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Female Sexual Dysfunction

Common Sexual Disorders and Causes of Decreased Libido


By Tracee Cornforth, About.com
Updated: July 18, 2007 About.com ealth!" #$"ea"e and Cond$t$on content $" re%$e&ed by the 'ed$cal (e%$e& Board

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Q W!at are t!e most commonl" seen sexual #roblems in women$


A A recent "ur%ey <conducted by *aumann and collea2ue" at the Un$%er"$ty of Ch$ca2o= of Amer$can &omen <a2e" 183>?= found that the mo"t common "e)ual problem $n &omen $" hypoact$%e "e)ual de"$re d$"order < ,##=, more commonly referred to a" lo& "e) dr$%e or l$b$do <@@.A5=, follo&ed by d$ff$culty &$th or2a"m <2A.15=. +a$n dur$n2 $ntercour"e33&h$ch occur" $n 1A.A5 of &omen33&a" the only cond$t$on to "ho& a relat$on"h$p to a2e 33 $t decrea"e" a" &omen 2et older.

,## $" a def$c$ency or ab"ence of "e)ual fanta"$e" and de"$re for "e)ual act$%$ty, a" def$ned by the Amer$can +"ych$atr$c A""oc$at$on <A+A=. The def$n$t$on $" %a2ue becau"e the A+A ac/no&led2e" that there can be "$2n$f$cant d$fference" $n "e)ual $ntere"t le%el" amon2 &omen. Accord$n2 to the "ur%ey ment$oned abo%e, @75 of &omen th$n/ about "e) a fe& t$me" a month and only @@5 th$n/ about "e) 23@ t$me" a &ee/ or more. app$er &omen "eem to th$n/ about "e) more often than unhappy &omen. #$ff$culty &$th or2a"m, or female or2a"m$c d$"order, $" a per"$"tent delay or ab"ence of or2a"m. Th$" def$n$t$on $" al"o from the A+A and $t a2a$n attempt" to allo& for $nd$%$dual %ar$at$on by not 2$%$n2 a "pec$f$c number or percenta2e to def$ne a 7normal7 amount of or2a"m". The "ur%ey "tate" that 2?5 of &omen "ay they al&ay" ha%e or2a"m" dur$n2 "e) and A05 "ay they are phy"$cally "at$"f$ed &$th the$r partner". There are &$de %ar$at$on" $n "e)ual funct$on$n2, and there $" no 2old3"tandard that &omen "hould feel they mu"t meet for the$r "e)ual funct$on$n2 to be con"$dered !normal.! 0f a &oman e)per$ence" a "e)ual problem that trouble" her, then $t $" a problem that need" to be addre""ed and "he "hould be encoura2ed to tal/ to her doctor about $t to "ee ho& $t can be $mpro%ed.

Q W!at causes decreased sexual desire in women$


A *o& "e) dr$%e can be cau"ed by a ran2e of factor", &h$ch %ary from one $nd$%$dual to the ne)t. Bat$2ue, the da$ly re"pon"$b$l$t$e" and mult$ple role" &omen often a""ume, and many po""$ble p"ycholo2$cal cau"e" can $mpact a &oman!" "e)ual appet$te. 0t $" al"o /no&n that certa$n health cond$t$on" and med$cat$on" can affect a &oman!" "e)ual de"$re. #epre""$on and an)$ety d$"order" can $nterfere &$th "e)ual de"$re, but "o can "ome of the dru2" u"ed to treat the"e cond$t$on". 'any ant$depre""ant", $n part$cular ,elect$%e ,eroton$n (eupta/e 0nh$b$tor", al"o called ,,(0" <e.2.., +ro;ac, +a)$l, Coloft=, ha%e "$de effect" that ha%e a ne2at$%e $mpact on &omen!" l$b$do". .ellbutr$n ,( $" a po""$ble alternat$%e, a" $t doe" not "eem to cau"e "e)ual problem". ,er;one, (emeron and *u%o) may not cau"e problem" &$th "e)ual de"$re e$ther. 0n add$t$on, b$rth control p$ll", mood "tab$l$;er", tranDu$l$;er" and other med$cat$on" ha%e been "ho&n to decrea"e l$b$do. 0f you not$ce a drop $n your "e)ual de"$re around the t$me you "tart a ne& med$cat$on, tal/ to you doctor to "ee $f there $" a connect$on. #o not "top ta/$n2 any med$cat$on &$thout tal/$n2 to your doctor f$r"t.

Q W!at is t!e di%%erence between sexual arousal and sexual desire$


A 0n mo"t &omen &ho are not e)per$enc$n2 "e)ual problem", l$b$do and arou"al are clo"ely related and d$ff$cult to "eparate. *$b$do refer" to a ba"el$ne $ntere"t $n "e) and m$2ht be redef$ned a" "e)ual appet$te. Arou"al refer" to the phy"$olo2$cal re"pon"e to "e)ual "t$mul$. .omen &$th h$2her l$b$do" 2enerally ha%e a 2reater re"pon"e to "e)ual "t$mul$, or 2reater arou"al. +hy"$cal man$fe"tat$on" of "e)ual arou"al $nclude %a2$nal lubr$cat$on and $ncrea"ed blood flo& to the lab$a, cl$tor$" and %a2$na.

Q W!at can increase sexual arousal in women$


A -ne of the "ymptom" of decrea"ed "e)ual arou"al $n &omen, $" a reduced amount of %a2$nal lubr$cat$on. -%er3the3counter %a2$nal lubr$cant" can au2ment lubr$cat$on. 0f a decrea"e $n %a2$nal lubr$cat$on ha" been cau"ed by menopau"e, hormone replacement therapy can help. Th$" $" the only appro%ed dru2 therapy for th$" d$"order. :$a2ra <"$ldenaf$l= and a cla"" of med$cat$on" called alpha3adrener2$c bloc/er", "uch a" (e2$t$ne <phentolam$ne=, can al"o $ncrea"e the %a2$nal lubr$cat$on re"pon"e to "e)ual "t$mulat$on. o&e%er, $t "hould be ment$oned that "tudy after "tudy of :$a2ra for %ar$ou" female "e)ual problem" ha%e not "ho&n an $ncrea"e $n "e)ual plea"ure $n &omen.

A"$de from pharmacolo2$c "olut$on", &omen can al"o choo"e beha%$oral therapy to help $ncrea"e "e)ual arou"al. ,uch therapy $" a$med at enhanc$n2 "e)ual fanta"$e" and focu"$n2 one!" attent$on on "e)ual "t$mul$. Bor &omen $n on32o$n2 relat$on"h$p", the therap$"t &ould al"o loo/ $nto the po""$b$l$ty of commun$cat$on problem" $n the relat$on"h$p, or lac/ of "e)ual "t$mulat$on by the &oman!" partner.

Q W!at can increase sexual desire in women$


A At th$" t$me, there are no appro%ed dru2 treatment" for lo& "e)ual de"$re. o&e%er, a recent "tudy of 44 &omen, a2e" 2@ to 4>, &$th ,## for an a%era2e of "$) year", found that .ellbutr$n ,( may be an effect$%e treatment. Appro)$mately one th$rd of &omen e)per$enced doubled $ntere"t $n "e)ual act$%$ty, "e)ual arou"al and "e)ual fanta"$e". Althou2h .ellbutr$n ,( $" an ant$depre""ant, the &omen $n th$" "tudy d$d not "uffer from depre""$on and they d$d not ha%e relat$on"h$p d$ff$cult$e". 'ore "tud$e" are needed to "upport th$" prel$m$nary data. There ha%e al"o been "tud$e" that $nd$cate that te"to"terone can $ncrea"e "e)ual de"$re $n &omen &ho!" lo& "e) dr$%e $" a re"ult of the "ur2$cal remo%al of the$r o%ar$e". Cont$nual treatment &$th te"to"terone doe" ha%e "$de effect" and may lead to 7ma"cul$ne7 "$de effect" $n "ome &omen <$.e., lo&er %o$ce, ha$r lo"", enlar2ed cl$tor$"=.

