Archive for the ‘Female sexual dysfunction’ Category

Ladies, Another Reason To Work on Your Abs

April 14, 2012

It’s a fact that some women experience sexual pleasure by working out-and this can be accomplished without toys or even a partner! The secret is to workout from the core abdominal muscles. The University of Indiana discovered this phenomenon by surveying hundreds of women who reported sexual pleasure during exercise,. Most of the women reported that the sexual pleasure including orgasm occurred during an abs workout. The lead investigator, Debbie Herbenick, has coined the pleasure experience while working out the abdominal core, coregasm.

Bottom Line: There are plenty of reasons to work out and especially paying attention to your core group of muscles. You may not get a six pack but you can have a lot of fun trying!

Important Discovery-The Elusive G- Spot Has Been Found

March 24, 2012

I attended a urology\gynecology convention in Las Vegas and I saw an exhibit by Intimina. They have a number of products but the one that caught my eye was a personal massager. There are three sizes of these hand-held massagers. One is palm-sized to a medium sized and finally a larger one with a gentle curve and flat tip that is targeted to the top of the vagina which is the vicinity of elusive G-spot.

These vibrators have multiple control buttons which allow you to switch between 6 levels of vibration patterns and 16 different speeds. The power is supplied by AAA batteries.

These massagers are made of non-irritating silicone and are waterproof which can be washed after use with gentle soap and water. Each massager includes a hygienic storage pouch with a one-year warranty.

For more information on the Intimina personal massager go to their website, http://www.intimina.com

Don’t Let Anti-Depressants Rain on Your Love Life

September 24, 2011

B.B., a 52-year old lady, had a history of depression, which has been controlled with Prozac. She noted a waning of her libido or sexual desire. She consulted with her doctor who prescribed the Prozac and he changed her medication to Wellbutrin, which allowed her libido to return to normal, and controlled her depression as well.
Sexual dysfunction, which includes loss of libido, decrease in arousal or vaginal dryness for women and decreased libido, and erectile dysfunction in men, is common in both men and women with depression. If that wasn’t bad enough, the treatment for depression with the antidepressant medication can cause sexual dysfunction. It is estimated that 30-70% of men and women who use antidepressant medication, such as Celexa, Prozac, Effexor, Zoloft and Remeron, experience a sexual dysfunction. The lowest rate of sexual side effects occurred in patients taking Wellbutrin.
Many men and women who experience these side effects of the medication may try to resolve the problem by stopping the use of their antidepressant medication. This should be avoided, as restoring sexual intimacy is not a good trade off if the depression returns. Fortunately, there’s a solution to this dilemma for those who suffer from depression or for those who require the use of antidepressant medications.
How do you know if your antidepressant is causing sexual problems? Experts say that the trouble is probably the result of the medication if a person who did not previously have sexual dysfunction experiences problems within two to three months of beginning antidepressant treatment.
What To Do

First and most importantly, do not make any changes in your treatment regimen without first consulting your physician. Here are some suggestions which you might discuss with your physician:

1. If you are experiencing sexual side effects from your antidepressant medication, your doctor may consider switching you to Wellbutrin, which has a low rate of sexual side effects. Wait to see if sexual side effects abate.
2. Consider taking your medication after you have engaged in sexual intimacy.
3. With your doctor’s permission you may consider a drug holiday. A drug holiday involves taking a short break from your antidepressant. By taking periodic two-day breaks from antidepressant treatment can lower the rate of sexual side effects during the drug holiday without increasing the risk of a relapse or recurrence of depressive symptoms.

Bottom Line: Sexual side effects are common in men and women with depression. Most men and women can be restored to a meaningful sexual function by sharing with your doctor your concern and having him\her making changes and adjustments in your medication or changing to another drug as described in my patient B.B.

Testosterone Is For Women, Too!

August 23, 2011

If you are a middle aged woman who is post menopause, you may find that your sex drive or libido has decreased to the point of no interest in sexual intimacy. It doesn’t have to be this way.

When we think of testosterone we usually think of this hormone as only existing in men. However, testosterone is also produced by the female reproductive organs.
A special menopause supplement in the March 1999 issue of the “American Journal of Obstetrics and Gynecology” recommends the addition of androgen (testosterone) to estrogen for all women undergoing surgical menopause. The use of androgen therapy may also be beneficial to women who experience loss of libido and other symptoms of testosterone deficiency during natural menopause.

