Dr (Col) V K Wadia is a renowned medical doctor with 35 yrs of practice. His expertise in treatment of Sex Problems, and effective result oriented counseling in Marriage & Relationship has won many accolades.

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Phone No. 9891152777 9891192777

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For patients unable to make a visit to the clinic personally, this option allows to obtain Sex & Relationship Counselling from Dr.Wadia over the Phone or Skype, and receive an opinion about possible treatment options.

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FAQ

1. Is sex inevitable? Is healthy sexuality important for well-being?

  • Next to survival, the most primitive & primal human instinct is SEX. It is inevitable- almost. The universe would have come to a stand-still if there was no sex.
  • Inevitable or not, sex and sexuality are important for personality development & well-being. They are inherent, inevitable components of one's overall personality.
  • You can not be a complete self & possess a good personality, without being a congruent sexual self. It is not possible to contribute effectively to self or society if sexually inadequate or frustrated.
  • An individual's happiness revolves around this healthy sexuality which is developed. Likewise the art & the science of performing sex are developed- though sexual instinct continues to be natural, inherent & spontaneous.
  • To develop a healthy personality, what is required is grooming of appropriate sexual personality & learning appropriate sexual behavior. This is possible only if one acquires the right perspective of sex whether by experience or with the help of professional counselors or therapsists.

2. Is it a sin to indulge in sex for pleasure?

No. Sexual interaction is not only a means for procreation but is also an end in itself for pleasure. Scriptures like Kamasutra, Sushrat Samhita, Charak Samhita; and sculptures like Khajuraho, Konark & many other temples where sex has been depicted on the walls bear testimony to the sanctity attached to sex by our forefathers.

3. What is the importance of sex?

Sex is the most primitive & primal human instinct; second only to survival.
  • Sex, besides Procreation & Pleasure, is important for Physical & Mental Health.
  • Its role in strengthening the bonds of intimacy between two steady partners is also well recognised.
  • On the psychological & emotional fronts too, an active sexual life has plenty to contribute. It is considered to be a stress buster. It releases physical & mental tensions, gives a sense of psychological fulfillment & enhances one's body image.
  • Some have talked very passionately of role of sex in spirituality wherein it has been equated with salvation ('Nirvana' or 'Moksha').
    There are ancient references which say that sex (Kama) is one of the 3 doors (dwars) or paths leading to salvation (Moksha)- the other 2 being riches & duty (Dhan & Dharma).
    Even present day contemporaries echo similar views. Dr Deepak Chopra, M.D, a prominent voice of Eastern philosophy & Chairman and co-Founder of the California-based Chopra Center for Wellbeing has this to say 'The peak experiences of sexuality such as orgasm, are characterized by a state of consciousness where there is a sense of timelessness, loss of ego, naturalness, vulnerability, surrender and defenselessness. This is a spiritual state. If we could be like this all the time, we would be enlightened'.

4. What is the relation between physical health & sex?

Different trials have shown an irrefutable correlation between the levels of Testosterone- the main male sex hormone on one side; and the mental health (depression), the cognition (risk of memory loss, Alzheimer disease), the muscle mass & the bone density (osteoporosis) on the other side. People, who indulge in regular sex with a steady partner, tend to stay healthier even in old age.

Various researches show that a regular sex, with a caring partner :
  • Burns calories & tunes Muscles.
  • Improves circulation reducing risk of Cardiac diseases.
  • Relieves Migraine, reduces Arthritic pain.
  • Slows down age-related changes like Osteoporosis, Memory impairment (Alzheimer).
  • In WOMEN, regulates Periods, makes Menopause easier; lessens Miscarriage/Stillbirths; increases Fertility & reduces Menstrual cramps.
  • Releases physical & mental Tensions.
  • Enhances Body image & counters depression. It is rejuvenating, leaves an afterglow, makes one look younger. It also gives a sense of fulfillment- Physical, Psychological & Emotional.

5. Why are people reluctant to take treatment for sex disorders?

This is because
  • Many people feel that sex is natural & that no one, including doctors/counselors, can do anything about sex problems if they occur.
  • Undue taboo & stigma are attached to sex.
  • At times, sex is considered sinful & immoral.
  • A false sense of guilt & shame exists in society about talking/indulging in sex.
  • Fear of intense humiliation at being labeled as impotent/frigid, lacking masculinity/ femininity.
  • Misplaced apprehension that partner may look down upon, ridicule, dominate or even break the relationship, if gets to know of the sexual problem. And therefore, ill-founded concern of keeping it a secret.
  • Has to be accepted as a way of life' attitude, especially as in old age.