Q W!at can cause lac& o% or'asm$


A The $nab$l$ty to ach$e%e or2a"m <anor2a"m$a= can be cau"ed by a number of factor", both phy"$cal and p"ycholo2$cal $n nature. *ac/ of adeDuate "t$mulat$on, acute "tre"", an)$ety, a" &ell a" depre""$on and relat$on"h$p problem" can all $nterfere &$th the ab$l$ty to e)per$ence or2a"m. -ther health cond$t$on", "uch a" $ncont$nence, can cau"e problem" too. E%eryday "tre"" and the many role" and re"pon"$b$l$t$e" &omen deal &$th can re"ult $n d$"tract$on", ma/$n2 or2a"m" more d$ff$cult to ach$e%e. 0n add$t$on, cultural and rel$2$ou" proh$b$t$on" may re"ult $n anor2a"m$a <po""$bly related to a he$2htened "en"e of 2u$lt=. Bortunately, there are %ery 2ood "elf3help boo/" a%a$lable to a""$"t &omen $n de%elop$n2 "/$ll" that &$ll $mpro%e the$r ab$l$ty to reach or2a"m. 'ed$cat$on" can al"o $nterfere &$th the ab$l$ty to e)per$ence or2a"m. 'any ant$depre""ant", $nclud$n2 +ro;ac, Coloft and +a)$l ha%e a h$2h propen"$ty to cau"e "uch problem". 0n add$t$on, ant$p"ychot$c dru2" "uch a" aldol, Thora;$ne and 'ellar$l can cau"e $nab$l$ty to reach or2a"m and :al$um may delay or2a"m. Bortunately there are other ant$depre""ant" <.ellbutr$n ,(= and ant$p"ychot$c dru2" <Cypre)a and ,eroDuel=, &h$ch don!t "eem to cau"e $nab$l$ty to e)per$ence or2a"m. Ant$hyperten"$%e dru2" may al"o $nterfere &$th or2a"m. Any d$"ea"e, "uch a" mult$ple "clero"$", that $nterrupt" the ner%e "upply to the 2en$tal" may cau"e lac/ of or2a"m.

Q How is #ain durin' sex treated$


A 0n po"tmenopau"al &omen &ho e)per$ence d$m$n$"hed %a2$nal lubr$cat$on, hormone replacement therapy $" often recommended. :a2$nal cream" conta$n$n2 e"tro2en may al"o help. E%en &omen &ho are not po"tmenopau"al e)per$ence problem" &$th %a2$nal lubr$cat$on &h$ch can create fr$ct$on dur$n2 "e), and ult$mately cau"e pa$n. 0n th$" ca"e, u"e of o%er3the3counter %a2$nal lubr$cant" before $ntercour"e $" a po""$ble remedy.

0f the &oman e)per$enc$n2 pa$n $" $n a relat$on"h$p, "he "hould commun$cate &$th her partner. To2ether they can &or/ to f$nd a po"$t$on that $" more comfortable. ,omet$me" a chan2e $n the t$me of day &hen you are more re"ted may help. 0f pa$n $" per"$"tent, "ee your doctor. The pa$n could be a "ymptom of another med$cal cond$t$on. 0n fact, mo"t phy"$c$an" %$e& dy"pareun$a <pa$n &$th $ntercour"e= a" a pa$n d$"order and treat accord$n2ly <ana2e"$c"Fcream", etc.=. Another factor to con"$der $" that for "ome &omen, feel$n2" of 2u$lt and "hame learned $n early ch$ldhood may $nterfere &$th adult "e)ual funct$on and may affect one or more pha"e" of the "e)ual re"pon"e cycle. 0n the"e $n"tance", a" &ell a" $n ca"e" of "e)ual abu"e, p"ychotherapy may be benef$c$al. 'arr$a2e coun"el$n2 or couple" therapy can al"o be of %alue.

Q (an women ever ex#ect sex to be t!e same a'ain a%ter a !"sterectom"$
A Ab"olutely. A recent, lar2e "tudy found that hy"terectomy <remo%al of the uteru"= d$d not $nterfere &$th "e)ual funct$on. o&e%er, remo%al of the uteru" and o%ar$e" <hy"terectomy plu" oophorectomy, "omet$me" referred to a" total hy"terectomy= cau"e" lar2e decl$ne" $n "e) hormone". ormone replacement therapy33&$th or &$thout te"to"terone replacement33may help to re"tore "e)ual funct$on $n &omen e)per$enc$n2 "e)ual d$ff$culty after th$" "ur2ery. A" &$th any ma9or chan2e $n phy"$cal funct$on$n2, "ome &omen do f$nd the$r "e)ual funct$on$n2 ne2at$%ely $mpacted. ,ome &omen m$"" the contract$on" of the uteru" they ha%e a""oc$ated &$th or2a"m. (emo%al of the cer%$) may re"ult $n a chan2e $n the phy"$cal "en"at$on e)per$enced dur$n2 deep penetrat$on dur$n2 $ntercour"e. 0n our cl$n$cal e)per$ence &$th &omen, there $" &$de %ar$at$on $n "e)ual funct$on$n2 po"t3hy"terectomy.

Q W!at is va'inismus$ Is t!ere an" !o#e %or women wit! va'inismus ever !avin' a !ealt!" sexual relations!i#$
A :a2$n$"mu" $" per"$"tent or recurrent "pa"m of the outer th$rd of the %a2$na that $nterfere" &$th $ntercour"e. 0t can u"ually be treated by the u"e of %a2$nal d$lator" of $ncrea"$n2 d$ameter plu" rela)at$on tra$n$n2. The "ucce"" rate $ncrea"e" $n couple" &here the partner $" $n%ol%ed $n the therapy proce"". .h$le treatment can help, $t $" $mportant to note that "ome &omen ha%e %ery $nt$mate, lo%$n2 relat$on"h$p" &$thout $ntercour"e.

Q Will !ormones !el# women wit! decreased sexual desire$ W!ic! !ormones$ Testosterone$ )stro'en$ Pro'esterone$ W!at about DH)A$
A 0n po"tmenopau"al or per$3menopau"al &omen, e"tro2en replacement can decrea"e pa$n dur$n2 $ntercour"e and fac$l$tate %a2$nal lubr$cat$on. ,tud$e" ha%e al"o "ho&n that te"to"terone $ncrea"e" l$b$do $n &omen, "o $f "omeone!" decrea"ed de"$re $" due to a drop $n hormone", $t can %ery l$/ely be re"ol%ed &$th te"to"terone. o&e%er, to date, the"e "tud$e" ha%e u"ed h$2h do"e" of te"to"terone, &h$ch m$2ht lead to ma"cul$n$;at$on $f ta/en for lon2 per$od" of t$me. Althou2h # EA $" al"o a male hormone, there ha%e been %ery fe& "tud$e" of $t" affect on &omen and none ha%e "ho&n that $t $mpro%e" a &oman!" l$b$do.

Q Is t!ere an"t!in' else t!at*s im#ortant %or women to understand about %emale sexual d"s%unction$
A ,e)ual re"pon"e %ar$e" bet&een &omen and &$th$n each $nd$%$dual. ,e)ual concern" are %ery common. ,ome "e)ual problem", &h$le d$"tre""$n2, may reflect normal %ar$at$on" $n a &oman!" l$fe. ,h$ft$n2 one!" focu" to enhanc$n2 $nt$macy rather than ha%$n2 all $nteract$on" re"ult $n $ntercour"e may help. Got all "e)ual concern" or problem" are 7dy"funct$on".7 .omen need to pay attent$on to chan2e" $n the$r da$ly l$%e" that may cau"e "e)ual dy"funct$on. 0n ca"e" &here med$cat$on" cau"e "e)ual problem", the "olut$on may be a" "$mple a" chan2$n2 the med$cat$on or ad9u"t$n2 the do"a2e. #on!t be afra$d to tal/ to your doctor and your partner. 0t can be d$ff$cult and uncomfortable to $n$t$ate a con%er"at$on &$th a doctor about "e), but the ma9or$ty of &omen can be helped $f they are &$ll$n2 to tal/ openly to the$r healthcare pro%$der to determ$ne the be"t treatment for the$r "pec$f$c problem.

For consultation & treatment (by appointment / or online) click How to Consult Us Low Sex Desire (Libido) Causes of Low Libido Diagnostic Tests Hormone Therapy & Other Treatments Response of Treatment The low sex desire is called when the desire for sex is lower than average. This decreased libido leads to un-satisfaction in opposite partner. Even the person who suffers with less i.e. diminished sexual desire & low frequency of sex suffers with various psychological depression disorders. Even the relation between the couples deteriorates.