Medical science now knows that testosterone is produced naturally by the ovaries and smaller amounts by the adrenal glands. Testosterone is an important factor in women’s health before and after menopause. Testosterone provides several benefits to women:
• improves relief of vasomotor symptoms of menopause 

• increases energy levels

• enhances of feelings of well-being

• decreases breast tenderness

• improves sexual desire

• increases sexual sensitivity

• increases the frequency of coitus

• enhances orgasm

Androgen therapy has been around since 1936, however the myths often associated with testosterone therapy in women have placed fear in many women and resulted in few women considering this therapy. Rare, but possible side effects of testosterone therapy include hoarseness or other voice changes, development of facial hair, acne, and over-sexuality. These side effects rarely occur at the low doses most often in use today; when side effects do occur relief is usually achieved by reducing the dose of testosterone.

The Symptoms of Testosterone Deficiency?
• diminished sexual pleasure

• decreased sensitivity of breast and genital tissues

• decreased orgasmic response

• decreased libido

• low energy

• depression
If you are experiencing any of these symptoms, talk with your doctor. Several forms of testosterone replacement are available including oral estrogen-androgen combinations such as Estratest, injections of testosterone, topical gels containing testosterone and, recently, there is an implantable forms of testosterone, Testopel.
Bottom Line: Testosterone is not just for men. If you are a woman and suffer from a significant decrease in your sex drive or libido, check with your doctor. You may be a candidate for testosterone replacement therapy.

This blog was excerpted from an article, Menopause and Testosterone, by Tracee Cornforth.
http://womenshealth.about.com/cs/menopaus1/a/menotestosteron.htm

When Sex Is No Longer Fun For Women

August 10, 2011

Women have sex drive and libido just like men. Although the sex drive of women is hormonally based and when the hormones are not aligned properly, havoc takes place. There are also a dozen other physical causes that can affect a women’s interest in sex. However, help is available and most women with decrease or loss of libido can be helped.
A woman’s desire for sex is based on a complex interaction of many components affecting intimacy, including physical well-being, emotional well-being, experiences, beliefs, lifestyle and current relationship. If you’re experiencing problems in any of these areas, it can affect your sexual desire.
Physical causes
Numerous nonsexual diseases can also affect desire for sex, including arthritis, cancer, diabetes, high blood pressure, coronary artery disease and neurological diseases. Infertility also can contribute to low sex drive, even after infertility treatments are over.
Many prescription medications — including antidepressants, blood pressure medications and chemotherapy drugs — are notorious libido killers. Antihistamines also can diminish your sex drive.
A glass of wine may make you feel amorous, but too much alcohol can spoil your sex drive; the same is true of street drugs.
Any surgery related to your breasts or your genital tract can affect your body image, function and desire for sex. Also, surgery in the pelvis on the uterus or ovaries can affect a woman’s sex desire and interest.
Finally, changes in your hormone levels may change your desire for sex: Estrogen helps maintain the health of your vaginal tissues and your interest in sex. But estrogen levels drop during the transition to menopause, which can cause a double whammy — decreased interest in sex and dryer vaginal tissues, resulting in painful or uncomfortable sex. At the same time, women may also experience a decrease in the hormone testosterone, which boosts sex drive in men and women alike. Although many women continue to have satisfying sex during menopause and beyond, some women experience a lagging libido during this hormonal change.
Treatments for low sex desire
Unfortunately, there is no simple pill or potion to increase sex drive in women. In fact, most women benefit from a multifaceted treatment approach aimed at the many causes behind this condition. This may include sex education, counseling, lifestyle changes and sometimes medication.
Healthy lifestyle changes can make a big difference in your desire for sex: Regular aerobic exercise and strength training can increase your stamina, improve your body image, elevate your mood and enhance your libido. Finding a better way to cope with work stress, financial stress and daily hassles can enhance your sex drive. Pelvic floor exercises (Kegel exercises) can improve your awareness of the muscles involved in pleasurable sexual sensations and increase your libido. To perform these exercises, tighten your pelvic muscles as if you’re stopping a stream of urine. Hold for a count of five, relax and repeat. Do these exercises several times a day. Remember a Kegel a day keeps the sex drive up so you can have a great time in the hay!
Systemic estrogen therapy — by pill, patch or gel — can have a positive effect on brain function and mood factors that affect sexual response. Local estrogen therapy — in the form of a vaginal cream or a slow-releasing suppository or ring that you place in your vagina — can increase blood flow to the vagina and help improve desire. In some cases, your doctor may prescribe a combination of estrogen and progesterone.
Male hormones, such as testosterone, play an important role in female sexual function, even though testosterone occurs in much lower amounts in women. However, replacing testosterone in women is controversial and it’s not approved by the Food and Drug Administration (FDA) for sexual dysfunction in women. Plus, it can cause negative side effects, including acne, excess body hair (hirsutism), and mood or personality changes. Testosterone seems most effective for women with low testosterone levels as a result of surgery to remove the ovaries (oophorectomy). If you choose to use this therapy, your doctor will closely monitor your symptoms to make sure you’re not experiencing negative side effects. I have had several dozen patients who have used testosterone replacement therapy for decreased libido with amazing results.