6. Why are there so many misconceptions about sex?

Everybody seems keen to know about sex, but few are willing to talk about it openly. This results in acquiring misinformation from unauthentic sources, leading to misconceptions. Also because Sexual/Psycho-Sexual Medicine in our country is not a well established, well defined, scientifically practiced stream of Medicine; the quacks monopolise this practice. The sexual myths & misconceptions thrive because of these quacks, and the quacks thrive because of these myths & misconceptions.

7. How do quacks exploit the patients suffering from sex problems?

Sex is a very personal world. It acquires a very special place in a man's life as it is considered to be a symbol of his manliness (mardangi). It has come to occupy the same platform for women, as an issueless woman is often socially ostracized & faces the ignominy of being labeled a baanjh- a social stigma. Sex is a very big concern as sexual inadequacies can break a relationship or a marriage. It can also be a ground for divorce & matrimonial alimony/compensation. This gives quacks an easy tool to exploit the sexual inadequacies of patients. Quacks put God's fear in the minds of the gullible patients and squeeze them.

8. Who should treat the sex problems?

A Psycho-Sexologist, preferably with a medical background, has a pivotal role to play in the sexual health of the patients & treatment of sexual disorders. He is the one who assesses whether the disorder is due to a Psychological reason alone needing just psycho-therapy; or is a result of a pathological disease (e.g. Hormonal Imbalance, Diabetes, Heart, kidney problems etc.), needing services of a specialist in addition. Even if the problem is not psychological, the symptoms of sex problem over a period become independent of the physical disease & tend to stay even after the disease has been treated unless specifically addressed by the Psycho-Sexologist. A Psycho-Sexologist's role acquires further significance as it is the 'BRAIN' that is considered to be the biggest sex organ of the body.

9. How do you compare the role of a Psycho-Sexologist vis-à-vis other specialists in sex therapy?

Both have their own roles to play which are independent, still interdependent. It is important to understand that coitus is between thighs but the orgasm is between the ears. While the former is taken care of by a Psycho-Sexologist plus others, later is exclusively the purview of Psycho-Sexologist. However ideally speaking, Psycho-Sexologist should be the first point of contact with the patient & the whole treatment should be carried out under his charge.

10. What is Sex therapy?

Sex therapy is the structured science of treating the sex problems with the help of counseling & drugs.

11. What roles are played by the mind & the body in sex therapy?

Sex basically involves 2 major components:
  • MIND: Brain is considered to be the biggest sex organ in the body. There is no denying that sex is largely in the mind. It depends on sexuality (sexual personality) of an individual which is sum total of Nature & Nurture. Nature means what a person inherits at birth & nurture is what one learns with passing days. After birth, nothing can be done to change the natural inheritance. However nurturing or bringing up can definitely be influenced. Sexual nurturing depends on acquiring the right kind of awareness about sex. Nurturing also depends on one's initial sexual experiences. If one learns the right perspective of sex and if the initial sexual experiences are pleasurable, the pleasurable sex gets reinforced with every episode of sex and thus, one tends to lead a healthy sexual life. Conversely, if initial sexual experiences are frustrating or painful, the indifference or aversion to sex gets reinforced with each subsequent sexual encounter, culminating into sexual problems. The commonest example is Premature Ejaculation in males. If initially, the sex is performed hurriedly under the fear of being caught like in garages, vehicles, corporate lunch breaks etc. one tends to develop Premature Ejaculation in the later part. Another common example is the fear of pain/bleeding in a woman. If first intercourse is without much foreplay leading to pain in a woman, subsequent intercourses too may be painful despite generous foreplay. That is how we say the body is where the mind is. Since sex is a conditioned response or a learnt behavior, mind plays the most significant role in sex.
  • BODY: It is true that sex is between the ears (mind) but it is equally true that its execution is between the thighs (body). So the Vigor & Vitality (sexual health) of the body is no less important. A healthy body is a pre-requisite for a healthy sex.
Also, sex does not involve a single system of the body. The origin of sex and therefore its problems, is of multidisciplinary nature. The various systems of the body involved in sex are the Psychology, Psychiatry, Uro-genital System, Endocrinology, Vanereology, Gynecology etc.