Causes of Low libido i.e. diminished sex desire are: ( ! Hormones Disorder: (a) Hypogonadotropic hypogonadism (hypothalamic or pituitary deficiencies! "ypogonadisms# "ypothyroidisms# Testosterone deficiency# hyperprolactinemias# "ypogonadotropics states: "ypothalamic - pituitary deficiencies: $diopathic %n&" deficiency# 'allman syndromes# (rader-)illi syndromes# *aurence-+oon-,iedl syndromes# pituitary hypoplasia# Trauma# post surgical# postiradiation# Tumour (-denoma# craniopharyngioma# other!# .ascular (pituitary infraction# carotid aneurysm!# $nfiltrative (/arcoidosis# histiocytosis# hemochromatosis! -utoimmune hypophysitis# drug-induced hyperprolactinemia# untreated endocrinopathies# 0iabetics %lucorticoid excess# "ypopituitarisms# 1ushings disease# -ddisons disease. $solated gonadotropin deficiency (non acquired!: (ituitary# "ypothalamic -ssociated with multiple pituitary hormone deficiencies: $diopathic pan hypo pituitarism (hypothalamic defects!# (ituitary dysgenesis# 2ollowing inflammation# $nfiltrative or destructive processes (autoimmune# hemosiderosis!#

2ertile eunuch syndrome# $diopathic hypopituitarism# (b! hypogonadism: testicular failure# development defect# drugs# trauma# congenital defect# congenital adrenal hyperplasia# 1hromosomal defect# testosterone hormone biosynthetic defect# +umps orchitis leading to testicular atrophy# (rimary testicular defectdisorders of testicular differentiation or inborn errors of testosterone synthesis# 'linefelter syndrome# 3ther 4 polysomies (i.e. 44445# 4445! &ainbow syndrome (d! "ypothyroidisms (e! 6ntreated endocrinopathies & 0iabetics (f! %lucorticoids excess# 1ushings disease# -ddisons disease 7! xcess asthenia i.e. chronic asthenia is a also a significant cause of low sex desire. 8! /ic9le cell disease# chronic cardiac disease# chronic renal disorder# chronic pulmonary dysfunction# chronic hepatic disease# $nfections mono-nucleosis# hepatitis# chronic balanitis# chronic prostatitis# and chronic urethritis. :! -ddiction as chronic alcoholism# chronic smo9er# heroin or cannabis use. ;! Drugs: /edative: <arcotics# tranquilli=ers# amphetamine# cocaine# many antidepressant# and anti-psychotics# anti -hypertensives# many other drugs. >! !sychiatric disorder as depression# neurosis# & many other psychiatric disorders. >! 0isorders of sex centre: $n the brain there is a particular center in the hippocampus part of fore brain# which regulates the desire of sex. /ex center has some well-defined portion# which control different component of normal sexuality. These are as follows as one part of sex center controls sexual desire other parts controls erection# time ta9en in orgasm en?oy of sexual act including en?oyment of orgasm. /o any disorder of sex center due to various causes can lead to less desire. This occurs due to desire controlling portions of sex center does not wor9 properly so that inspite of @not having any physical or mental disorders the patient desire for sex is low. ,eside low sex desire patient may be sexually otherwise for or patient may be suffering with impotence# premature e?aculation. The causes of sex centre dysfunction can be divided into two groups: ( ! immediate cause# and (7! remote causes. /uch a classification is helpful in the treatment of decreased libido. $f the loss of desire is due to immediate causes# a removal of these factors results in adequate sexual desire. $f it is due to remote causes# then detailed sex therapy may be necessary for a more lasting cure. $t can cause less sexual desire alone or patient may have associated erectile disorder# premature e?aculation# or lac9 of en?oyment of sex. Some important information: Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & 'ohnson treatment therapy by hormone therapy is one of the #ery remar%able ad#ancement in the last ( years) Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs

!ndian Hindu i%h &uslim male female sex master & *ohnson in#estigation+ cause diagnosis & treatment facilities are a#ailalable at #ery few centres in the delhi, Delhi - !ndia , india.)treatment of thousands patients has been successfully done at our centre) Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & 'ohnson treatment therapy by hormone therapy is #ery successful) Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & 'ohnson treatment therapy by hormone therapy after finding the correct cause of Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & 'ohnson treatment therapy by hormone therapy medical treatment results are #ery good) /fter Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & 'ohnson treatment therapy by hormone therapy patient becomes more satisfied) 0e ha#e treatment for Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & 'ohnson treatment therapy by hormone therapy) 1efore starting treatment for Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & 'ohnson our team of doctors decide how to treat Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & 'ohnson ) /t our Delhi -!ndia. center+ we ha#e highly "ualified expert doctor+ who are well trained in diagnosis of cause of Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & *ohnson/t our Delhi -!ndia. centre+ our doctors are experienced in Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & 'ohnson treatment -therapy. of Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist

sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & *ohnson treated by drug -medical. treatment) Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & 'ohnson is one of the common cause of inferiority complex in many boys & men) Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & *ohnson is must) Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & 'ohnson therapy can be by oral hormone pills) Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & *ohnson cause - causes. are in#estigated at our hospital) Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & *ohnson occurs due to #arious causes as mentioned abo#e) 2atient with Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & *ohnson should go to "ualified specialist) Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & 'ohnson patient should be in#estigated -#arious in#estigations , in#estigation . before starting treatment) Our Hospital , centre is situated in east+ 3ast +new+4ew+ Delhi -!ndia.) !t is closer to Central+ central delhi+ four %ilometer from outh+ south delhi + 4orth+ north delhi+ & 0est+ west+ delhi) Our Delhi centre is eight %ilometer from 4oida+ 4oida+ 5a6iabad+ gha6iabad+ 7aridabad+ faridabad & 5urgaon+ gurgaon) Our hospital, centre is one of the most famous Low sex desire libido decreased Treatment pecialist Delhi Doctor !ndia consultant clinic therapy therapist sexology sexologist exologists problem problems hormone senior expert most famous "ualified modern allopathic ayur#edic herbal treatments surgery surgical medicine causes diagnosis in#estigations tests cause $iagra Cialis tadalafil blood supply decreased increasing drugs !ndian Hindu i%h &uslim male female sex master & *ohnson techni"ue leading treatment center in Delhi+ !ndia and the 0orld)

"bsent #rgasm

$t is a condition in which women does not gets orgasm even after prolong sexual intercourse &when she gets orgasm after prolong sex then it is called inhibited orgasm. $n some women even after normal sex desire# excitation & en?oyment# they do not achieve pea9 o sexual en?oyment i.e. orgasm. -s against many women get multiple orgasm during same sexual act. /ome women get orgasm during clitoral stimulation during manual stimulation or masturbation# but do not orgasm during vaginal sex. The orgasm is divided into clitoral orgasm & vaginal orgasm. $n one study approximately AB never experienced the orgasm in their lifetime & rest few percent women achieve the orgasm occasionally. The absence of orgasm is classified as either primary means she has never experienced the orgasm. /econdary or acquired anorgasmia is called when inhibited orgasm develops later in life. 0ue to absence of orgasm coitus is not very pleasurable for such ladies. ,ut luc9ily this problem is very easily amenable to treatment with newer drugs & advent of modern sex therapy techniques. $t may be generali=ed i.e. absence orgasm with masturbation as well as no coital orgasm also. $t can be situational also in which she gets orgasm with masturbation not during sex. $n some women orgasm occurs only after very prolong stimulation to wife so that couple is always under pressure to achieve orgasm rather than en?oying the sexual act. This 9ind of inhibited orgasm is very frustrating for the couple -bsence of orgasm is most common sexual dysfunction in women whether married or unmarried.

Causes of Lac$ of #rgasm "re


(%) Hormones Disorder : "ypogonadotropic hypogonadism (hypothalamic or pituitary deficiencies! "ypogonadisms# "ypothyroidisms# Testosterone deficiency# hyperprolactinemias# "ypogonadotropics states: "ypothalamic - pituitary deficiencies: $diopathic %n&" deficiency# 'allman syndromes# (rader-)illi syndromes# *aurence-+oon-,iedl syndromes# pituitary hypoplasia# 3varian 0ysfunctions "ypothyroidisms 6ntreated endocrinopathies & 0iabetics %lucorticoids excess# 1ushings disease# -ddisons disease &) -bsence of proper excitation of %. spot by her partner ') )ea9 (. 1. +uscles () )rong techniques of ?er9s & other sex techniques. )) 0ue to fears due to various sexual myths *) -ny guilt or negative thin9ing about her sexuality +) Excess asthenia i.e. chronic asthenia is a also a significant cause of absent orgasm. ,) 0efect of spinal cord -) -fter an abdominal or uterine disorder requiring surgical procedure %.) -ny radiation exposure %%) -ny ma?or surgery on genitals %&) +ultiple sclerosis %')-ddiction as chronic alcoholism# chronic smo9er# heroin or cannabis use. %() 0ue to 0rugs: /edative: <arcotics# tranquilli=ers# amphetamine# cocaine# many antidepressant# and anti-psychotics# anti -hypertensives# alpra=olam# dia=epam# many other drugs. %)) 0ue to (sychiatric disorder as depression# neurosis# & many other psychiatric disorders.

%*) -ny 9ind of sexual dysfunction in man leading to non-en?oyment of sexual act by female may lead to low desire in women. %+) -ny cause of painful sexual intercourse (as due to vaginismus or dyspaerunia! will also lead to secondary loss of interest in sex in females whether married or unmarried.

