Tuesday, January 31, 2023

Ask the Doctor – Dr Deepak Jumani, Leading Sexologist

Q1. I am 48-year-old, businessman and having high blood pressure and diabetes since last 4 years. My sex life is not good.  I want to know what the libido is. What causes low libido? What are hormones?  How do I rekindle my sex life?


A1. The theory of libido is that it’s one of the fundamental sources of energy for sexual life. This is also called as sex drive, which is controlled by many factors such as hormones, metabolic hormones, neurotransmitters in the brain, pheromones (related to smell), psychological stimuli (such as imagination, mood, sight), physical stimuli (such as touch taste and smell) and of course cultural customs.  People often find that as they grow older sex drive begins to decline and this is because our body produces fewer hormones as we age. This happens usually after the age of 40 years in men and post menopause in women.

The common causes of low libido or low sex drive are Stress, depression, anxiety, low self-esteem, poor body image, tiredness fatigue, lack of sleep, menopause in women, andropause in men, underactive testes/ovaries, hormone deficiencies, prostate problems, hysterectomy, previous sexual abuse, relationship difficulties, smoking, drugs and alcohol, poor diet, lack of exercise, sedentary lifestyle, obesity, monotony, low exposure to sunlight, having a baby, breast feeding, too much exercise, very hot baths and saunas.


All that lowers the libido have an effect on the sex hormones and this can decrease the sex interest and also fertility.


Hormones are chemical messengers that are produced in our body and transported by the blood to pass information around the body. Sex Hormones are vital for healthy sexual function in both men and women. Amongst them the main sex hormones are Testosterone Estrogen and Progesterone. Besides these there are other hormones and chemical messengers which play a good role in maintaining a healthy libido.


Due to any exciting physical and psychological stimuli, or when one falls in love, hormones, neurotransmitters and other body chemicals trigger intense feelings. This is what happens in our body when you meet someone, find them attractive, begin a relationship, fall in love and then commit to a long-term relationship.  Pheromones triggered through smell are secreted by men and women, these boost attraction. Adrenalin fires up the energy to desire and the heart starts beating faster. Dopamine a neurotransmitter levels rise, and this intensifies sexual feelings, Testosterone and Estrogen charges the libido, PEA (Phenyl Ethyl amine) triggers the love struck makes one feel euphoric as if you are feeling like walking on air, often feel churning feeling in the stomach, one loses appetite. There is ultimately release of Oxytocin which helps the couple to bond and develop an attachment.


The male hormone Androstenedione is a hormone which is produced by both men and women and this helps increase the production of testosterone which enhances the libido. DHEA(Dehydroepiandrosterone) is again a male hormone that converts to androstenedione and this increases the sexual desire in men and women. Ultimately the bottom line is both increase the production of testosterone which the master sex hormone. This master sex hormone testosterone is made in huge quantities during puberty and reaches a peak during twenty years of age and it starts to drop as we age around forty. Rigorous exercise for 30 minutes a day for one month can increase DHEA, over exercising can actually impede the sex drive DHEA can also be increased by reducing stress be it by yoga or meditation or any other behavioral methods and dietary adjustments. In fact, it is an antiaging nutrient if taken in right quantity under medical supervision. If taken loads of DHEA or Testosterone it can stimulate growth of facial hair in women, acne, insomnia and even infertility in men as it can reduce the sperm counts.

So, all you need it to take your anti-diabetic drugs like metformin and SGLT 2 inhibitors under your doctors’ supervision. Take ideal antihypertensive drugs like ARB’s and control your salt, oil and sugars. Physical activity and Nutritional intervention are a must and control of metabolic issues like diabetes, hypertension and under medical supervision of refurbishing hormone therapy can rekindle your sex drive back to normal.


Q2. I am 53 years old, and my wife is 50-year-old. I do not have any medical problems and have a good desire to have sex. My wife has severe allergy issues, and she is on constant medication for the same. She gets irritated and avoids having sex giving excuses

She has no medical problems except allergy. How do I get her back in action?


A2. I am glad you both have no medical issues, and your desire levels are good. I feel your wife is taking some anti allergic medicines which is causing her reproductive organs to dry off and she may be getting pain and itching, and this is the reason she may be avoiding being intimate. Try and find out from your doctor what allergy medicines she is taking and change them to newer safer ones which shall not make her feel dry and itchy… Your wife also needs counselling to make her understand that All unmet sexual desires result in many psychosomatic illnesses. Also get her hormone assays done.  Research has proven that Constant medications for allergy even for common cold not only dries up the nasal mucosa but also dries up the tissues of the reproductive tract and produces pain and irritation while having intercourse. To avoid this discomfort women avoid having sexual intimacy.


We invite you to write into us with any query that you may need to be answered by our medical panel. Write to inbox@seniorstoday.in


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