12. How do the sex problems originate?

Sexual problems arise either because of Psychological reasons (mind) or Physical reasons (body). However, it is well accepted now that all the sexual problems of even physical origin, ultimately become Psychological because of 'fear to perform' or what is called 'Performance Anxiety'.
To have a healthy sexual life, the 'mind' & the 'body' are required to work in tandem and 'the connect' between the two too, should be efficient.

13. What are the commonest sex problems?

The commonest of all the sex problems in males are Impotence (ED- Erectile Disorder) & Premature Ejaculation. Almost 20% of all males at some stage of their lives, suffer from these.

The problems commonest amongst women are the low libido (desire), disparunia (painful intercourse) & Anorgasmia (inability to reach orgasm/climax).

There are many other problems too.

14. What are the principles of sex therapy?

Sex problems are unique to each individual because each individual is unique. The therapy can ill afford to be restricted to a particular or specific stream or discipline of Medical Science. The approach is required to be eclectic & holistic considering each individual's bringing up, awareness, societal values, customs & traditions, religious & cultural backgrounds etc.

The sex therapy revolves around the single fact i.e. whether the cause or origin of sex problem is brain (psychogenic) ALONE or there is an underlying disease (physical) too.
  • If psychogenic alone, treatment is psychotherapy with or without drugs.
  • If genesis is physical, person is investigated to find out the underlying disease which then is treated. In this case too, psychotherapy is must because by the time the disease is treated, the symptoms of sex problem become autonomous & tend to stay unless specifically addressed by a Sexologist.

15. What are the steps involved in sex therapy?

The peculiarity about sex problems is that even if the problem lies with one partner, both the partners suffer equally, necessitating therapy for both. They are treated as one dyad (each considered half patient) unless individual is single, or the partner is not available or is unwilling; in which case treatment is given to the willing/available partner.

If relationship crisis is at the core of the sex problem, then the focus of therapist is on the relationship rather than the individual partners.

Various steps involved in treatment are:

  • Diagnosis & treatment of physical causes like Diabetes; diseases of Heart, Kidney, Thyroid; certain cancers; spinal diseases; some surgeries; tobacco & liquor addiction, substance abuse- the list is too long.
  • Unlearning the inappropriate behavior/technique/sexual conduct & learning the appropriate one.
  • Addressing psychological cause (ignorance, myths, misconceptions, stress, anxiety, spectatoring).
  • Changing the mind-set (Sex is dirty, oral sex is abnormal, good women do not move in bed, we have come off-age, sex is not pleasure oriented, sex is only penetrative & genitalia oriented, simultaneous orgasm is mandatory etc.)
  • Instituting CBMs (Confidence Building Measures) for building confidence, self esteem, body image.
  • Building healthy relationship.
  • Improving sexual as well as non-sexual communication.
  • Improving perception.
  • Increasing awareness about the importance of Foreplay & Afterplay.
  • Understanding orgasm.
  • Fantasizing & imagery.
  • Creating awareness about exploring each others' sexual needs.
  • Sexual pleasure enhancing techniques to counter sexual monotony/boredom & to create novelty.
  • Practicing 'sensate focus exercises' & 'masters & johnson's technique' especially in premature ejaculation & impotence.
  • Eros therapy for women.
  • Kegels exercises.
  • Providing appropriate perspective of sex (especially in challenged situations like Cancers, Spinal Injuries etc.) i.e. sex is not only between thighs or genitalia oriented or penis-in-vagina or penetrative but is between ears, is intimacy oriented & is participative.


There is no customized, tailor made, quick-fix solution in cases of sex, marriage & relationship problems. Each case is unique needing a different approach....

16. What are the treatment options available in sex therapy? Are all sexual diseases curable?

Advent of Viagra in 1996 brought a revolution in the Science of the treatment of sexual dysfunction. This not only gave teeth to the therapy, but made a perceptible contribution towards diagnosis of such diseases. This, added to the fact that we have such wonderful investigation tools like Penis Doppler, prompted highly qualified doctors to jump into the field of sexology, hitherto, the monopoly of quacks; making sex practice very scientific.

This also led to extensive research widening the spectrum of treatment options.