Disorders of Sex Centre


n the brain there is a particular center in the hippocampus part of fore brain# which regulates the en?oyment achieved during sex. )hen this pea9 excitation reaches a particular threshold# the muscles around vagina starts contracting. This phenomenon is called orgasm. /ex center has some well-defined portion# which control different component of normal sexuality. These are as follows as one part of sex center controls sexual desire other parts controls excitation i.e. lubrication in response to sexual excitation# time ta9en in orgasm & en?oyment of sexual act including en?oyment of orgasm. /o any disorder of sex center due to various causes can lead to absent orgasm in females. This occurs due to orgasm controlling portions of sex center does not achieves the pea9 of sexual excitation & final orgasm so that in spite of @not having any physical or mental disorders the patient either does not getting orgasm or getting it after long delay. ,eside absent orgasm patient may be sexually otherwise fit or patient may be suffering with low desire or some other sexual dysfunctions. /he causes of sex centre dysfunction can be di0ided into two groups: ( ! immediate cause# and (7! remote causes. /uch a classification is helpful in the treatment of decreased libido. $f the loss of desire is due to immediate causes# a removal of these factors results in adequate sexual desire. $f it is due to remote causes# then detailed sex therapy may be necessary for a more lasting cure. &) /exual (erformance anxiety means development of anxiety before sex. (atient develops obsessive concern for her orgasm i.e. whether or not /heCll get orgasm. 0ue to this anxiety /he tries to concentrate more on getting it & contracting the pelvic & leg muscles rather than allow it to occur in natural response to erotic pleasure. ,ut unluc9ily most ladies do not 9now that orgasm occurs spontaneously & automatically in response to more & more en?oyment she gets in touching & loving by her partner. Thus the more she tries to get orgasm# but the ?ust opposite happens i.e. she never gets it. Thus this anxiety to get orgasm every time where as it really further worsens the prospects of getting orgasm. This performance anxiety can be cured by sex therapy in few sittings. ') Spectator "ttitude: Those women who suffer with absent orgasm# whenever /he goes for sexual activity though engaged love ma9ing# her brain is always thin9ing and involuntarily (unconsciously! trying hard to achieve the vaginal orgasm. This is called spying for her own orgasm. Thus her mind is always preoccupied about whether sheCll get the orgasm or not. Thus in place of en?oying the sexual experience # /he remains concerned for orgasm# thus sex centre does not reaches the pea9 & orgasm never occurs. /he loses confidence in her capability to achieve the orgasm# and instead of relaxing & en?oying /he starts watching her own sexual responses li9e CspectatorsC# rather than being involved in what is going on. /o that in place of en?oying the partnerCs touch# /he always 9eeps spying her own sexual response leading to lac9 of en?oyment of sexual activity thus@leading to repeated failures in getting orgasm. These all above problems contributes to repeated absent orgasm. /o that in all cases of absent orgasmic patients# after proper diagnosis & treatment of primary cause# these secondary problems also need to be tac9led by sex therapy then only patient can get

permanent cure. /o by sex therapy# the patient is taught how to avoid spectator role and become free of performance anxiety./o these problems hinder her in getting orgasm Thus the anxiety of failure into getting into orgasm and spectatoring (the patient watching all the time to see if /heCll get orgasm or not! are also the important cause. -fter correcting these causes the normal orgasm starts occurring. $f these factors are removed by sex therapy# orgasm starts occurring. The new# intensive team treatment of sexual dysfunction has revolutioni=ed sex therapy. C$n most cases# for cure of absent orgasm detailed sex counseling & sex therapy is necessary.

D1"23#S1S #F C"4S
2irst step in proper treatment of low sex desire is accurate diagnosis of cause of her absent orgasm during sex. /o we first try to find out cause. )e ta9e detailed history# thorough sex counseling and physical examination by female doctor# examination genitals. -fter that depending on li9elihood of particular# cause relevant tests are done at our centre. Thus you may consult us at our centre & at same time you may get all test done also. The time ta9en in getting all the reports ready is 8> hours. /o if you are from out of 0elhi# you may come here for two days.

D /"1L D H1S/#56
2or diagnosis of cause of absent orgasm# detailed history is ta9en. -fter which thorough physical examination is done for relevant causes. #nset: )e ta9e detailed history# as for duration of absent or delayed orgasm whether it is from the beginning or of recent onset# whether it is mild# moderate or severe. Then we decide whether it occurs all the time or only occasionally. "ow is the response of previous treatmentD &esponse to previous therapy# any pain during sex# /tress (physical or mental!# "istory of precipitation by some drugs any past history of sexual abuse or painful sex. 7"813"/1#3 #F 2 31/"LS: )e examine whether any /exual 0evelopment defect is present or not. The vagina is examined for some local problem. $f the vaginal examination is painful with accompanied spasm is proof of the some local cause. /tatus of female hormone is assessed by examination of various estrogenic signs. %alactorrhoeas & features of other hormones disorders are chec9ed up. ,lood supply of vagina is assessed by# palpating texture of vaginal wall. <erves supplying the female genitals examined by sensation testing & 0eep Tendon reflexes. Then other systems of body are also examined. Diagnostic /ests: 2or diagnosis of cause of investigation following tests are required. These tests include 1omplete sex hormones profile as Estradiol# /",% etc. Thyroids test /erum prolactins -ndrogen levels $nvestigation for systemic diseases 3ther tests which may be required depending on li9elihood of the any of above causes. 0etailed /ex 1ounseling: detailed sex counseling session# in which our male & female sex counselors meet with respective patient# tal9ing in detail resulting in detection of primary cause leading to low sex desire. $n biochemistry Tests as liver function or 9idney function tests are done. These tests confirm the diagnosis of absence of orgasm confirmed.

/5 "/8 3/ #F "9S 3/ #52"S8 3nce the diagnosis of lac9 of orgasm is confirmed after detailed history# examination# relevant investigations# we start the treatment. $t involves giving the sex therapy session# which is focused on eliminating the anxiety & spectatoring for achieving orgasm & hormone therapy or other treatment as indicated. /he 0arious treatment options are: %) /ex Therapy &) "ormone Therapy ') Treatment of any secondary cause found as infection# or local cause or any psychiatric disorder. () Sex /herapy: The various sex therapy is offered by sex therapist are structured directed sex therapy sessions leading to elimination of the anxiety that whether /heCll achieve the orgasm or not & /he becomes confident of her ability. ,y these exercises she starts getting orgasm regularly. -long with we tell the partner about the various sexually very sensitive areas of her body including %. spot# stimulating which in proper way ma9es women get a very intense orgasm. Then various vibrators are used which leads to quic9 discharge. /ex therapy begins with detail sex education about the anatomy of male & female genitals. Then we give the patients specific exercises# which# the couple has to do at their home. -fter every exercise session lady becomes more confident in her ability to achieve the orgasm. -long with these exercise various orgasmic tools are also used. )ith these exercises along with behavioral therapy# hypnotherapy# & coupleCs therapy leads to cure in approximately two months. 1ertain pelvic exercises also help in getting orgasm quic9ly. )e teach patient how to eliminate excessive focusing on having an orgasm. Even some women fa9e the orgasm to please her partner & hide her inadequacy. () Hormones /herapy: "ormones therapy is given to cure the hormone problem whenever hormone disorder is found. Estrogen treatment is given when deficiency of hormones are found. "ormones therapy helps n fast cure of this problem & do not have any adverse effects as they given to only those patients in whom some hormone disorder is found. )) 3ther drugs found effective are anti-inflammatory# serotonin reupta9e inhibitors etc are used when indicated. 5esponse of /reatment: -s we have fully dedicated team of highly qualified# experienced# doctors# sex counselors# sex therapist# who are expert in the treatment of female sexual problems# we get cure in almost all cases. $t is cured in most patients by two months treatment.

1mpotence: rectile Dysfunction Causes


Erectile dysfunction can be caused by any number of physical and psychological factors. $n general# E0 is divided into organic (having to do with a bodily organ or organ system! and psychogenic (mental! impotence# but most men with organic causes have a mental or psychological component as well. Erection problems will usually produce a significant psychological and emotional reaction in most men. This is often described as a pattern of anxiety and stress that can further interfere with normal sexual function. This Eperformance anxietyE needs to be recogni=ed and addressed by your doctor.

-lmost any disease can affect erectile function by altering the nervous# vascular# or hormonal systems. .arious diseases may produce changes in the smooth muscle tissue of the penis or influence mood and behavior.

