SEXUAL PROBLEMS - Part 2

ALTERATIONS IN SEXUAL EXCITATION

It is highly desirable that instead of putting our energy in dealing with problems when they are already present, we were able to go ahead and organize our lives in each of the evolutionary stages in a healthy way, promoting healthy habits instead of going after desperately trying to "extinguish fires", addressing problems as they arise, or worse, trying to deny them even aware that time is not only not resolved, quite the contrary. In this spirit, we propose a series of steps that anyone can be taking in order to preserve their sexual health, in the case of men, erectile response capacity.

The erection is unintentional

The man can not have an erection or remove at will. You can only get carried away by a stimulant from a sexual point of view, and their autonomic nervous system will implement the relevant mechanisms. And, curiously, the more you strive for a man to have an erection and most of it is outstanding, the easier it does not appear or be interrupted. Good sex is not always intercourse (vaginal penetration) It is educational for any couple to enjoy the pleasure accomplice shared without intercourse as a sexual dish on the menu. Caresses of all kinds, with hands, mouth, skin, sex toys, the fellatio, cunnilingus the ... are many alternatives that allow to discover that both can enjoy sexual pleasure without the participation of the penis erect. It's a good educational practice against the crippling impact that a possible "Gatillazo" cause in men and couples who, in addition to not wait, have not developed alternative strategies for enjoyment. They run the risk of experiencing lack or loss of erection as the absence or loss of sexual pleasure. In sum, if any man, at one point, it is found to be too much of its erection, it is better to let the idea of penetrating and enjoy a pleasure that does not require an erect penis. It is not true that there will be time The sexual encounters can be programmed, it is not necessary that sex is spontaneous: Do not do it either better or more authentic It is also very educational to go on a regular basis to explore the possibility of introducing or questioning, although apparently small changes in our lifestyle. Know and realize the powerful influence that stress, overwork or her addiction has on our sexuality.

The pleasure requires your time, put on the agenda. Forget the myth of spontaneity. We need to be spontaneous within the agreed times the pleasure. Otherwise, the multiple obligations prevented leave space-time for pleasure. It's what you always tend to sacrifice, with the delusion that there will be time, that if we expect to emerge from spontaneously is better, more authentic. But not usually the case, awaiting the spontaneous outburst, suddenly the days are weeks, even months ... And "body that is not working atrophy," something that happens also to sexual intercourse. The pioneering research on sexual behavior by Alfred Kinsey allowed him to observe that people most often enjoyed sex during capability that kept more years of enjoyment. In contrast, the more sparsely people enjoy sex, it tends to be spaced more and more promptly abandoned in adulthood. The erection, if not stone, you can enjoy.

The penis maintains its ability to feel pleasure but not rigidly erect. Moreover, with a willingness on the part of the couple, you may also enter the flaccid penis or vagina in almost flaccid. There are ways to enjoy genital sensations without the "requirement" of rigidity, a frequent cause of their inability paradoxical. Caring for the health care sexuality Another aspect within the lifestyle changes is that of the general healthy habits. Sexual health is an aspect of global health. We have already mentioned that problems with erection are symptoms sentries that there are other diseases such as hypertension, atherosclerosis, diabetes and so on. In fact, every time we have more evidence of the similarities between the heart and the erectile tissue.

The healthy practices for him so too are for it. Anyone who wishes to maintain their health, too sexual, including the erectile response capacity, should leave the snuff and other drugs, drink in moderation and pay attention to drugs that are prescribed. Each time we know more about the possible adverse effects of some antisexuales. If difficulties arise sexual being medicated, we must consult with the doctor in this regard. And who is suffering from any systemic disease control and follow medical advice is to look after their health, too sexual.

Erectile dysfunction

The difficulty or inability to achieve or maintain an erection sufficient to carry out penetration and make intercourse has been historically known by the name of impotence.