The time tested techniques like Masters & Johnson's Technique, Sensate focus exercises, Eros Therapy (for women) etc ensure a good outcome. With a wide variety of available drugs & modalities like Testosterone, Sildenafil, Verdanafil, Tadalafil, Yohimbine, SSRIs, Clomipramine, Dopexitine; various sprays; penile injections; vacuum devices; sexual enhancers, surgeries (penile implantation, vascularisation etc), the cure is almost assured in the right hands. Those few diseases which are not curable, are at least treatable or manageable with the altered perspective of sex & modified sexual behavior.

17. Can sex problems be prevented?

Since the leading causes of sex problems like ignorance, myths, misinformation, the negative conditioning (wrong learning), performance anxiety etc., are psychological in nature, they are highly amenable to sex counseling. Thus with age-appropriate education, such dysfunction can be prevented. Adolescent counseling, Pre-marital (before marriage) & Marriage counseling can go a long way to help the cause especially because the targets groups can be identified.

18. How does relationship counseling help?

Relationship is the plank of sexual indulgence.

The significance of relationship in life can not be overemphasized. If ever life has a meaning, it is a meaningful relationship. In youth, nothing seems sweeter than an intimate relationship. Nearer the sunset years of life, no amount of riches or materialistic gains seem to justify the meaning or the purpose of existence. It is only a gratifying relationship you have or have had, the treasured memories of which you hold or reflect; makes your remaining life worth living. Without going into whether sex is the cause or the consequence of a good relationship, it would be prudent to understand that relationship for sure is at the core of sex. Sex tends to be mechanical without a healthy relationship.

There are times when people experience roadblocks in relationship. The issue at its face may look irresolvable or insurmountable. More often than not, it is not because of the bad intentions on the part of the partners or due to the gravity of the problem. It is more because men, unlike women who are from Venus, would continue to be from Mars having different needs, and thereby the perspective, and thus the approach. It is also because of the different bringing up & perceived values of the partners. So despite best intentions towards each other, their approaches may vary leading to conflicts. A faulty approach may be the result of lack of proper insight, clouding of vision, inadequate communication, miscommunication, misperception, preconceived or biased notions, grandisation of trivial issues, bloated egos etc. etc.; on part of one or both the partners. The affected parties usually fail to analyze the problem in an unbiased, logical fashion. Over a period if there have been frequent arguments, partners bring down shutters before their minds the moment a discussion starts or an argument breaks. Their minds become impervious. Mind, as a result of preconceived thoughts, stops registering even if the partner wants to convey something new, different & logical. That is the time when relationship counseling becomes pertinent.

Incidentally, the counselors do not have any quick-fix or tailor made solutions of such problems. In fact counselors never offer solutions. With discreet & unobtrusive approach giving due respect to confidentiality, all that the counselors do, is to provide a conducive platform to the discorded couple where they are able to voice their concerns hitherto in mind, out in the open/aloud & thrash them out with the partners. Speaking the thoughts aloud makes their own vision clearer & also helps the other partner to understand & evaluate them. Counselor without being judgemental, has the cut out task of ensuring free flowing but constructive communication so that the partners look at the controversial issues from other's perspective. They encourage counselees to see problems from a practical angle. The effort of counselor is to empower counselees with the capability to analyze the problems themselves, realistically & rationally. This empowerment helps them at that point of time & subsequently too, in overcoming such challenges on their own. Counselors by virtue of being specially trained professionals with neutrality & without bias, are better positioned to analyze the problems at the ground zero level & help sparring couple to iron out their differences.

Thus relationship counseling does help couples to see the flip side of the situation & help them resolve their issues & lead a harmonious life.

It is of utmost importance to understand that the two partners must try to resolve their differences on their own as for as possible. But before they approach counselors, they must exhaust all available options. However, seeking counseling if needed, should not be delayed so much as to make the reconciliation impossible.

Read Sex & relationship to learn The 'mool- mantras' of relationship

19. Is premarital counseling important?

Yes. The marriage has many facets about which even educated people are not aware of, till they themselves cross the bridge; by when it may perhaps be too late. Premarital counseling is very important especially in the Indian context since the marriages in our country are not the unions of two individuals but of two families. Often, the families are from different cultures, economical status, backgrounds, customs, traditions and religious & societal values. The selection of a compatible partner, awareness regarding own & others' sexuality, each-others' Anatomy (erogenous zones) & Physiology (sexual needs), menstruation, the art & science of performing sex, the first night, conception, contraception, emergency contraception, sexual myths, inter-spouse communication (sexual/nonsexual, coital/noncoital, verbal/nonverbal) are must-know for all would-be brides & grooms.