.ascular diseases account for nearly half of all cases of E0 in men older than ;A years. .ascular disease includes atherosclerosis (fatty deposits on the walls of arteries# also called hardening of the arteries!# a history of heart attac9s# peripheral vascular disease (problems with blood circulation!# and high blood pressure. (rolonged tobacco use (smo9ing! is considered an important ris9 factor for E0 because it is associated with poor circulation and reduced blood flow in the penis. Trauma to the pelvic blood vessels and nerves is another potential factor in the development of E0. ,icycle riding for long periods has been implicated# so some of the newer bicycle seats have been designed to soften pressure on the perineum (the soft area between the anus and the scrotum!. +edications used to treat other medical disorders may cause E0. /ystemic diseases associated with E0 : 0iabetes# /cleroderma# &enal (9idney! failure# *iver cirrhosis# "emochromatosis (too much iron in the blood!# 1ancer and cancer treatment 0iseases of the nervous system associated with E0 : Epilepsy /tro9e +ultiple sclerosis %uillain,arrF syndrome -l=heimer disease Trauma (ar9inson disease &espiratory disease associated with E0: 1hronic obstructive pulmonary disease Endocrine conditions associated with E0 : "yperthyroidism "ypothyroidism "ypogonadism (enile conditions associated with E0 (eyronie disease (riapism (painful# abnormally prolonged erections! +ental conditions associated with E0 : 0epression )idower syndrome (erformance anxiety <utritional states associated with E0 +alnutrition Ginc deficiency ,lood diseases associated with E0 /ic9le cell anemia *eu9emias /urgical procedures associated with E0 o (rocedures on the brain and spinal cord &etroperitoneal or pelvic lymph node dissection -ortoiliac or aortofemoral bypass -bdominal perineal resection (roctocolectomy &adical prostatectomy o Transurethral resection of the prostate 1ryosurgery of the prostate 1ystectomy

Common medications associated with D o -ntidepressants -ntipsychotics -ntihypertensives (for high blood pressure! o

-ntiulcer drugs such

as cimetidine (Tagamet! "ormonal medication such as Goladex# *upron# finasteride ((roscar!# or dutasteride (-vodart! 0rugs that lower cholesterol -lcohol abuse +ind-altering agents such as mari?uana and cocaine

Further /esting

Laboratory testing: *aboratory testing is necessary for most men# although no laboratory wor9 may be
needed. $f laboratory tests are performed# they would normally start with an evaluation of your hormone status (testosterone or male hormone!# particularly if one of your symptoms is low sexual desire (low libido!. ,lood tests for testosterone should ideally be ta9en early in the morning because thatCs when levels are usually at their highest. 3ther blood tests# such a luteini=ing hormone and prolactin# can help determine if there is a problem with the pituitary gland. o 5our blood may be chec9ed for glucose# cholesterol# thyroid function# triglycerides# and prostatespecific antigen ((/-!. o - urinalysis loo9ing for blood cells# protein# and glucose (sugar! may also be done. 1maging: -n ultrasound may be performed. This test may be done on the lower abdomen# pelvis# and testicles# or restricted to ?ust the penis. o - duplex ultrasound is a diagnostic technique that uses painless# high frequency sound waves to visuali=e structures beneath the s9inCs surface. The principle is similar to the sonar used on submarines. /ound waves are reflected bac9 when they contact relatively dense structures such as fibrous tissue or blood vessel walls. These reflected sound waves can be converted into pictures of the internal structures being studied. o This procedure is usually performed before and after in?ection of a smooth muscle relaxing medication into the penis# which normally should significantly increase the diameter of the penile arteries. The procedure itself is painless. 0uplex ultrasonography is most useful in evaluating possible penile arterial disorders# but further studies of the venous drainage system as well as arterial x-rays are usually recommended if vascular reconstructive surgery is anticipated.

2urther testing: 2ollowing completion of this phase# the doctor should be able to determine the general type of dysfunction and the need for additional testing such as penile or pelvic blood flow studies# nocturnal penile tumescence testing# penile biothesiometry (nerve testing!# or additional blood tests. 5our doctor will discuss your results with you (including your partner when possible!# summari=e the ris9 factors such as smo9ing and medications that may be involved# review the various treatment options that can be considered# and wor9 with you to develop a strategy and program to help you and your partner achieve a satisfactory result. o 3ne of the most common tests used to evaluate penile function is the direct in?ection of (%E into the penis. ((%E is a medication that increases blood flow into the penis and normally produces erections.! $f the penile structure is normal or at least adequate# an erection should develop within several minutes. 5ou and your doctor can ?udge the quality of the erection. $f successful# this test also establishes penile in?ections as one possible therapy. o <octurnal penile tumescence testing (<(T! may be useful in distinguishing mental from physical impotence. This test involves the placement of a band around the penis that you would wear during 7 or 8 successive nights. $f an erection occurs# which is expected during rapid eye movement (&E+! sleep# the force and duration are measured on a graph. $nadequate or no erections during sleep suggests an organic or physical problem# while a normal result may indicate a high li9elihood of emotional# psychological# or mental causes. o 2ormal neurological testing is not needed for most men. ,ut anyone with a history of nervous system problems such as loss of sensation in the arms or legs and those with a history of diabetes may be as9ed to undergo testing. o The sensitivity of the s9in of the penis to detect vibrations (biothesiometry! can be used as a simple office nerve function screening test. This involves the use of a small vibrating test probe placed on the right and left side of the penile shaft as well as on the head of the penis. The strength of the vibrations is increased until you can feel the probe vibrating clearly. -lthough this test does not directly measure the erectile nerves# it serves as a reasonable screening for possible sensory loss and is simple to perform. +ore formal nerve conduction studies are only performed in selected cases.

1mpotence: rectile Dysfunction /reatment


1urrently# virtually any man who wishes to have erectile function can obtain it# regardless of the underlying cause of his problem. +any reasonable treatment options exist. 5our first step is to find a well-trained# experienced# and compassionate doctor who is willing to ta9e the time to understand you and fully discuss the treatments available to you. /ex counseling is an important part of erectile dysfunction management. +any professional sex counselors are s9illed in wor9ing with patients with E0# but your primary care doctor and urologist may also serve in this capacity to some degree. These are usually the first professionals to learn about the problem. +en are frequently reluctant to discuss their sexual problems and need to be specifically as9ed. 3pening a dialogue allows your doctor to begin the investigation or refer you to a consultant. -fter testing is completed# your doctor can then discuss your particular situation# the most li9ely cause# and reasonable treatment options. 3ptions include sex counseling# medications# external vacuum devices# hormonal therapy# penile in?ections or intraurethral suppositories. $n highly selected cases under the supervision of a urology specialist in E0# combination therapy using several of these methods together can be used. $f none of these therapies is satisfactory# penile prosthesis implants can be considered.

;acuum de0ices: /pecially designed vacuum devices to produce erections have been used successfully
for many years. They are safe and relatively inexpensive. They wor9 by using a manually generated vacuum to draw blood into the penis to create the erection. )hen used successfully# their other significant benefit is a high degree of reliability compared to drug treatments# which tend to be less predictable. The typical vacuum device consists of a plastic cylinder that is placed over the penis# tension rings of various si=es# and a small hand pump. -ir is pumped out# causing a partial vacuum# which creates the erection. 3nce an erection is obtained# a tension ring# which acts li9e a tourniquet to 9eep the blood in the penis and maintain an erection# is placed at the base of the penis. This technique is effective in >A-HAB of men. $t is not recommended to leave the tension ring in place longer than 8A minutes.

These devices are generally safe# but bruising can occur. 3ther unwanted effects include pain# lower penile temperature# numbness# no or painful e?aculation# and pulling of scrotal tissue into the cylinder. +any of these problems can be helped by proper selection of the tension rings and cylinder# use of adequate lubrication# and proper technique.

o o

The devices are very reliable and seem to wor9 better with increased use and practice. They can be operated and used quic9ly with experience but still are perceived to be less romantic than other options. 3ne drawbac9 to the use of these external vacuum devices is the need to assemble the equipment and the difficulty in transporting it. +any men lose interest in using the device because of the preparations that are necessary# lac9 of easy transportability# inability to hide the tension ring# and the relative lac9 of spontaneity. -bout half the men who use a vacuum device obtain good or excellent erections with them# but only half of these men consistently use the device over long periods of time.

/ildenafil citrate (.iagra!: .iagra is a prescription medication for the treatment of erectile dysfunction. $tCs the first oral medicine (a pill you ta9e by mouth! available thatCs been proven to improve erections in most men with impotence. /ince its introduction in +arch HHI# no other therapy for E0 has achieved such wide public recognition. ;iagra doesn<t impro0e erections in normal men= only in those with difficulty in achie0ing or maintaining erections sufficient for sexual intercourse due to a true medical problem> 1t is not an aphrodisiac and will not increase desire> 4nli$e other treatments for erectile dysfunction= ;iagra re?uires sexual stimulation to function> @ithout this stimulation= ;iagra won<t ha0e any effect> .iagra wor9s by bloc9ing an en=yme found mainly in the penis that brea9s down a chemical produced during stimulation that normally produces erections. .iagra allows this chemical of arousal to survive longer and improves erection function. That is also why sexual stimulation is necessary for .iagra to wor9.

$n general# .iagra wor9s successfully in about >;-JAB of all impotent men. The greater the degree of damage to the normal erection mechanism# the lower the overall success rate. +en with diabetes and those with spinal cord in?ury reported between ;A->AB responding successfully to treatment with .iagra. The worst response rate was in men who became impotent after radical prostate cancer surgery. ,ut even in this hard-totreat group# :8B reported improved erections particularly if they had the Enerve-sparingE type of prostate surgery.

