REDUCED DESIRE FOR SEX TREATMENT IN JAIPUR

Frigidity or Hypoactive Sexual Desire Disorder (HSDD) means reduced or absent sexual fantasies or desire to engage in sexual behavior and should be associated with significant distress in self or the partner OR cause interpersonal difficulties.

It can be of lifelong (if present since beginning as due to some genetic factor, the desire centre in brain is working less) or acquired where the desire goes down after being normal for some time. It can be generalized where the lack of desire is for general or situational where it can be for the current partner only.

THERE CAN BE MANY CAUSES:

  • Depressive Disorder (most common)
  • Drug induced – Some drugs of abuse like alcohol, tobacco or medicines like SSRI, antiemetics.
  • Hormonal – Raised prolactin level like in tumors of brain esp. Prolactinoma during lactaion (breast feeding), reduced testosterone levels.
  • Dysperiunia – If sex involves pain and discomfort to either partner eg. due to reduced lubrication, or inflammation of vagina.
  • Dislike for partner – Due to foul smell from mouth or genitals, poor hygiene, poor technique, demand for something not acceptable to one (like anal sex,oral sex, other ways of pleasure which the other partner finds disgusting), excessive voilence in love making, the female stops taking care of herself smelling of baby urine or potty or kitchen, she is untidy etc.
  • Interpersonal Difficulties – There is a suspicion of extra marital relationship, poor comminication, one partner is too domonant, sex is only to perform as marital duty or not to disappoint the other partner, this can be a serious marital concern and may lead to marital discord or divorce.

CAUSES

  • Psychological Conditioning – Believed to have learnt to ejaculate fast while having sex before marriage in a dhani of agriculture field or in girls house as there was a risk of being seen.
  • Anxiety due to any reason, especially fear of not satisfying partner, fear of losing hardness, suffering from anxiety disorder.
  • Infection of urinary tract especially prostate.

TREATMENT

Learning control of ejaculation under guidance of a qualified sexologist. For temporary relief some medicines like Dapoxetine 30 mg 3-4 hours before sex, Tab Paroxetine 20 mg before sex or Clomipramine 25 may be tried.

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MANAGEMENT

  • He/She should be appropritely investigated by S Prolactin level, S Testosterone, evaluation for depressive or other psychiatric problems, interpersonal stressors, communication skills and levels should be evaluated.
  • Testosterone in appropriate doses can be given f needed, or Antidepressants started if depression is detected. Most important is to improve comminication. Partners should know likes and dislikes of each other in sexual matters, turn ons and turn offs, try to maintain a good level of general and genital hygiene, avoid repeating the same thing over and over again, try to switch position or place to have sex Some new medicines have come in market to increase desire but experience with them is very poor in the medical comminity.

KIGELS EXERCISES

  • First identify the correct muscle by holding your urine for some time. The muscle that gets tight is the Pubo Coccygeal Muscle. This is the same muscle that controls ejaulation.
  • Once you know the muscle, pull your anus and urethra up tightly, release again pull as tight as you can. Repeat for 10-15 times.
  • Next- When you pull the muscle up, hold it in tight position for 5 seconds and then release. Now follow this routine 15 times for at least 3-4 times a day.
  • Initially this should be started in lying down position and should be changed gradually to sitting or standing position after some time.
  • This takes at least 4-6 months of regular muscle training to feel the result. These should be associated with trying sex in female on top position. When the male has the urge to ejaculate, he should give a signal to his partner to stop thrusting so the ejaculation is post poned. This is not learnt over night, it needs time so don’t be disappointed if initially you can’t control and ejaculate.
  • Stop Start technique is still quite effective if practiced properly. Pre Mature Ejaculation has excellent results if treated by a qualified sexologist but trying OTC medicines may do more harm than benefit. THINK, CHOICE IS YOURS.

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