Bottom Line: Sex is not over when a women enters middle age. There are many treatment options that can help her get back in the saddle. Contact your doctor for more information.

This article has been excerpted from the May Clinic Newsletter: http://www.mayoclinic.com/health/low-sex-drive-in-women/DS01043/DSECTION=causes

New YouTube video on female sexual dysfunction-When It’s No Longer Fun “Down There”

January 12, 2011

Dr. Neil Baum, urologist Please see my video on “female sexual dysfunction” on YouTube. To see video go to: http://bit.ly/hfZafP

Don’t Let Anti-Depressants Put Your Sex Life To Bed

May 24, 2010

Today depression can be successfully treated with medication.  Unfortunately, sexual dysfunction is a common side effect of nearly all classes of anti-depressant medications. The side effects include decreased libido, inability to orgasm, decreased sensation in the genitals, vaginal dryness (in women), and erectile dysfunction (in men).

There are other causes of loss of libido, which includes hormone deficiency in both men and women and can easily be diagnosed with a blood test for testosterone and if the level is diminished, replacement therapy can easily be accomplished with injections and gels in men and with medication and gels in women.

If anti-depressants are the likely cause, there are several possible options. There are some anti-depressants that are less likely to cause loss of libido.  Wellbutrin is one of those medications that is associated with less sexual side effects than other anti-depressants.

The drugs used to treat erectile dysfunction, Viagra, Levitra, and Cialis have been effective in resolving the side effects of anti-depressant medication in both men and women.

For those who are on anti-depressant medication, consult with your doctor and tell him\her about the sexual side effects and the doctor may be able to decrease the dosage of the anti-depressant medication that causes the sexual side effect yet provide adequate medication to control the depression.

Another option is to ask your doctor about changing the time of day that you take your medication.  For example, if you plan to have sexual intimacy in the evening, then take your anti-depressant medication before you go sleep.  Thus the blood level of the anti-depressant will be lowest the next evening at the time you engage in sexual intimacy.

You can also ask your doctor if you can divide your anti-depressant medication and take it twice a day rather than one large dose which will elevate the blood level of the anti-depressant more than using smaller doses several times a day.

Finally, consider a drug holiday.   This involves taking a short break from your anti-depressant medication. There are reports that a two-day break from antidepressant therapy can lower the rate of sexual side effects during the break without increasing the risk of a recurrence of depressive symptoms. This approach, the weekend holiday, works with quick-clearing drugs, such as Zoloft and Paxil. One potential risk with taking a drug break from antidepressants that have very short half-lives, such as Zoloft and Paxil, is the recurrence of symptoms of depression.

Bottom Line:  Sexual side effects are commonly associated with the use of anti-depressant medications.  However, if you speak to your physician, alternatives may be found that will put your sex life back on track.

Dr. Neil Baum is a physician in New Orleans.  He can be reached at (504) 891-8454 or on his website, http://www.neilbaum.com

Sexuality in Later Life

April 28, 2010

that won’t cause sexual problems.