.iagra wor9s best if ta9en about hour before sexual activity. 3nly tablet should be ta9en per day. $t should be ta9en on an empty stomach. $ncreasing the dosage of .iagra beyond the recommended amounts will not improve the response and will only result in greater side effects. The most common side effect of .iagra use is headache# affecting about >B of users. drop in blood pressure# transient di==iness# and facial flushing are reported in AB. $ndigestion occurs in JB# and nasal congestion in :B. ,etween 8B and B of users report some visual problems while on .iagra. This visual disturbance is described as either blurred vision# increased light sensitivity# persistence of a bluish tinge or temporary loss of the ability to distinguish between blue and green. <one of these side effects is severe and most are described as mild. .ery few users stop ta9ing the medication because of side effects. o .iagra is absolutely not to be ta9en by men with heart conditions who are ta9ing nitrates such as nitroglycerine or isosorbide ($sordil# $smo# $mdur!. Those with serious heart disease# exertional angina (chest pain!# and those ta9ing multiple drugs for high blood pressure are advised to see9 the advice of a heart specialist before beginning therapy with sildenafil. o <o nitrate-based drugs should be given to men with suspected heart attac9s if they have ta9en .iagra within 7: hours. 1ombining .iagra with nitrate-based medications can cause a severe and dramatic drop in blood pressure with potentially very dangerous consequences. This is also why you should absolutely never share your .iagra prescription with anyone else. $f they happen to be ta9ing one of the drugs that interacts dangerously with .iagra# the results could be very serious. $f there is any question about possible drug interactions# always chec9 with your doctor or pharmacist. o 1ertain street drugs such as EpoppersE also can cause serious problems if ta9en with .iagra. Ecstasy is a street drug that may increase sexual desire but interferes with performance. This has prompted some men to combine ecstasy with .iagra. This mixture (a combination sometimes called EsextasyE! can improve erection ability but also causes severe headache and priapism. ((riapism is an abnormally prolonged erection that becomes extremely painful and may result in permanent damage to the erection mechanism.! There are also potentially dangerous effects to your heart from mixing .iagra with various other street drugs.

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/everal medications can interfere with the chemical processing of .iagra by the liver. These can include 9etocona=ole (an antifungal medication 9nown by the brand name <i=oral!# erythromycin (an antibiotic!# and cimetidine (also 9nown as Tagamet# for reducing stomach acid!. - lower dose of .iagra should be used if you are ta9ing any of these medications. /ildenafil is available in 8 doses: 7; mg# ;A mg# and AA mg. The starting dose depends on the clinical situation. - man in his ;As with mild sexual dysfunction that is probably related to psychological factors can start on the 7; mg dose. +en with moderate-to-severe E0 can begin at the ;A mg dose# and# after testing the effect of the drug on at least 8 occasions# the dose can be modified. +en with severe E0 may need to quic9ly move up to the AA mg dose. These men are less li9ely to achieve a satisfactory response# but they should ma9e at least 8-: attempts with the drug before considering another form of therapy. /ildenafil should be ta9en on an empty stomach about :;->A minutes prior to sexual intercourse. /timulation is necessary to produce an erection. -n increased ability to achieve good erections can last up to 7: hours but usually only about : hours. The drug should not be ta9en daily. /everal drugs very similar to .iagra have recently been approved by the 20-. These drugs# called vardenafil (*evitra! and tadalafil (1ialis!# have essentially the same activity and general precautions as .iagra. 1ialis has a longer duration of increased sensitivity to develop an erection (up to 7:-8> hours! compared with .iagra and *evitra (up to : hours!.

6ohimbine: This herbal product has been available for many years. $t comes from the bar9 of a )est
-frican tree. $ts use has been questioned because# even in good# well-controlled studies# yohimbine is only slightly better than placebo (no drug at all!. - renewed interest in this agent has occurred# particularly when combined with sildenafil or some of the other oral drugs. 5ohimbine is safe with few 9nown adverse effects. The customary daily dose is one tablet of ;.: mg ta9en 8 times a day. "pomorphine (4prima!: -pomorphine is a medication that dissolves under your tongue. $t is not yet approved by the 2ood and 0rug -dministration (20-!. -pomorphine has a central effect on the hypothalamus# which is an area in the brain 9nown to involve erections. /ide effects are nausea# sweating# di==iness# drowsiness# vomiting# yawning# and wea9ness. +ost of these were considered mild to moderate. /estosterone: +en with low sex drive and E0 may be found to have low testosterone levels. "ormone replacement may be of benefit by itself or as a complementary therapy used with other treatments. *ibido and an overall sense of well-being are li9ely to improve when serum testosterone levels are restored.

5eplacement testosterone is a0ailable as pills= inAections= patches= and a gel that is rubbed into the s$in. +en with low sexual desire and E0 may have low testosterone (male
hormone! levels. "ormone replacement may occasionally be of some benefit# especially when used in combination with other therapies. Testosterone supplementation alone is not particularly effective in treating erectile dysfunction. /exual desire and an overall sense of well-being are li9ely to improve when serum testosterone levels (the levels in the blood! are restored. -s a general guideline# testosterone levels of 8AA or less is considered low# but this varies depending on the laboratory that does the testing. 3ral therapy (pills! is the least effective and the most li9ely to be associated with liver problems# even though this is a small ris9. $n?ections are most li9ely to restore testosterone levels# but this therapy requires periodic in?ections# usually every 7 wee9s# to sustain an effective level. /9in patches and gels deliver a sustained dose and generally are well accepted. FollowBup testosterone (hormone! levels and periodic blood counts and prostate chec9s are necessary for all men on long-term testosterone replacement therapy. $n?ection therapy: -lthough many substances are touted as aphrodisiacs (meant to arouse sexual desire!# the modern age of such drug therapies began in HH8 when the in?ection of papaverine# an alpha bloc9er that produces vasodilatation (widening of the blood vessels!# was shown to produce erections when in?ected directly into the penis. /oon afterward# other vasodilators# such as (%E and &egitine# were demonstrated to be effective either as single drugs or in combination. /elf-in?ection of these agents has been of enormous benefit because they represent the most effective way to achieve erections in a wide variety of men who otherwise would be unable to achieve adequate rigid erections. $f the structure of the penis is healthy# the use of in?ectable drugs is almost always effective. $f you choose this therapy# your doctor will teach you how to perform the in?ections# and the urologist (specialist! must determine the appropriate dose. The dosage is ad?usted to achieve an erection with adequate rigidity for no more than HA minutes. "lprostadil= a synthetic !2 %# is the most commonly used single drug for in?ections into the penis as a treatment for E0. $t wor9s well in the ma?ority of men who try it. $n one study of >I8 men with E0#

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H:B reported having erections suitable for penetration after alprostadil

(!2 %) inAections. @hen !2 % is used in combination with papa0erine and 5egitine= the mixture is called /rimix# which has roughly twice the effectiveness of alprostadil alone. "owever# Trimix is quite expensive and
is usually not covered by insurance# while (%E is often a covered benefit in most insurance medication plans. The main side effects are pain from the medication (not from the in?ection!# priapism (persistent or abnormally prolonged erection!# and scarring at the site of the in?ection. +any men are uncomfortable with penile in?ection therapy even though the in?ection itself is painless. The in?ection cannot be done more often than 8 times a wee9. +en on anticoagulant medications (blood thinners! should probably choose an alternate therapy.

1ntraurethral therapy (8edicated 4rethral System for rections= 84S ) :


-lprostadil# (%E # has been formulated into a small suppository that can be inserted into the urethra (the canal through which urine and semen are excreted!. $n a selected group of men# the drug was effective in >;B. This drug may be effective in men with vascular disease# diabetes# and following prostate surgery. This is a useful alternative for men who do not want to use self-in?ections or for men in whom oral medications have failed. $t has been quite successful when used together with sildenafil (.iagra! in cases where each drug alone has failed. This type of combination treatment should 3<*5 be done under the supervision of a urologist experienced in E0. 2ew side effects occur. The most common is pain at the site where the pellet is deposited. There may also be a small amount of bleeding. $t is important for the user to urinate immediately before using the +6/E system. - temporary tourniquet is often helpful in allowing the medication to stay in the erectile tissue a little longer and seems to give a somewhat better response.

