New Agent for Female Sexual Dysfunction Has Promise

Female sexual dysfunction, decreased sex drive, decreased vaginal lubrication, and lack of orgasm, is more common than male sexual dysfunction or erectile dysfunction. Unfortunately, until recently no treatment has been found to be effective for female sexual dysfunction.

A new drug, bremelanotide, appeared to reduce distress and increase satisfaction among premenopausal women with female sexual dysfunction, researchers reported here.

In a study that specifically looked at decreased sexual desire reported that treatment with bremelanotide resulted in women boosting the number of satisfactory sexual events in a month.

Patients taking bremelanotide reported more nausea, flushing, and headaches than those on placebo. About 10% of the woman using bremelanotide withdrew from the study because of adverse events, but the drug was generally well tolerated.

Bremelanotide is now awaiting approval from the FDA.

Bottom Line: Female sexual dysfunction affects millions of women. Until now little could be done to help women regain their desire for intimacy. The FDA is now looking into the use of bremelanotide as a solution for this common problem.

No More Dirty Ol’ Men-Testosterone May Just Be The Answer

Testosterone, the hormone made in a man’s testicles declines with age. The symptoms of low testosterone include lethargy, falling asleep after meals, irritability, loss of sex drive or libido, and loss of muscle mass. Most of these symptoms can be reversed by hormone replacement therapy.

Men over age 65 who have a low testosterone level and symptoms of low testosterone have shown marked improvement in their symptoms with testosterone replacement therapy. Older men who receive testosterone replacement have reported a decrease in their waist circumference, a decrease in their blood pressure and a decrease the total cholesterol level.
Testosterone replacement therapy can be administered by an injection every 7-14 days, daily application of a gel to the skin each morning, or the insertion of testosterone pellets under the skin using a local anesthetic. These pellets will last 4-6 months and need to have follow up pellets 2-3 times a year.

Bottom Line: Testosterone replacement therapy is effective in older men and helps them restore their energy level, their libido or sex drive, and improve their cardiovascular health.

Use It Or Lose It – Erectile Dysfunction Lower In Men Who Have Intercourse More Often

Men, I have good news for you.  Having intercourse more often may help prevent the development of erectile dysfunction (ED). A new study reports that researchers have found that men who had intercourse more often were less likely to develop ED.

Investigators from Finland observed that men reporting intercourse less than once per week had twice the incidence of erectile dysfunction compared with those reporting intercourse more than once per week. Also the risk of erectile dysfunction was inversely related to the frequency of intercourse, i.e., more intimacy less ED.

Regular intercourse has an important role in preserving erectile function among elderly men, whereas morning erection does not exert a similar effect. Continued sexual activity decreases the incidence of erectile dysfunction in direct proportion to frequency of intercourse.

Bottom Line:  Regular intercourse protects men from the development of erectile dysfunction, which may, in turn, impact general health and quality of life.  Therefore, if your partner tells you that they have a headache, you tell them your doctor said it was healthy for you to “do it”!

 

Take Two and Call Me In the Morning-Not Aspirin, But Sex

In the past, this blog focuses on wellness, exercise, and mental health.  In this issue I will devote to the benefits of having intimacy with your partner.  Who would ever imagine that an activity that is so much fun could be so beneficial to your health.

Sexual intimacy is a form of exercise.  Each time that you engage in the sex act you burn approximately 100 calories.  Of course, if you have sex like Lady Chatterly’s Lover, then it’s a lot more.  Now 100 calories a pop doesn’t sound like much, but if you engage in sex 2-3 times a week, that’s 5000-7500 calories a year.  That’s equivalent to the energy required to jog from New Orleans to Mobile, Alabama.

In addition to the aerobic work out of huffing and puffing and increasing your heart rate, sexual activity provides resistance training.  This is the contraction of the muscles of the back, pelvis, and extremities against passive resistance.

Another advantage of regular sex is that it can actually lower your total cholesterol level, and increase the high-density lipoproteins (HDL) or the good cholesterol.  So if you indulge yourself in an extra steak with butter, indulge yourself in extra sex and you’ll be calorically even.

Sex also jump-starts your hormones.  Men can have a surge of testosterone during sex.  Testosterone is the hormone produced in the testicles that is responsible for libido or sex drive, muscle mass, and strength of bones.  Regular sex increases the level of estrogen in women which results in increase in the blood supply to the vagina keeping the vaginal tissues young, supple and moist.  There is even evidence that sex prior to or at the time of the menstrual period may relieve the symptoms of premenstrual syndrome (PMS).  There are other studies that suggests that oxytocin, a hormone secreted by the pituitary gland during sexual intimacy, contributes to long-term bonding between partners.

Sexual intimacy also results in the release of endorphins which is the ultimate painkiller or analgesic.  Endorphins are many times more potent that morphine, the most powerful man-made analgesic in use for the relief of pain.  So the next time you have a headache, don’t turn down sex but turn on and your relief is just a few minutes in the sack away.  There’s even a scientific explanation for the relief of headache pain with sex.  During sex there is an increase in the blood supply to the muscles and the genital organs.  As a result there is a decrease in the blood supply to the brain thus taking the pressure off of the tension in the brain.

