On February 27, 2021, Seniors Today hosted its weekly Health Live webinar with Dr Deepak K Jumani, a leading sexologist to speak and answer questions on sexual health for senior citizens. Dr Noor Gill captures the highlights of the session.
A little about Dr Jumani: Prof Dr Deepak K Jumani is a well-known and senior sexual health physician and counsellor from Mumbai. He is attached to the Sir JJ Govt Group of Hospitals and Grant Medical College as an Asst Prof of Medicine (sexual health). He is also attached to the Mumbai Police Hospital, Doctor House, and Apollo Sugars Clinics as a consultant sexologist. He is an American Board Certified Clinical Sexologist and a fellow of American College of Sexologists. He has also been granted the very prestigious FRCP by the United Kingdom. He is the Course Director of the fellowship programme in clinical sexologyclinical sexology started by Maharashtra University of Health Sciences and this is the first approved course in sexology by the MCI. He also was Chairman of the Indian Medical Associations Initiative of Sexual Health, a pan-India sex education programme. He is also one of the members who formed the consensus for the Management of Erectile Dysfunction in Indian men. He has contributed several chapters in various textbooks and journals of diabetes and endocrinology on topics related to sexual dysfunction. He is the author of the book “Sex has no Expiry Date”.
– Sex is a subject where nature and culture collide. We are born sexual and spiritual creatures, we cannot dichotomise any one of them. Doctors never ask about their patients sexual dysfunctions and patients never come out and talk about it themselves which creates a gap, a taboo. As we age, we develop a lot of metabolic issues such as – diabetes, hypertension, we may become obese, our lipid profile may go haywire. Ageing is inevitable, but intimacy is ageless, it has no barriers. We are all born out of love and love never expires.
– 40%of men are not satisfied by their sex life and 62% women are not satisfied by their sex life, across the globe. 50% of married couples in Japan, in the most developed countries, are living a sex-starved life. Today, we are seeing increased number of divorces and one out of five divorces are due to sexual dysfunction, either in the male or the female.
– Age, weight, height do not matter; if it is consensual, if both the parties like each other, they have the right to live their life and enjoy it while they are at it. Sex is the strongest urge, the highest desire a man or a woman has.
– On ane partner being obese and the other partner not being obese: these days, we give a lot of importance to body image. There are a hundred different ways where if the partner loves their partner and can motivate them to reduce weight, challenge their body, and help them with it through exercise, diet control, bariatric surgery, non-invasive liposuction, etc. and help them deal with their body image issues, they can have a healthy sex life. Even if the partner is obese, the two can still enjoy sex. You can try different positions. Sex can be enjoyed in any position, with any shape of the body. It is immaterial, and it’s all in the mind. If you feel like you’ve lost interest in your partner because of their obesity, it is wrong.
– Husbands watch porn and the wives are working in the kitchen, and the wives know what the man is doing but the signal that the man is sending to his wife is that he finds the woman in the movie more likeable or attractive than his wife. This is absolutely wrong. He shouldn’t do that. He shouldn’t watch porn alone, he should watch it with his partner and get excited. The male should criticize the lady in the movie and appreciate his partner. By doing this, he is limiting the lady in the movie, exciting his partner and giving her motivational incentives to get the sex that he wants. He is not going to get sex from the movie or the laptop of the computer.
– All of us like variety, variety is the spice of life. Sex as an action is the same, penis goes into the vagina but the initiation of the act has to be different every time to rekindle or spice things up. This helps create intimacy and also increase his attachment to his wife.
– Erectile dysfunction is the inability to have and sustain an erection.
For every patient who has erectile dysfunction or any type of dysfunction, diet forms the most important part because it is the diet that makes you look and feel sexier. It is the diet that is responsible for one being healthier, sexier, and fitter. Medically speaking, if you look at patients who have cardiac disorders, Dr Dean Ornish, a leading cardiologist in America proved that 98% of the blocks in the coronary artery can be dissolved with nutrition and lifestyle modification. Cleveland Clinic also says that with nutritional intervention you can halt and reverse the process of atherosclerosis.
– These are some of the lifestyle and nutritional changes a man over the age of 40 years should try making
Cut down on the following three things after the age of 35-40 and it will help in retarding the complication of metabolic disorders and it will also help in having a healthier sex life.
S – Salt; if you consume large quantities of salt, you are likely to develop hypertensive and your medications will be for lifetime and those can cause sexual dysfunctions
O – Oil; if consume excess of oil, you develop dyslipidemia, atherosclerosis sets in quicker, again you will have to medication for long durations; leading to sexual dysfunction.