/ypes of 8edical /herapy "0ailable to 8anage rectile Dysfunction "d0antages Disad0antages <o surgery required 6seful only in the few men with abnormal hormone levels (ainless <eed to ta9e medications regularly /imple /ignificant side effects (such as fluid retention# liver damage! "ormonal +ay restore sexual desire (testosterone! therapy $f unsuccessful# does not interfere *imited effectiveness with other treatments "ighly variable blood levels when in?ections used (atches and gel now available -bsorption may be unreliable with patches and gels $nexpensive (in?ections! Expensive (patches and gel! /afe <o surgery required (ainless +ay use treatment only when desired 2requent side effects (:AB! include headache# indigestion# Easily hidden and transportable facial flushing# nasal stuffiness and rarely visual changes $f unsuccessful# does not interfere (temporary blue tint! with other treatments (otentially lethal interaction when used together with nitrate 1an be used in combination with medications such as nitroglycerine# $mdur# $sordil other therapies under proper /ildenafil (.iagra! &is9 of an interaction is present for 7: hours after ta9ing supervision sildenafil +aximum use is once per day +ust be ta9en on an empty stomach ,enefit lasts :-> hours or up to 7: +aximum effect ta9es :;->A minutes hours in some cases 0oes not EcureE underlying problem 20- approved <o effect on libido (desire! or sensation /ide effects# if present# usually quite mild .ery effective with overall success rate of >;-JAB $nexpensive /afe <o surgery required (ainless +ay use treatment only when desired $f unsuccessful# does not interfere with other treatments $nexpensive /afe <o surgery required (ainless /ide effects uncommon 1ondom use required <o reports on long-term use (ossibly common side effects (headaches! *ac9 of scientific studies on effectiveness .ery high failure rate .ery limited effectiveness .ery dangerous if used with sildenafil (.iagra! <o longer in general clinical use for E0 <eed to ta9e medication every day <o reports on long-term use /ide effects# including nervousness# headache# di==iness# and nausea 8edication

.asodilators (nitroglycerine!

5ohimbine (5ocon!

+ay increase sexual desire $f unsuccessful# does not interfere with other treatments 7A-7;B success rate $nexpensive +ay be of some use in combination with sildenafil (.iagra! /afe <o surgery required (ainless /ide effects uncommon Trental ((entoxifylline! $f unsuccessful# does not interfere with other treatments ;AB success rate in selected patients $nexpensive /afe <o surgery required (ainless /ide effects uncommon +ay improve success and reduce Tra=odone (0esyrel! side effects of yohimbine $f unsuccessful# does not interfere with other treatments 7;B estimated success rate $nexpensive <o surgery required 6sually painless +ay use treatment only when desired <ewer medications may reduce ris9s (enile in?ection therapy

J;-IAB failure rate *imited effectiveness

<eed to ta9e medication every day <o reports on long-term use /ide effects# including headache# di==iness# and stomach upset +ay only help with marginal penile blood ;AB failure rate

<eed to ta9e medication every day <o reports proving benefit <o reports on long-term use /ide effects# including lethargy and drowsiness 3ptimal dosage un9nown J;B failure rate *imited effectiveness (riapism

$ntraurethral pellet therapy (+6/E!

External vacuum therapy

Easily hidden and transportable &efrigeration not required $f unsuccessful# does not interfere with other treatments JA-J;B success rate "ighly effective $nexpensive 1an be used in combination with other treatments such as sildenafil (.iagra! <o surgery required (ainless +ay use treatment only when desired (ellet must be inserted directly into penis through urethral Easily hidden and transportable opening $f unsuccessful# does not interfere &equires refrigeration with other treatments +ild occasional burning or discomfort (experienced by about +aximum usage up to 7 times per one third of uses! day (ossible priapism (rare N B! <o needles# in?ections# or scarring 1an cause mild di==iness# faintness# or low blood pressure -pproved by 203nly : dosages are available :;B success rate +ay require a tension ring or penile tourniquet for best &easonably effective results $nexpensive :;->;B success rate 1an be part of a combination therapy plan if properly supervised /afe &equires some manual dexterity and strength <o surgery required <ot easily hidden (ainless /omewhat bul9y to transport +ay use treatment only when &emoving tension ring within 8A minutes recommended desired Tension ring necessary to maintain erection +ay improve natural erections in (ossibly uncomfortable e?aculation some users +ay need to interrupt foreplay $f unsuccessful# does not interfere (roper tension ring si=e crucial for best results with other treatments &equires practice J;-I;B success rate

&equires in?ections directly into the penis &is9 of infection# bruises# pain# and permanent scarring inside the penis (ossible painful permanent erection (priapism! <o completely acceptable medication currently available 3ptimal combination of drugs not 9nown *ac9s formal 20- approval (except for prostaglandin K1aver?ect# EdexL! +ay not be covered by some insurance companies 6sually not effective in men with blood flow problems or vascular disease +ost effective form (Trimix! not covered by most insurance plans and may be quite expensive 1annot be used by patients on +-3$sM or blood thinners

"ighly effective $nexpensive M+onoamine oxidase inhibitors O

Si 'DINI' yang satu ini memang dapat membuat kaum pria menjadi pusing tujuh keliling dan menurunkan kepercayaan dirinya. Beberapa cara berikut ini merupakan metoda alternatif untuk menyingkirkan si "DINI'.

Sex Theraphy
Sex therapy, yang dilakukan untuk mengontrol ejakulasi dilakukan denganbantuan istri. Pada dasarnya cara ini dilakukan melalui beberapa langkah. 1. Istri melakukan masturbasi terhadap suami yang menderita ejakulasi dini dengan posisi suami berbaring terlentang, sampai suami merasa ingin orgasme dan ejakulasi. 2. Pada saat suami merasa ingin orgasme dan ejakulasi, istri melakukan penekanan pada penis dengan menggunakan ibu jari, telunjuk dan jari tengah, selama beberapa detik untuk menghambat terjadinya ejakulasi. 3. Istri melakukan masturbasi terhadap suami sampai terjadi ereksi yang cukup, lalu segera memasukkannya ke dalam vagina dalam posisi istri di atas tanpa melakukan gerakan. Bilasuami merasa akan ejakulasi,istri segera mengangkat tubuhnya dan melakukan penekanan padapenis seperti pada langkah kedua. Selanjutnya rangsangan dengan masturbasi diulang lagi, dan dilanjutkan dengan hubungan seksual seperti di atas.

4. Dilakukan setelah beberapa hari melakukan latihan di atas. Pada langkahini, suami diizinkan melakukan tekanan untuk mempertahankan ereksinyaselama melakukan hubungan seksual dengan posisi istri di atas.

5. Dilakukan bila suami sudah lebih mampu mengontrol ejakulasi. Padalangkah ini pasangan dapat melakukan hubungan seksual dengan posisisamping. Kalau dengan posisi ini suami mampu menahan ejakulasi, maka hubungan seksual dapat dilakukan dalam posisi suami di atas. Latihan tersebut diharapkan tetap dilakukan selama 6-12 bulan setelah itu, dan kapan saja diperlukan. Tetapi cara ini tidak selalu mudah dilakukankarena beberapa alasan. Pertama, ketertutupan pihak pria terhadap istrinya.Kedua, tiadanya komunikasi dan kerjasama suami istri dalam masalah seksual. Ketiga, perasaan enggan atau malas untuk melakukan latihan karena harus membuang waktu dan dianggap tidak praktis.

Latihan Kegel
Bagi mereka yang menghindari obat, Prof Wimpie menyarankan agar mencoba latihan Kegel atau lakukan sex therapy dengan pasangan . Senam atau latihan kegel dikenal sebagai latihan otot-otot panggul untuk meningkatkan kualitas hubungan seksual. Kegel adalah suatu latihan otot dasar panggul Puboccoccygeus (PC) atau Pelvic Floor Muscle yang semula dipergunakan untuk terapi pada wanita yang tidak mampu

mengontrol keluarnya urin. Otot PC disebut juga otot 'seksual' karena mendukung vagina, penis, uterus, rectum dan bagian tubuh lain yang terkait fungsi seksual seperti orgasme dan ejakulasi baik pada wanita maupun pria. Untuk menemukan lokasi otot PC, Anda dapat menghentikan urine saat Anda buang air kecil. Cobalah berhenti buang air kecil sampai tiga kali sehingga Anda dapat menentukan posisi otot-otot PC tersebut. Latihan Kegel ini diperkenalkan oleh Dr. Arnold Kegel, seorang gynecologist, sejak tahun 1945. Latihan ini merupakan rangkaian gerakan yang berfungsi untuk melatih kontraksi otot PC berkali-kali dengan tujuan meningkatkan tonus dan kontraksi otot. Latihan ini baru menunjukkan manfaatnya setelah dilakukan minimal enam minggu. Sementara untuk pria ternyata latihan Kegel ini telah dikembangkan sejak tahun 1978 oleh Zilberger. Namun prinsip utamanya tetap pada latihan penguatan otot-otot panggul. Latihan ini bermanfaat menguatkan otot panggul termasuk penis serta menambah kemampuan potensi seksual. Dan hasilnya ternyata memuaskan. Caranya dengan mengencangkan otot-otot tersebut sebanvak 10 kali dan mengendorkannya 10 kali setiap hari, dalam tempo satu hingga satu setengah bulan, secara otomatis Anda akan menjadi terbiasa untuk menunda ejakulasi sehingga orgasme berulangkali dapat dialami. Sadarilah bahwa ejakulasi dini merupakan gangguan fungsi seksual, bukan hal yang alami. Namun, tidak banyak pria yang menyadari bahwa dirinya mengalami ejakulasi dini. Selain tidak menyadari, banyak pula yang tidak mau mengakui.