This name, with a large negative charge, seemed to describe both the physical impossibility as the frustration of the patient and health professionals who had to deal with these cases very few resources. Fortunately, today we talk about erectile dysfunction. This represents more than a name change. There are new therapies, new pharmacological and surgical remedies that have banished the gloom of this sexual problem and allow clinical response to this that sexual dysfunction is estimated that can affect almost two million Spanish. In fact, erectile dysfunction and premature ejaculation are the problems of a sexual nature more frequent among boys, impacting on the quality of life of those who suffer as a partner.

Erectile dysfunction and premature ejaculation are the problems of a sexual nature more frequent among boys Another consideration relevant to the need to address the response capacity of man's erection is that it can behave like a sentinel symptom of other underlying diseases, such as hypertension, atherosclerosis, diabetes and so on.

The first major study on the incidence among the population of this problem was the so-called MMAS (Massachusetts Male Aging Study) conducted in the United States in 1994 in 1290 men aged between 40 and 70 years. The prevalence of erectile dysfunction of any degree was 52% of the male population. Subsequently, Spain (1999) the survey was conducted EDEM (Epidemiology of erectile dysfunction Men's), which was assessed at 2476 Spanish men, between 25 and 70 years of age. We found some degree of erectile dysfunction in 12.1% of cases. In the Spanish case, if we look at the range that includes men between 40-70 years, 24.6% suffer from erectile dysfunction, which shows that the prevalence of erectile dysfunction in our country is less than that detected in the MMAS. Both studies showed that those sexologists constatábamos in our daily consultations: the incidence of erectile dysfunction increases with age .

However, it is not uncommon for a man to have temporary erection problems at some point in their lives. If you ever happen to be isolated should not be cause for concern. Erectile dysfunction by age From the perspective of the causes and the most suitable type of treatment, age is a factor. Erectile dysfunction is most frequent causes in different periods of human evolution. In the young "A year ago that I am powerless. Has been since I have a girlfriend and we wanted to have sex. I do not know what's happening, but I avoid that we are alone and I apologize for giving such a situation does not happen. It is increasingly difficult to convince I am not that nothing happens. " This is the case of John, who with scarcely 18 years and experienced the frustration and anguish of a man who is seen as powerless. "As we started to leave, not the friends stopped to tell 'Already you've pulled?" and so on. ante conceal them, but I felt compelled to do with it as soon as possible. Although it was not quite sure what they wanted to do when she and I were alone the first few times. " Juan erectile dysfunction is due to the psychological pressure that it causes the responsibility that he himself is attributed to "get it right as a man." The idea of meeting a guy who has not had sexual experience after serving as a slab, although they do not know exactly what needs to be met, feels that the pleasure of your girl is his responsibility and foremost the responsibility of his penis.

These cases are quickly and easily treatable. In the young adult "Since a few months ago I can not get an erection. My wife and I work, get home late and tired, barely forces as something for dinner and tombs to rest and sleep. In the company things are going well, what happens is I have a lot of work, and I like it, but it is much. The truth is that long ago that sex is merely a kind of obligation over, comes the weekend and plays. Many times I really wanted to rest . If we go out to dinner and a drink, what I really want to do is sleep later, but if we do not do is not normal. Now, since I have no erection, things are much worse. Haunts me the idea of sex, the weekend. She notes that, and avoid being more aggressive with me.

We are discussing more for anything. " The sex therapy progresses faster and more effective if both partners are involved in the process Luis, 32, works at a company in which he is appreciated for his dedication and professional success. It has no conflict with Rose (29 years, his wife) but work stress, lack of time for them, and now their difficulties in bed, have begun a process that, not having been consulted, their relationship rapidly deteriorate . Work-related stress, the feeling of being overwhelmed, is the initial trigger of their erectile dysfunction.

These failures erection occurs when there are labor problems or job loss. In many cases, the processes depression triggered by the situations of unemployment caused erectile dysfunction. Not surprisingly, the depressive states are very harmful on the sexual response. Even at times, lack of erection associated with lack of sexual desire is the first and perhaps the only manifestation of the depressive disorder. The treatment of these cases of erectile dysfunction may involve simultaneous tables coping with anxiety, depression and other psychological conflict of basic or partner (table DE3), so at times, and for a brief and transitory, may require the use of drugs such as antidepressants or anxiolytics in the process of sex therapy.

