual side effects and counselling of the couple will surely bring back the sparkle in your sex life.

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