Padahal, mengakuinya adalah langkah awal penyembuhan........


Selamat mencoba dan kembalikan kesenangan serta kepercayaan diri Anda
Posted by Wulan at 11:12 PM 0 comments Labels: Ejakulasi Dini SUNDAY, DECEMBER 16, 2007

EJAKULASI DINI
Masalah disfungsi seksual merupakan momok mengerikan bagi pria. Pria mana yang mau dibilang tidak "perkasa"? Jika masalah yang terjadi tidak segera diatasi dapat berakibat terganggunya keharmonisan rumah tangga. Ingat bunyi pepatah, "Sex is not everything, but without sex, everything will be nothing." Apa sih Ejakulasi Dini? Tidak seterkenal disfungsi ereksi. Pria yang mengalami ejaku!asi dini masih mampu mencapai ereksi dan melakukan hubungan seksual walaupun ejakulasinya terlampau cepat terjadi. Prof Wimpie Pangkahila menjelaskan bahwa sebenarnya ada beberapa pengertian yang dianut oleh para ahli mengenai ejakulasi dini, yaitu: Batasan ejakulasi dini didasarkan pada waktu tertentu ketika terjadi ejakulasi. Ejakulasi dini ditentukan oleh berapa kali seorang pria mampu melakukan gerakan ketika berhubungan seksual sebelum terjadi ejakulasi. Ejakulasi dini diartikan sebagai ketidakmampuan menahan ejakulasi sampai pasangannya mencapai orgasme. Ejakulasi dini ditentukan oleh mampu tidaknya pria mengendalikan ejakulasi agar terjadi sesuai dengan keinginannya. Berdasarkan pengertian yang keempat, maka ejakulasi dini berarti ketidakmampuan

mengontrol ejakulasi sehingga terjadi dalam waktu singkat, yang tidak sesuai dengan keinginannya, sedangkan ejakulasi sendiri adalah peristiwa penyemburan air mani ke luar secara mendadak yang menandai klimaks bagi pria. Tampaknya pengertian keempat yang kini lebih dapat diterima. Beberapa Penyebab Ejakulasi Dini Ejakulasi dini tidak datang dengan sendirinya pada pria, melainkan ada penyebabnya. "Ada penyebab psikis seperti stress berkepanjangan, kebiasaan ingin cepat selesai ketika melakukan hubungan seksual," ungkap Prof Wimpie Pangkahila. Tidak hanya itu, lebih lanjut Prof Wimpie Pangkahila yang merupakan Guru Besar Fakultas Kedokteran Universitas Udayana menjelaskan, "Ada penyebab fisik terutama kurang berfungsinya serotonin yang berfungsi menghambat." Gangguan kontrol saraf yang mengatur peristiwa ejakulasi juga diduga menjadi penyebab terjadinya ejakulasi dini. Sayangnya, pria dengan disfungsi ereksi pada umumnya mengalami ejakulasi dini. Sebaliknya, pria dengan ejakulasi dini pada akhirnya dapat mengalami disfungsi ereksi. Ringan Beratnya Ejakulasi Dini Ternyata ejakulasi dini berbeda-beda. Ejakulasi dini dapat dibagi menjadi tiga jenis berdasarkan tingkat keparahannya, yaitu: Ejakulasi dini ringan, Ejakulasi dini sedang, dan Ejakulasi dini berat. Jenis Ejakulasi Dini Ringan Ejakulasi terjadi setelah beberapa kali gesekan singkat. Sedang Ejakulasi terjadi setelah penis masuk ke vagina. Berat Ejakulasi terjadi begitu penis menyentuh kelamin wanita bagian luar. Ejakulasi terjadi sebelum penisnya menyentuh kelamin wanita bagian luar. Apapun jenis ejakulasi dini yang dialami, baik pria maupun wanita akan merasa tidak puas karena ejakulasi terjadi dalam waktu sangat singkat di luar kehendak sehingga hubungan seksual harus berakhir. Dampak ejakulasi dini Mau berat atau ringan, yang pasti ejakulasi dini mengakibatkan hubungan seksual berlangsung tidak harmonis. Pada ejakulasi dini, ketidakharmonisan bahkan disebabkan karena ketidakpuasan pada kedua belah pihak. Pria yang mengalami ejakulasi dini merasa tidak puas karena hubungan seksual berlangsung sangat singkat di luar kehendaknya. Walaupun dapat mencapai orgasme, pria yang mengalami ejakulasi dini juga merasa sangat kecewa karena tidak mampu memberikan kepuasan seksual kepada pasangannya. Apalagi kalau pasangannya mengungkapkan kekecewaan dalam bentuk reaksi yang menyalahkan penderita. "Pria yang mengalami ejakulasi dini sering mengalami stres, tidak percaya diri, rendah diri,

dan malu terhadap pasangannya. Dalam waktu lama dapat terjadi disfungsi ereksi. Pasangannya tentu kecewa, tidak puas, jengkel, marah, dan akhirnya mengalami disfungsi seksual seperti hilangnya gairah seksual," papar Prof. Wimpie Pangkahila. Lebih jauh, reaksi yang muncul adalah perasaan takut atau khawatir setiap akan melakukan hubungan seksual. Perasaan ini justru akan semakin memperburuk keadaan ejakulasi dini. Kalau keadaan ini terus berlangsung, maka pada akhirnya pria itu dapat mengalami disfungsi ereksi. Wanita yang mempunyai pasangan mengalami ejakulasi dini pada umumnya tidak dapat mencapai orgasme karena hubungan seksual segera berakhir. Kekecewaan yang muncul selanjutnya dapat berubah menjadi kejengkelan disertai perasaan takut setiap akan melakukan hubungan seksual. Akibat lebih jauh dapat berupa hilangnya dorongan seksual dan dispareunia (rasa nyeri yang terjadi saat bersetubuh). Bagaimana mengatasi ejakulasi dini? Pertama-tama disarankan untuk melakukan sex therapy. Jika sex therapy tidak berhasil, maka lakukan cara yang kedua yaitu menggunakan obat. Obat untuk mengatasi ejakulasi dini adalah obat yang berkhasiat mengontrol ejakulasi. Ada beberapa jenis obat yang dapat mengontrol ejakulasi. "Tergantung penyebabnya. Karena penyebabnya banyak berkaitan dengan fungsi serotonin, maka diperlukan obat yang mengatur fungsi serotonin, kata Prof Wimpie Pangkahila. Lebih lanjut, Prof Wimpie menjelaskan, "Obat misalnya, golongan SSRI (Selective Serotonin Reuptake Inhibitor). Namun, perhatikan efek samping, karena obat ini bukan obat yang dijual bebas." Tetapi mengingat obat tersebut mempunyai efek samping, maka penggunaannya harus di bawah pengawasan dokter. Seperti penjelasan di atas, ada obat untuk mengontrol ejakulasi. Kalau ejakulasi dini diakibatkan oleh gangguan ereksi, maka dengan memperbaiki fungsi ereksi, ejakulasi dapat diperlambat. Jadi obat disfungsi ereksi bermanfaat kalau ejakulasi dini disebabkan oleh gangguan ereksi. Cara pengobatan lainnya ialah dengan cara operasi terhadap saraf yang mengontrol terjadinya peristiwa ejakulasi. Tetapi cara ketiga walaupun pernah dilakukan di negara tertentu, sampai kini ternyata tidak populer dan tidak banyak digunakan. "Mengenai suplemen, banyak yang mengklaim bisa mengobati ejakulasi dini tetapi tanpa hasil uji klinik," kata Prof Wimpie Pangkahila. Jadi jika ingin mencoba minum suplemen, pastikan suplemen tersebut dilengkapi bukti berdasarkan uji klinik yang telah dilakukan. "Andaikata ada hasil uji dengan hasil signifikan, perlu dilakukan analisis apa kandungan di dalamnya. Dan harus tahu apakah peneliti memang berkompeten melakukannya. Kalau hanya suplemen saja, misalnya vitamin, tidak mungkin dapat mengatasi ejakulasi dini," tegas Prof Wimpie Pangkahila. Untuk diketahui, ejakulasi dini bisa disembuhkan. Tapi ingat, bukan penyembuhan ke "orang pintar" tapi dengan pengobatan ke dokter. Sebelum perceraian menjadi satusatunya solusi, lebih baik segera berkonsultasi dengan ahlinya untuk mengakhiri derita ejakulasi dini. (Sumber. www.medicastore.com)
Posted by Wulan at 7:25 PM 0 comments Labels: Ejakulasi Dini