It’s All in Your Mind

We live in a global village. The millennial man is going great guns with his sense of achievement and accomplishments in almost every sojourn he undertakes. However, there still are some issues he shirks away from discussing. One of which is low libido and its concomitant problems, such as sexual dysfunction. These are talking points one must not refrain from for it has a bearing on both the individual and his family. Though a scapegoat could be found in the underlying premise of a socio-cultural background that is less open, the new-age man can prepare adequate grounds to disrupt the same. Dr Mehak Nagpal, Consultant Sexologist and Psychiatrist at Centre for Sexual and Mental Health clinic at New Delhi, says, “Situation of low libido or sex drive among men is due to many reasons. The most potent being psychological; though there are other environmental, personal, economic and, physiological reasons too that can lead to one or another form of sexual dysfunctions. Some often neglected reasons are fatigue and tiredness from working round the clock, anxiety or stress, sedentary lifestyle, feelings of dissatisfaction with a relationship, etc.” This is one problem that must not be pushed under the carpet. “Men find it difficult to satisfy their partners as they are driven by the idea of doing things in an ideal manner. It leads to performance pressure. This burden can lead to psychological problems such as clinical depression and performance anxiety which exacerbate problems of low libido,” quips Dr Mehak. Of course, as a society, we must be able to differentiate between the real and the imaginary and not mix the two into unwholesome mixtures.

Another factor for low libido could be the ageing process. Dr Mehak says, “As men age they may not be as much interested in indulging in a sexual interaction. This happens because libido tends to plummet with age and HEALTH andropause and testosterone production goes downhill. Testosterone maintains the sex drive, sperm production, muscle, hair, and bone health, hence a low testosterone level can affect both the body and the mood.” With hormones heading south there is a downward spiral on other aspects of healthy living too. Besides this, there are medical factors that are responsible for low libido. “There are physical illnesses, uncontrolled diabetes, high blood pressure, chronic diseases affecting blood flow, nerve disorders and pain. These are conditions that must be specifically dealt with by specialist doctors so that they do not create problems of low libido or sexual dysfunctions,” says Dr Mehak.

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The complications that unravel are many. “When libido goes down men have fewer sexual thoughts and fantasies. They show less interest in sex and masturbation. They may initiate sexual activity less frequently too,” says Dr Mehak.

Stimulation levels among men also hit rock bottom. “Even sexual stimulation, visually, by words, by touch, may fail to provoke their interest. However, they may still retain capacity for sexual activity.” In seeking treatment many men take to hormonal supplements. “An increasing number of men with low libido are asking for testosterone supplementation these days, even though most of them actually have a normal testosterone level. It is important to bear in mind that adding this hormone can come with many long-term side effects as well. Therefore,

when undertaking treatments or medication, it is important to look at all the hormones involved, besides testosterone; these are FSH, LH, Prolactin etc.” explains Dr Mehak. Dr Arvind Vaid from Indra IVF Hospital, Delhi says, “Sexual dysfunction in men can be in the form of erectile dysfunction, early ejaculation, retrograde ejaculation, low libido or decreased desire. But, the most common cause is psychological. Psychological reasons can stem from stress, loss, fears etc. It is something that affects you to a great extent, so much so that you cannot perform with your partner.” This goes to mean that if psychological causes can be taken care of most people would not suffer from erectile dysfunctions (ED). However, one needs to be careful if other medical reasons factor in to cause erectile dysfunctions. Dr Arvind says, “The causes could be three. Diabetes is one reason. When your blood glucose levels fluctuate it could cause some sort of erectile dysfunction. Another reason is men with cholesterol disorders can have problems due to narrowing of the diameter of veins. It causes trouble in blood flow and thereby leads to ED. Also, taking some drugs for the long haul may cause ED.” Men looking to cure a condition of erectile dysfunction must treat their psychology. A wrong mental construct should not be allowed to rule says Dr Arvind. “Treatment through counselling is effective and one must pursue it for long haul. Improve your psychology and you can set yourself free. Also one should try to live stress-free. Try to go on long holidays with wife and family. Family support is essential to overcome feelings of lonliness. In very severe cases, urologists can equip the person with pump-like implants.” Dr Manu Gupta, Urologist, Sir Gangaram Hospital, Delhi says, “Healthy lifestyle, weight loss, exercise and occasionally taking drugs like viagra are initially recommended (though it varies from case to case basis). Testosterone supplementation is the best therapy for treatment in men with low testosterone in a non-reproductive age group. Treatment should be done under careful supervision of an expert urologist only.”

At the level of society, we must upgrade education and information to nip the problems in the bud. There is no sense of shaming lest we remain silent about it.

From the February 2019 issue of FHM India.