Thus, it provides that the patient will enjoy the self-sufficient and to focus specifically on the sexual problem, where the involvement of your partner will be key to facilitating the resolution of the problem. One factor that contributes to a possible depression or anxious is that, in addition, there is a separation or divorce. On other occasions, the man has no partner and precisely their fear of failure makes autosabotee any fledgling relationship in sight that could end in sex. The fear of not being able to size it increasingly moving away from social relations. In all cases where men have no partner, the sex therapy is even more important and decisive. Obviously, the process of therapy is typically more prolonged and there is addressed to support their self-esteem.

In middle-aged adults "Since a few months ago I do not have erections with my wife. I've tried but did not get, I get nervous, because before I started thinking that I can not succeed. I have 54 years, until a year ago had ever lost an erection. We gave no importance, but now, not stand erection. If you do not ejaculate soon, I lose the erection. At first, my wife told me not to worry, but I see ever more distant. I had come to ask whether there is another. Not I know how to convince them that I do not understand what happens. " Adolfo, smoking a packet and a half of snuff daily, with an office job that you get a sedentary life, without sufficient physical exercise, with a few pounds over, a slightly high blood pressure and with some "cholesterol" is suffering from a mild ailment in its vascular system.

The mechanism of penile erection is part of that system so that everything that affects the circulation, affects the erection. Not that I can not get an erection by all the things that physically happen, but if it adds to the concern and to have it self, completing the circle of factors that have recently deteriorated erect their response. Addressing the problem of Adolfo is relatively fast if it has to start with the collaboration of his accomplice wife. The therapy sexual advances always faster and more effective if both partners are involved in the process. It is clear that improving their quality of life is also crucial to improve their erection during the next few years, which will require the treatment of medical problems and, in a predictable manner, with the help of a group of drugs prosexuales, the PDE5 inhibitors (Viagra, Cialis, Levitra).

It should warn that drugs that are cited have to be taken under medical prescription. This is a drug that is not safe if ingested without the supervision of a physician and with the appropriate dosage. In addition, for those who might be tempted to increase its power thanks to them, it should warn you that it is not. As a drug that is, cure a disease but will not be used for other faculties.

In the older man

The elderly is not a disease. Fortunately, more and more men arrive at a certain age in a healthy state. In this situation, there was no reason to expect any problems with sexual response. There is no retirement age sex. However, today too many men who accumulate factors that impair their health and sexuality is a fundamental aspect of health, so it will be increasing cases of erectile dysfunction with age .

The more the disease will manifest itself, especially those that affect the circulatory and nervous systems, the more likely it is that this will translate into factors that reduce capacity for erection in men. Other factors that often are in addition to those who degrade the quality of erections are the same drugs that treat such diseases, which often have side effects such as disruption of the ability of erection of the penis with a greater or lesser intensity. The vast majority of cases of erectile dysfunction are easily diagnosable when addressing the medical, psychological and social The treatment of erectile dysfunction in the older man passes the medical care of the disease or diseases that make it appear. Often the treatment of these cases also benefits from the use of PDE5 inhibitor above (Viagra, Cialis, Levitra), which, as a sort of "chemical crutches," are useful, either at the beginning of the recovery of the erectile capacity or are a drug support more or less permanently to humans, depending on your overall state of health.

The success is the proper integration of these resources and medical pharmacology in the process of sex therapy, which, if any, benefits from the involvement of the couple, as usually happens in the treatment of sexual problems.

Solutions

Fortunately, today the vast majority of cases of erectile dysfunction are easily diagnosable when addressing the medical aspects (his physical condition, disease, drugs, drugs, etc..), Psychological (how it is and how it is impacting the partner, if any) and social (the context in which they lived and the problem) that may be implicated in the onset of dysfunction. The sex therapy has been aided by the integration of psychotherapeutic resources for the increasing development of the sexual pharmacology, which provides medicines whose optimal management is in the hands of the medical sexologist at the appropriate therapeutic intervention for each case.