Help is available

There are several things you can do on your own to keep an active sexual life. Remember that sex does not have to include intercourse. Make your partner a high priority. Pay attention to his or her needs and wants. Take time to understand the changes you both are facing. Try different positions and new times, like having sex in the morning when you both may have more energy. Don’t hurry-you or your partner may need to spend more time touching to become fully aroused. Masturbation is a sexual activity that some older people, especially unmarried, widowed, or divorced people and those whose partners are ill or away, may find satisfying.

If you do seem to have a problem that affects your sex life, talk to your doctor. The most common problem that affects women is painful intercourse. For most women, lubrication can be provided with creams orjellies. If the problem is estrogen deficiency, this can be supplied with topical estrogen creams or oral estrogens if there are no contraindications such as estrogen receptor positive breast cancer.

If a man complains of a loss of libido, the problem may be related to testosterone deficiency that can be replaced with injections, topical jells or the insertion of testosterone pellets. If impotence is the problem, it can often be treated with oral medications such as Viagra, Levitra, or Cialis. If the medications are not successful then injections, vacuum devices, or surgical implants can be performed.

Bottom line: Just because a man or women enters their senior years does not mean that sexual intimacy has to cease. Older men and women can and do enjoy intimacy.

Hypoactive Sexual Desire- or I’ve Got a Headache!

April 25, 2010

He: “Are you in the mood?”

She: “Naw, I’ve got a headache!”

If you are a female and you experience these feelings about loss of desire for sexual intimacy, you may have hypoactive sexual desire (HSD).  In other words, you’re rarely in the mood; you neither initiate sex nor seek stimulation. Hypoactive sexual desire is the most common form of female sexual dissatisfaction and occurs when there is a persistent lack of desire or absence of sexual fantasies.

Lack of desire often occurs as a result of problems with your partner.  Communications problems, anger, a lack of trust, a lack of connection and a lack of intimacy can all adversely affect a woman’s sexual response and interest.  If this sounds like you, counseling and therapy with your partner is probably your No. 1 treatment option to overcome HSD.

In addition to psychological causes there are medical causes of HSD.
Many commonly prescribed drugs, such as antihypertensives, antidepressants and birth control pills, interfere with sex drive, arousal and orgasm by affecting the balance of sexual hormones and the transmission of chemical messengers. Antidepressants, known as selective serotonin reuptake inhibitors (SSRIs), combat depression by increasing the production of serotonin in the brain. Although serotonin may decrease depression, it also dampens sexual desire.

The onset of menopause, either surgically produced by removing the ovaries or naturally as a consequence of aging, is characterized by a gradual decline of the hormones estrogen, progesterone and testosterone. Reduced testosterone levels can lead to a decline in libido. Ironically, the conventional hormone replacement regime of estrogen given to relieve menopausal symptoms can make matters worse, because estrogen increases a protein (called steroid hormone-binding globulin) in the blood that binds to testosterone, causing testosterone to become less available to the body.

Depression is also associated with HSD. A common symptom of depression is diminished sex drive, which, in turn, can exacerbate depression. Studies indicate that 12 percent of all women will experience clinical depression at some point in their lives. One of the side effects of the popular antidepressants Prozac, Paxil and Zoloft is loss of libido. Even with a lower-grade form of depression that is not easily recognized because you can function with it. A woman with depression may feel isolated and overwhelmed and withdraw from sex and social activities.

Overcoming HSD
If you’re suffering from loss of libido and think there is a medical basis for your problem, here are some solutions to consider:

Talk to your doctor about testosterone, especially if you have had your ovaries removed, are taking estrogen or under severe stress. Get your testosterone level evaluated and if it is below 20 nanograms per deciliter, consider starting testosterone therapy. Testosterone is central to a woman’s sexual function that no amount of sexual stimulation can make up for its absence.  Using testosterone to treat FSD has not been approved by the FDA, so you’ll need to find a physician open to prescribing it to treat lack of sexual desire. If you are already on hormone replacement therapy for menopausal symptoms, ask your doctor to add testosterone to your regimen.

Switch to medications known to have less effect on sexual function or lower dosages. The antidepressants Prozac, Zoloft and Paxil, of which women are major consumers, cause loss of libido in as many as 60 percent of patients. I suggest asking your doctor to change to an antidepressant that has less sexual side effects like Celexa, Wellbutrin, BuSpar, Serzone or Effexor.