20. How important is the Sex Counseling?

Since sex is an art as well as a science, a good sexual counseling goes a long way to prevent sex problems; and to take care of them if they still occur. The counseling assumes more significance if sex is considered a pleasure & intimacy oriented phenomenon where-in orgasm is more important than ejaculation. Counseling is an effective tool since sex is a learnt behavior that improves with learning & experiencing.

Since sex is one’s very personal world with no reference points available, people often are ignorant whether they are leading a normal or abnormal sexual life. Sexual counseling is needed for those also who perceive their sexual life to be normal.

21. What all, does the sex counseling include?

It includes all issues having a direct or indirect bearing on sex life of men & women, like:

  • Counseling about Sexual Myths: The most rampant sexual myths are dhat, night emission or bedwetting, masturbation, semen loss, penile & breast size, flaccid penis, bent penis, lax vagina, virginity, periods, 1st night, sex frequency, conception, contraception, sex in aged etc.
  • Adolescence Counseling: Sudden spurt in hormones in adolescence results in rapid physical, sexual & emotional changes. Inability to understand own body & its needs, sexual curiosity, sexual myths, inhibition about talking of sexuality, non-availability of credible info, peer pressure, proneness to risky sexual behavior because of hormonal surge, urge for sexual experimentation- all lead to confusion, anxiety, awkwardness and at times- low esteem; unless addressed specifically. Knowledge is strength.
  • Premarital (before marriage) Counseling: Marriage is often an un-traversed path both for men & women. It is an enigma- a mystery. It at times, scares men & women alike because men are from Mars & women from Venus with diverse physical, emotional & sexual needs besides the mindset. Awareness about institution of marriage, selection of medically & sexually compatible partner, awareness of own & partner’s sexual anatomy & sexual needs, the 1st night, consummation of marriage, conception, contraception, Emergency Contraception, communication, the art & science of making love & preservation of marriage are important aspects to understand before one steps into wedding.
  • Marital or marriage counseling: Any marriage older than a week has reasons for divorce. A stitch in time saves NINE. The counseling addresses marriage concerns & crises. It provides insight about issues like consummation of marriage, effective communication, fighting sexual monotony/boredom, enhancing sexual pleasure, painless separation/divorce if unavoidable etc.
  • Relationship Counseling: The only meaning to life if ever, is a meaningful relationship. Good relationship is at the core of sexual interaction and a loving & lovable partner is the biggest aphrodisiac. Sex minus relationship is not only mechanical but perhaps beastly too. Relationship should never be taken for granted. One has to work on relationship all the time. The relationship counseling helps in improving verbal/nonverbal, sexual/ nonsexual communication so as to prevent relationship crisis, or to manage if it occurs. The counseling helps overcome biases & prejudices, clouding of vision etc.
  • Aging: Andropause (men), Menopause (women), Modified sex techniques.
  • Sexual Dysfunction Counseling: Low sexual desire, painful sex, sex addiction & orgasmic disorders in men & women. Impotence & premature ejaculation besides other ejaculatory dysfunctions in men. Vaginismus & poor lubrication-swelling response in women.
  • Sexual Variants & Paraphilias : Oral/anal interactions, Pedophilia & other Paraphilias etc.
  • Counseling for LGBT (Lesbians, Gays, Bisexuals, Trans-Sexual): All good- as also bad, things are not only in the mind alone. One can ill-afford to be an Ostrich with the head in sand & presume they do not exist in our society.
  • Sexual offences Counseling: For both victims & offenders.
  • STD, AIDS Counseling: Prevention & treatment.

22. Is the sex not natural & spontaneous? Who all should take sex counseling?

Sexual urge is between ears (mind) & is innate. But the sexual act is between the thighs and is learnt. One learns to perform sex either with experience (exploration & experimentation) or through sexual counseling. Sex therefore, is a behavior. And like all behaviors, one has to learn its proper technique. If faulty, it has to be unlearnt then re-learnt. Learning the right behavior or the art or the science of sex is a process that goes on all through one’s life. At no point, can an individual claim to know all about this behavior. So even those who have no sexual problems, are benefited by counseling to enhance their sexual pleasure & prevent sex problems to happen.

