Sexual Dysfunction

If one is asked to name the single elemental force that governs life in the earth, the answer would be – urge to procreate, in other words – urge of reproduction or propagation of species. The fire in every man and woman on earth is this sexual drive that is almost a command of nature. That is why the sexual act has been the most pleasant sensory feeling of the human race.

In order to enjoy sex, create another human being; fulfill the urge of the partner, one must be healthy. Sex is basic, natural instinct and it demands good health, complete concentration.

Ayurveda has a separate branch called ‘Vrisha sikitsa’ to deal with Aphrodisiac treatment. It has excellent medicines, oils, massages to rejuvenate and restore vigour and virility. The comphrensive treatment ‘vaaji karnam’ which literally means “inducing horse power.” Combined with Rasayana treatment is the treatment of choice for low sexual dysfunctions.

Charaka had said that “Vaaji karnam” enables man to indulge in excessive sexual acts. Ayurveda prohibits sexual union when the woman is menstruating. The primary objective of Ayurvedic vaaji karanam is to enable a person to produce off springs. Absolute celibacy is not desirable. Suppression of sexual urge leads to mental stress.

Ayurveda recommends two special therapies – Rasayana and vaaji karnam – for physical and mental health. Of the seven ‘dhathus’ or tissues specified by Ayurveda, the seventh tissue “Sukla” is responsible for reproduction. The Ayurvedic treatment for sexual dysfunction boosts sukla tissue by building up all body tissues.

Rasayanam: According to susruta, the objectives of Rasayana treatment are

1. To increase longevity to 100 years,

2. Increase the power of the brain

3. To improve health and to make a person more active,

4. To remove toxins from the body, and

5. To maintain the youth of the individual.

Rasayana gives a divine glow to the body. It promotes vigour and alacrity. Rasayana medication like chyavanaprasha, if taken regularly for a long period, does promote mental and physical vigour. It detoxifies the body.

Vaaji karnam enhances the benefits of Rasayana. It increases sexual stamina.

Sexual dysfunction in Men

Impotence / Erectile dysfunction

This is an inability of a man to achieve or maintain an erection. It denotes the inability of a man to have sexual inter course.

There are 3 forms:

• Primary impotence is when the man’s inability to get an erection is from the very beginning.

• Secondary impotence is – the man can normally attain an erection but fails on one or more occasions, in between normal activity.

• Third form is impotence caused by advancing age.

Erection of a penis occurs due to a complex interaction of neurological, Vascular, hormonal and psychological actions. Pleasurable stimuli cause the brain to command dilation of arteries supplying blood to erectile tissues (corpus cavernosum and corpus spongiosum) which become engorged with blood and dramatically expand. In order to keep the blood in the penis to sustain erection of the tissues, muscles tighten around the veins that normally drain blood from penis, slowing the out flow of the blood. Once ejaculation takes place or the stimulation stops – the arteries constrict and the veins relax.

Causes

Psychological factors like Depression, fear, anxiety, ignorance, Guilt complexes arising out of masturbation habits in adolescence. Seventy percent of the causes of impotence are due to psychological reasons.

• Organic factors – hormonal disorder, damage to nerves of the penis due to surgery like prostate surgery, diabetes. Spinal diseases, multiple lesions of the external genitals like tight foreskin, disturbance of the endocrine glands (diminished activities of thyroid or pituitary glands), diseases of the central nervous system (Tabes dorsalis – neuro syphilis also called loco motor ataxia), low sex drive, certain drugs etc. Many drugs can affect the ability to achieve like anti hyper tensives, anti depressants, some sedatives like cimetidine, digoxin, lithium and anti psychotics.

Premature ejaculation

Premature ejaculation is ejaculation that occurs too early, usually before, upon immediately after penetration.

Causes

• Psychological factors like anxiety.

• Unusually sensitive penile skin

Premature ejaculation can be very distressing to a man and his partner.

Decreased libido

Decreased libido is a reduction in sex drive.

Causes

1. Low testosterone levels

2. Psychological causes depression, anxiety, relationship problems

3. Some drugs, like the drugs for high blood pressure

Lack of desire

Desire (also called sex drive or libido) is the wish to engage in sexual activity. It may be triggered by thoughts, words, sights, smell, or touch. Desire leads to the first stage of the sexual response cycle, excitement. Excitement is sexual arousal. During excitement, blood flow to the penis increases, leading to an erection. Also, muscle tension increases throughout the body. In the plateau stage, excitement and muscle tension are maintained or intensified. Orgasm is the peak or climax of sexual excitement. At orgasm, muscle tension throughout the body further increases. The man experiences contractions of the pelvic muscles followed by a release of muscle tension. Semen is usually, but not always, ejaculated from the penis. Although ejaculation and orgasm often occur nearly simultaneously, they are separate events. Ejaculation can occur without orgasm. Also, orgasm can occur in the absence of ejaculation, or with the use of certain drugs (such as some antidepressants). Most men find orgasm highly pleasurable. In resolution, a man returns to an unaroused state. After orgasm, men cannot have another erection for some time (refractory period), often as short as 20 minutes or less in young men but much longer in older men. The time between erections generally increases as men age.

Treatment

1. Allopathic

Sildenafil is the drug most frequently used to treat erectile dysfunction.

Sildenafil, which is taken by mouth, increases the frequency and rigidity of erections within 30 to 60 minutes; erections last about 10 to 30 minutes. The drug is effective only when the man is sexually aroused. Side effects of sildenafil include headache, flushing, runny nose, upset stomach, and vision problems. More serious side effects, including dangerously low blood pressure, can occur when sildenafil is taken with certain other drugs (such as nitroglycerin or amyl nitrite). Because of this, a man should not take sildenafil while taking drugs such as nitroglycerin.