As in almost every sexual dysfunction, the prognosis is better in cases involving a couple with no major conflicts and with a willingness to active collaboration between the two. Major medical causes of erectile dysfunction

Source: Consensus on Erectile Dysfunction.

Prepared by 12 scientists. 2002 Conflicts Couples Problems with self-image Low self-esteem Stress Problems in the social environment or labor Factors of development and sex education - Neuropathy: very prohibitive education about sex.

- Beliefs neuropathy sex wrong.

- Sexual Trauma neuropathy in childhood or early experiences.

- Neuropathy Sexual abuse in childhood.

- Fear neuropathy excessive pregnancy and sexually transmitted infections.

Other sexual disorders and sexual identity

- Paraphilias

- Issues of sexual identity

- Issues of sexual orientation

- Premature ejaculation

- Disorders of sexual desire Anxiety performance and attitude of spectator Psychiatric Disorders - Depression

- Anxiety

- Psycho Sexual and psychological causes of erectile dysfunction

Source: Consensus on Erectile Dysfunction. Prepared by 12 scientists. 2002 Vascular causes: 60-80% Neurological causes: 10-20%

Hormonal causes: 5-10% Generic pathologies

- Generic Pathologies

- Arteriosclerosis

- Snuff

- Hyperlipidemia

- HTA

- Diabetes

- Peyronie's Disease

- Pelvic Fractures

- Injuries perineal

- Fracture chambers

- Kidney transplant heterotopic

- Leriche syndrome

- Bypass aortoiliaco or aortofemoral

- Aftermath of the Radiotherapy

- Aftermath of priapism Of the central nervous system

- Stroke

- Sleep apnea syndrome

- Alzheimer's Disease

- Parkinson's disease

- Brain tumor Of the spinal cord

- Injuries

- Cause compressive (Herniated Disc)

- Demyelinating disease (Escl. Multiple)

- Cause tumor (medullary tumor)

- Vascular Disease (Medullary Infarction)

- Infectious Disease (Tabes dorsal)

- Myelomeningocele

- Degenerative diseases Iatrogenia Peripheral nerves

- Diabetic neuropathy

- Alcoholic Neuropathy

- Aftermath postsurgical

- Prostatectomy

- Cystoprostatectomy

- Transurethral resection of prostate

- Surgery of the spinal cord

- Rectal Amputation Excess estrogen

- Latrogénico exogenous

- Liver Diseases

- Tumor

- Producing estradiol or HCG Hyperprolactinemia

- Latrogénica by drugs

- Pituitary tumor Hypogonadism

- Hypogonadism

- Hipergonadotróficos Thyroid dysfunction

- Hyperthyroidism

- Hypothyroidism Malfunctioning adrenal

- Cushing's syndrome and disease

- Adrenal insufficiency Hiponutriciones severe

Major causes resulting from the ingestion of erectile dysfunction drugs

Source: Consensus on Erectile Dysfunction.

Prepared by 12 scientists. 2002 Drugs with hormonal action

- Reduce or inhibit the action of testosterone: antiandrogens, estrogens, anabolic steroids, spironolactone, ketoconazole, digoxin, clofibrato, cimetidine.

- Increase levels of prolactin, a hormone whose main function is to stimulate milk production in nursing mothers, although it is present in all people, both men and women: cimetidine, metoclopramide, phenothiazines, opiates, endorphins, haloperidol, Tricyclic antidepressants, methyldopa. Psychotropic drugs

- Antipsychotics and neuroleptic: phenothiazines, tioxantinas, thioridazine, butirofenonas.

-Antidepressants: Tricyclic tetracíclicos, IMAOs, SSRIs.

- Anxiety: benzodiazepines. Antihypertensive drugs

- Sympatholytic: clonidine, methyldopa, reserpine, guanethidine.

- Beta-adrenergic blockers: propranolol, pindolol, atenolol, metoprolol.

- Diuretics: spironolactone, thiazides.