Viagra, the little blue pill used to treat erectile dysfunction in men, may help jump-start your sex life as long as you have the desire to engage in sex and have been stimulated enough for it to take effect,. It’s especially helpful if your lack of desire is related to hysterectomy or menopause. Doctors aren’t exactly sure how Viagra helps rekindle lust but it helps women achieve arousal, which is the phase that comes after desire, by increasing blood flow to the vagina, clitoris and labia.

For more information contact your physician or find a physician who has experience treating HSD.  I also recommend the best-selling book For Women Only by Jennifer and Laura Berman.

Low Sexual Desire-When It Isn’t All You Want It To Be

April 22, 2010

Has your desire for sex and sexual intimacy gone into the tank?  Are you having fewer thoughts about engaging in sexual intimacy with your partner?  If so, you may be suffering hypoactive sexual dysfunction.  You might take comfort in knowing that this is a common problem that affects both men (35%) and women (45%).  That’s the bad news.  It is a problem that most who suffer from decreased sexual desire will not share with their partner or with their doctor.  The good news is that help is on the way and many who suffer from this common problem can be helped.  In this article I will discuss the causes of decreased sexual desire and what treatment options are available.

Causes of low sexual desire

Low sex desire is a very common sexual disorder.  It occurs when one partner does not feel intimate or close to the other.  Often the problem is result of a diminished affection for the other partner, power struggles between the two partners and not having enough time to be alone in order to be intimate.  Low desire can also be a result of a strict or religious background where sexual intimacy is often associated with scorn and negativity.  The problem can also occur when there is a history of sexual trauma at an earlier age or sexual abuse by a parent or relative.  Lack of desire is also associated with medical conditions such as heart disease, diabetes, kidney disease, thyroid deficiency, and arthritis.  Drug abuse and excessive alcohol consumption are culprits in causing decreased sexual desire.  There are literally hundreds of medications that are associated with the side effect of inhibited sexual desire.  These include anti-depressants, Paxil, Zoloft, and Prozac.  Hormone deficiency is another common culprit such as a decreased testosterone in men and decreased estrogen in women as is so common following menopause or surgical removal of the ovaries.  In addition to these physical causes of decreased sexual desire, there are psychological conditions such as depression, stress, fatigues, lack of sleep, and lifestyle problems such as career changes and martial discord that can be a primary cause or can contribute to the problem.  Finally, there is a problem referred to as fear of failure that impacts both men and women.  If a man has impotence, premature ejaculation, restarted ejaculation or a women has painful intercourse or does achieve an orgasm can lose interest because they don’t want to experience repeated failure and embarrassment in the bedroom.

Treatment of decreased sexual desire

If the problem is due to estrogen deficiency, then your doctor can simply order estrogen replacement therapy which includes either oral medication or topical vaginal creams or suppositories that can restore the vaginal lining to a normal state.

If the problem of decreased libido is a side effect of medication, your doctor can reduce the dosage of your existing medication or change to another class of medication that is not associated with diminishing sexual desire.

Wellbutrin has been reported to improve symptoms of low sexual desire in women.  The reports are that nearly a third of the women will experience a doubling of their interest in sexual activity after using Wellbutrin.  Although Wellbutrin is an anti-depressant, the drug was shown to be effective in women without depression and only complaining of decreased sexual desire.

Psychotherapy has also been shown to be helpful in managing low sexual desire.  For women who are in a stable relationship, the therapist explores problems with communication between the partners or provide advice and education to enhance sexual stimulation by the woman’s partner.

On the horizon is a new drug that may just be the female equivalent of Viagra.  The drug is specially used for treating decreased sexual desire.  If you are interested in participating in research study involving this new medication, call 504 891-8454 to see if you qualify to participate in the study.

When to call the doctor?

If you are not satisfied with your current level of sexual desire and intimacy and you find that the remedies suggested in the tabloids and other self-help publications are not effective, you should consider consulting with your doctor so that they might identify physical and\or psychological causes that are treatable.

Bottom Line:  Decreased sexual desire is a common condition in both men and women.  Fortunately, most of those who suffer from decreased sexual desire can be helped.  If you are one of these men or women, share this article with your partner and make an appointment to see your doctor.