Other oral drugs that have been used in the treatment of erectile dysfunction are phentolamine, yohimbine, and testosterone. Phentolamine is sometimes prescribed for erectile dysfunction but is less effective than sildenfil. Yohimbine is occasionally used to treat men whose erectile dysfunction is caused by psychologic factors, but the drug can cause side effects (including anxiety, shaking, rapid heart rate, and increased blood pressure) and is only minimally effective.

2) Psychologic therapy:-

Some types of psychologic therapy (which include behavior – modification techniques, such as the sensate focus technique) can improve the mental and emotional factors that contribute to erectile dysfunction. Psychologic therapy can even help when the erectile dysfunction has a physical cause, because psychologic factors often compound the problem.

Specific therapies are selected based on the particular psychologic cause of the man’s erectile dysfunction. For example, if the man is suffering from depression, psychotherapy or antidepressants may help with erectile dysfunction. Sometimes psychotherapy can reduce anxiety about sexual performance in men with erectile dysfunction from any cause. Improvement may take a long time, and many sessions are usually required. A man, and often his partner, must be highly motivated for psychotherapy to work.

The two fold treatment of sexual dysfunctions in Allopathic system – physical and mental levels – need high motivation and physical immunity to tolerate the side effects of the strong medication. As said earlier, drugs like sildenafil can cause serious side effects on the psychological level “the sensate focus” technique may not fetch the desired results because of modesty of Asian particularly of Indian Women! Many married couple may feel that touching each other in a ‘forced’ systematic manner, is not the same as ‘spontaneous’ desire. Desire for sex can not be switched on and off like the switch of an electric bulb.-

Sexual dysfunctions in women

Dyspareunia.

Dyspareunia is pain during sexual Intercourse

Causes

1. Vaginal dryness

2. Use of contraceptives like poorly fitting diaphragm

3. Inflammation

4. Injury

5. Infections

6. Tumours

7. Menopause

8. Psychological factors.

When a woman has a sexual intercourse for the first time,

the hymen (membrane covering the opening of the vagina) if still intact, may be torn as the penis enters vagina, causing pain and sometimes bleeding. This is a superficial pain and will disappear. As women age, the lining of the vagina thins and becomes dry due to decrease in estrogen levels. This condition is called atrophic vaginitis. As a result, intercourse may be painful.

Psychological factors may be difficult to identify. Dislike or repulsion towards a sex partner, fear of pregnancy, or a traumatic sexual experience like rape could be some of the psychological reasons

Vaginismus

Vaginismus is a sudden and painful contraction of the

muscles surrounding the vagina, usually in response to the 'vulva' or vagina being touched. Sexual intercouse is painful or impossible

Causes

The woman has a unconscious desire to prevent sexual intercourse and the condition may be associated with fear or aversion. Earlier episodes of painful attempts of intercourse can lead to vaginismus. Physical disorders like plevicinfection, irritation due to douches etc, injury or surgery etc can also cause vaginismus. Kegel exercises are suggested to be performed.

Vulvodynia

This denotes chronic discomfort in the vulva - the area

Containing the external genital organs.

Causes

• Injuries, irritants like soap or synthetic under clothing

• Hormonal changes

• Eating greens, chocolates, berries or nuts can result in Urine that irritates the vulva.

The vulva may burn or sting. It may feel raw or irritated. It

could be quite distressing as daily activities are affected.

Decreased libido

This denotes reduction in sex drive fluctuation in the levels of

hormones such as estrogen, may cause low libido. Depression, anxiety stress, matrimonial problems, oral contraceptives, beta - blockers can also reduce sex - drive.

Sexual arousal disorder

This is the persistent inability to attain vaginal lubrication.

Psychological factors, physical disorders, vaginal dryness counseling, kegel exercises, use of topical estrogen, sensate focus therapy may help.

Ayurvedic Remedies

Ayurveda has wonderful medicines and treatments for sexual dysfunctions of both men and women. The treatment is three – pronged. Rasayana rejuvenates. Vajikarnam increases sexual stamina. Diet regimen combined with yogasanas completes the cure.

The first step is

1. Approach an experienced Ayurvedic physician.

2. The ancient Ayurvedic texts like charaka samhita, susrutha samhita and Ashtanga samhita deals with this subject in detail and have very effective treatment for almost all sexual problems. Hence have trust in your Ayurvedic physician.

3. After a through examination, the Ayurvedic doctor treats you first for diseases like piles, improper digestion, digestive disorders, constipation diabetes and intestinal worms.

4. Then the patients (Male & female) are given internal medicines to correct the exact problem. The treatment may vary according to condition of the patient.

5. The entire treatment comprises of using specially made herbs, according to the dosha type and constitution of each patient and their problems.

Action of certain Important Herbs are:

Withania somnifera (Ashwamed / Aswagandha), Mucuna pruriens, Crocus sativas, Stryax officinali (shilaj) Orchis mascula, Anacyclus pyrethrum, Sida cordifolia, Bombax malabaricum, Pedalium murex,

Hibiscus abelmoschus, Pueraria tuberosa, Euphorbia thymifolia etc.

Ayurvedic preparations for vim & vigour

1. Aswagantharishtam (very good for infertility when given with "Sathavari Rasayana)

2. Bhringa Rajasavam

3. Dasamoolaristam

4. Aswaganthathi lehiyam

5. Narasimha krtham

6. Santhanadhi Thailam

7. Maharadwaja pills

8. Pancha pana rasa

9. Vikrantha Bhasma