Difficulties with vaginal lubrication

Defines the disorder of the female sexual arousal such as persistent or recurrent inability to achieve or sustain arousal. The symptom that sees women and that it best describes the disorder is difficult to lubricate your vagina in response to a proper sexual stimulation. It has the feeling of staying dry so that the penetration, attempted penetration or the mere manipulation of the vulva it is frankly uncomfortable or annoying. It is less or not at all significant for a woman to the fact that this decline in the genital swelling adequate (or clitoridiana lip) and lack of elongation, vaginal dilation and excitement. The specific prevalence of the disorder has not been well defined.

The studies in this regard include among all the female sexual dysfunction, so that describes a prevalence ranging from 25% to 63% of the female population. In any case, the disorder of the female sexual arousal is a key factor in the woman's age. This disorder is usually presented especially after menopause, whether surgical or physiological. With the cessation of the rule (menopause) is common to see this problem, which is triggered by lack of estrogen in women, as discussed in the chapter devoted to sexuality in menopause and menopause. Other medical causes, much less frequent, can be anything from certain illnesses, the very fabric of genital atrophy (kraurosis), usually at an advanced age, and can be a side effect of some drugs, such as the repeated use of Certain creams with steroids.

When the arousal disorder appears in younger women, who have not yet reached its climacteric, usually due to psychological causes, mostly related with concern and fear about the sexual experience itself immediately: fear of pregnancy, infection, to be discovered to be rejected by the couple, and so on. In the younger girls is not uncommon that it is a simple technique of bad sexual stimulation. The little game prior to sexual intercourse which prevents the vagina is lubricated adequately, so that both attempts at penetration as the same penetration are upset, something that disconnects even more to women in their process of arousal, which in turn away the possibility that its response to flow lubrication.

Vaginal dryness

It is the main annoyance of women with sexual arousal disorder. It is important that every woman, especially one that is at its start to feel menopause and vaginal dryness, know how to avoid this to be an insurmountable obstacle to their sexual enjoyment. Of entry Any woman who begins to receive vaginal dryness and/or insufficient lubrication during sexual intercourse, regardless of their age, should devote special attention to the enjoyment of non-coital sexual game, that is, fondling of all kinds, which although they are key to the enjoyment of any partner in such cases can make the difference between feeling pleasure or annoyance. It is very important to take care of the vulva and vagina, like any other part of our body. If we provide to our skin care creams, the vulva and vagina also require attention when displayed vaginal dryness. In the pharmacy can be found without the need for a prescription, gels containing soy isoflavones, moisturizing and softening properties that help prevent vaginal dryness.

Isoflavones tablets, capsules Evening primrose oil and vitamins A and E also improve the status of full-body skin and mucous membranes. In the chapter on sexuality in menopause and menopause are commented on the criteria on the appropriateness of hormone replacement therapy (HRT), as well as the constraints that must be followed during the treatment of hormone replacement with estrogen and progestins. Whether the woman uses HRT, more particularly, if you do not, it is remarkable the advantage, in terms of quality of life and ease to continue to enjoy their sexuality, the use of vaginal lubricants and gels above. In the case of the use of lubricants, it is preferable that they are water-based or water-soluble. Lubricants that do not dissolve in water coming from oil, so fundamental is the Vaseline and other mineral oils. These, because of its indissoluble in water, they adhere to the vaginal mucosa, which can facilitate the development of germs and infections disguise until they are too advanced. It is desirable that the lubricant has a slightly acidic pH, no higher than 5.0, similar to normal vagina and that allows the best defense against infections or imbalances in the vaginal bacterial flora.

It is preferable to a gel light, easy to implement. There is less risk of vaginal irritation as possible when the lubricant has no substance to it in taste, smell or color. Better if its effect is long-lasting lubricant. This facilitates the spontaneity in the sexual encounter by not needing to be outstanding at the time of its application prior to intercourse. The gels isoflavones fulfilled that role. Finally, it is recommended that the lubricant is easily removed with washing, which also occurs in the more soluble in water. The gels isoflavones do not require washing because they act as a moisturizer and softener.