For men, sexual intimacy is protective for the prostate.  Prostate infections and prostate enlargement, which begins after the age of 50 in most men, result in compression of the urethra, the tube in the penis that allows transmission of urine from the bladder to the outside of the body.  As a result men complain of difficulty with urination.   For dozens of years,  older men have gone to the doctor to have their prostate gland massaged to express the retained secretions that produce many of the symptoms of prostate disease.  For most men this is uncomfortable and expensive if you don’t have Medicare or insurance to pay for the doctor’s visit.  One inexpensive and fun way to relieve these symptoms produced by an enlarged prostate gland is to engage in sexual intimacy either through intercourse or even masturbation.   Both will produce prostate pleasing results.  So if you want to be good to your prostate gland, be good to your significant other….in bed.

Sex is good for stress.  Never let the sun set on an argument.  Having sex is an effective method of reducing the tensions that exist between partners.  You can’t be arguing when you are having good sex.

So for those of you who are not interested in going to the YMCA or a health club, you can have the benefits of a health club not in your own back yard but in your bedroom.   There are naysayers that say this is fooey. Take Two and Call Me In the Morning-Not Aspirin, But Sex. For those of you who need more motivation, give me a call and I’ll write you a prescription!

Want To Lose Weight? Check Your Testosterone Level!

This blog was excerpted from an article by Dr. Julius Goepp in Life Extension, October 2010.

Low testosterone promotes abdominal obesity in aging men. As men age, many men become trapped in a vicious cycle that leads to life-threatening abdominal obesity. No matter how much men exercise or how little they eat, these men are unable to shed this excess weight that accumulates in their belly. It has been demonstrated that low testosterone and obesity reinforced each other, trapping men in a spiral of weight gain and hormonal imbalance. In spite of this widespread threat to men’s health, most physicians do not test for testosterone levels in their obese male patients. If they did, millions of men could be protective against the scourge of metabolic syndrome, type 2 diabetes, high blood pressure, atherosclerosis, erectile dysfunction and cancer. If you haven’t to be one of these plagued  men, please have your testosterone blood levels measure and share the results with your doctor. Experts now recommend testosterone testing for most men of middle-aged men and beyond.   There is compelling evidence for the role of testosterone therapy as a means of promoting weight loss.

Preventing Erectile Dysfunction

What can you do to keep erection problems at bay?

Give yourself time. “As a man gets older, it may take a longer period of genital stimulation to get an erection,” says Dr. Baum. “For men aged 18 to 20, an erection may take a few seconds. In your thirties and forties, maybe a minute or two. But if a 60-year-old doesn’t get an erection after a minute or two, that doesn’t mean he’s impotent. It just takes longer.”

The time period between ejaculation and your next erection also tends to increase with age. In some men aged 60 to 70, it may take a whole day or longer to regain an erection. “It’s a normal consequence of aging,” says Dr. Baum.

Consider your medication. Drugs your doctor has prescribed might be at the root of the problem. Or it might be those over-the-counter antihistamines, diuretics, or sedatives you’re using. Realize, of course, that what affects your neighbor may have no effect on you.  More than 200 drugs have been identified as problematic. Drug-induced impotence is most common in men over 50, says Dr. Baum. In fact, in an American Medical Journal study of 188 men, drugs were the problem 25 percent of the time.

If you suspect your medication, consult your doctor or pharmacist. He may be able to change the dosage or switch you to a different drug. Do not, however, attempt to do this on your own.

Beware of recreational drugs. Examples include cocaine, marijuana, opiates, heroin, morphine, amphetamines, and barbiturates.

Go easy on the alcohol. Shakespeare hit it on the head when he said in MacBeth that alcohol provokes desire but it takes away the performance. That happens because alcohol is a nervous-system depressant. It inhibits your reflexes, creating a state that’s the opposite of arousal. Even two drinks during cocktail hour can be a cause for concern.

Know that what’s good for the arteries is good for the penis. The penis is a vascular organ.  The very things that clog your arteries-dietary cholesterol and saturated fat-also affect blood flow to the penis. In fact, all men over age 38 have some narrowing ofthe arteries to the penis.

So watch what you eat. High cholesterol is probably one of the leading causes of impotence in this country.

Don’t smoke. Studies show that nicotine can be a blood vessel constrictor. A study of healthy adult mongrel dogs at the University of California at San Francisco showed that the inhalation of smoke from just two cigarettes was enough to prevent five dogs from getting a full erection and a sixth dog from maintaining one. The researchers believe that inhalation of cigarette smoke blocks erection by inhibiting the smooth muscle relaxation of the erectile tissue.

Relax. Being in a relaxed frame of mind is crucial. Here’s why. Your nervous system operates in two modes. When the sympathetic nerve network is dominant, your body is literally “on alert.” Adrenal hormones prepare you to fight or take flight. Nerves shuttle your blood away from your digestive system and penis and into your muscles.

Plan ahead. It is a good idea to decide in advance what you’ll do if you don’t get an erection.   If it happens repeatedly, call your doctor.

PANEL OF ADVISERS

NEIL BAUM, M.D., is director of the New Orleans Male Infertility Clinic, a clinical assistant professor of urology at Tulane University School of Medicine, and a staff urologist with Touro Infirmary in New Orleans, Louisiana.

RICHARD E. BERGER, M.D., is a urologist with Harborview Medical Center in Seattle, Washington.

He is the author of Biopotency: A Guide to Sexual Success.

JAMES GOLDBERG, PH.D., is research director of the Crenshaw Clinic at San Diego, California, and a clinical research pharmacologist.

IRWIN GOLDSTEIN, M.D., is co-director of the New England Male Reproductive Center at the Boston University Medical Center in Massachusetts and is an assistant professor of urology at Boston University School of Medicine.

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

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.