S – Sugar; if you take excess of sugar, again you are prone to develop diabetes and that can lead to sexual dysfunction
– One of the common issues that men have is the flaccidity of their penis or the lack of rigidity in it. The penis does not have muscles that we can tone to make it stronger or harder, so what is it exactly in the penis that makes it rigid? The architecture of your penis in nothing but sponge and spongy tubes. Multiple horizontal tubes in two bundles which is covered by harder tissue followed by the skin. These tubes are normally closed, hence the penis is small/ flaccid. Whenever these tubes open up or dilate, blood rushes through them and that is called an erection. So the erection is nothing but blood and its flow inside the spongy tubes of the penis. Which directly implies that if you want to have a good erection, you need good blood flow in your penis. You can improve the blood flow in your penis by-
- Consuming food that increases the blood
- Doing certain exercises that can increase the flow and pumping of blood to the penile tissue.
What are some food items that can help the men in increasing the flow of blood to the penis of help the women to increase the flow of blood in the pelvic region to get more lubrication and orgasms and feel healthier:
- All red-coloured fruits- pomegranate, cherry, strawberry, raspberry, apple
- All red-coloured vegetables: carrots, beets, tomatoes
- Cows ghee and cow’s milk
- Onion, ginger and garlic
- Flax seeds, sesame seeds and saffron
- 6-8 almonds
- 1-2 pieces of walnuts
- 1 spoon of honey
- Figs
- Avocados
- Dark chocolates
- Vanilla
- White of the boiled egg, fish
– Studies have shown that a man having two ejaculations per week reduces the incidence of heart attack by 50%. The penis is the barometer of your cardiac health. If your coronary arteries get blocked, say they have 50%, 70% or 80% blockage, the penile arteries get blocked 3-5 years before that! This is because the diameter of the coronary artery is much larger than the penile artery. If you are able to get good erections, your heart is normal. With prostatic issues, there are patient who come with lower urinary tract symptoms such as early ejaculation, erectile dysfunction, but nowadays we have so many medications which can reduce the prostatic size and symptoms and improve their sex life. Benign prostate hypertrophy is an ageing process and should not stop you from having sexual intercourse.
– There is no set limit to how much you can masturbate. But, it has to be done judiciously. Masturbation is normal, healthy and beneficial but we need to have some discipline. There are no set parameters or limits.
– If neither of you have a sexually transmitted disease, both of you are monogamous and healthy, you can avoid using condom after a woman has enter her post-menopausal age.
– There have been a lot of studies on the association between Covid-19 and sexual dysfunctions. The virus affects the haemodynamic system of the lungs, the oxygen saturation is affected and the exchange of oxygen and other metabolites is hampered. Along with this, the inner lining of the blood vessels (called the endothelial dysfunction) is also affected. These two things, along with the stress that the virus puts on your body, makes your body vulnerable to sexual dysfunction. If the endothelial lining pf the vessels gets damaged, the men, do suffer from erectile dysfunction.
– Covid patients also suffer from loss of sense of smell and the sense of taste. It also affects the production of pheromones. Smell is an aphrodisiac, which is hampered. With the loss of taste, there is also decreased production of saliva. Saliva contains testosterone, when you kiss or when you watch something erotic, there is an increase in your saliva production. Hence, covid patients have loss of pheromones, loss of testosterone, there is also endothelial dysfunction and they become breathless. But once the virus is tackled with, these things are reversible. They might need some testosterone preparations in the beginning.
With age, your testosterone levels start to drop. Testosterone replacement therapy is a lifetime treatment and it comes with its contraindications.
- Patients with prostate issues
- Patients with cardiac issues
– No one should take Viagra without a doctor’s prescription. Viagra even though it causes penile erection by increasing the blood flow, but there are a lot of side effects and contraindications to the drug.
Contraindications of Viagra:
- If the patient is on nitrates such as sorbitrate, glyceryl trinitrate and is also taking vaigra, they will develop low blood pressure and will collapse.
- Deformities in the penis
- Lymphomas and leukemias
- Recent cardiac event
– You should not take it without a prescription also because there are a lot of counterfeit, false, duplicate medications sold in the market. Viagra is an expensive drug but there are people who are selling the same drug at half the rate. So, please don’t take it without the prescription of a doctor and take it from a reputed chemist who sells genuine medications.
– All diabetic patients should try to bring their HbA1c levels to 7 which is now possible with metformin and SGLT2 inhibitor drugs and follow lifestyle modifications. In diabetes, the vessels lose their elasticity, thus placing the penis in a flaccid position. They must try to bring their HbA1c down and bring their metabolism under control.
– Ayurvedic preparations such as ashwaganda, sheelajit, bhrami, etc. are available but there is no robust study for them. The ancient people tell us that these are good sources, but us as people of science only believe things when we see them from our own eyes or have a proof of it in the form of data or medical evidence. But with these preparations you cannot guarantee results as you can with pharmacotherapeutic drugs.
– Vajroli asan and vajroli mudra, kegel exercise are some exercises which can help reduce and enlarged penis.
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