23. What should be the frequency of sex?

It is not the frequency, but the satisfaction level that matters. Complete sexual gratification once a week is superior to a sexual encounter every day that is bereft of orgasm.

24. What is the yardstick of ideal sex?

Sex is a very personal world. There are no reference points. It is as good as one or one’s partner thinks. However, there will always be scope to make it better. It is a life long exploration & experimentation process with a caring partner where increasing awareness about each others' needs, plays a vital role.

25. Till what age, is the sex recommended?

After the peak at about 22-25 years of age, the sex hormone starts decreasing. This, along with normal wear & tear of the body that goes with aging, does affect the quality of sex adversely. However the sexual urge & the sexual activity last as long as the life does provided, a lovable & loving partner is available & there is no major illness. So sex per-se has no expiry age. All it requires is to bring about certain modifications in the sex techniques.

It is imperative to understand that the virility (sexual vigor & vitality) is different from fertility (producing children). While sex is an ever-lasting need, the fertility ceases in females with setting-in of menopause unlike in males where it lasts till the last breath.

26. Till what age is child bearing possible?

‘Virility’ and ‘fertility’ though connected, can exist independent of each other. However, the quality of egg in woman & sperm in man deteriorates with aging & it is always a good idea to complete one’s family by 30 years of age. Fertility (child bearing) in a woman ceases with menopause that may occur usually any time after 40 years whereas ability to produce children in man seems to go on for ever.

27. What are the causes of Sex problems?

  • Psychological / Psychogenic / functional
  • Physical / Pathological / Organic


There has always been a raging debate whether the genesis/origin of bigger chunk of sex problems is Psychogenic or Pathological. But whether Psychological or physical, ultimately all cases of sexual disorders land up in Psychological problems.

28. What are the psychological causes of Sex problems?

Reasons are the biggest culprits of sexual dysfunction. Few important Psychological causes are:
  • Misinformation
  • Myths, Misconceptions
  • Mental pre-occupation
  • Mental fatigue/ stress/ tensions
  • Missing or inadequate communication
  • Mis-communication
  • Mis-perception
  • Matrimonial discord
  • Mis-matched sexual drive
  • Monotony- sexual monotony/sexual boredom, lack of sexual novelty
  • Most important- Performance anxiety

29. What are sexual myths?

  • Most rampant myths after religious, are the sexual myths.
  • Myths arise out of misinformation & misconceptions.
  • The list of such myths is too long but the commonest are about the celibacy or brahmcharya, dhat (semen in urine), night emission or wet dreams, masturbation, semen loss, penile & breast size, lax vagina, virginity, periods, first night, consummation of marriage, sex during periods, sex with virgins for STD cure, sex with animals, conception, male births, contraception, homosexuality etc.

30. What is Performance Anxiety/fear of failure/fear to perform?

  • An individual may develop anxiety if unable to perform even once, for as small a reason as physical tiredness, mental fatigue, lack of sleep or even an inconsequential argument.
  • Anxiety affects performance which in turn reinforces anxiety causing further decline in performance.
  • This sets in a vicious cycle of anxiety -----> declining performance ----->anxiety.
  • This vicious cycle is the biggest hurdle faced by the therapist & to break this cycle, the biggest challenge.

31. How are physical reasons or body conditions important for causing Sexual Dysfunction?

  • It is true that the 'orgasm' is between the ears (brain), and ‘brain’ being extremely sensitive, even a little anxiety/stress can play havoc with sexual performance. However, it is equally true that 'coitus' (intercourse) is between the thighs (sexual apparatus- visible & not so visible) and therefore, any ill health affecting this apparatus, can play as much havoc with the sexual adequacy.
  • Thus, while brain is the biggest sex organ of the body responsible for initiation & sustenance of sex; the importance of the body can not be undermined. Often- though not always, it is the body that gives sex the shape it deserves, by physically executing the act.
  • No amount of brain participation works, if the sexual apparatus is rendered ineffective, by an underlying cause/disease.

32. What are the physical causes/diseases which affect sex adversely?

The list of physical causes is literally endless. But the commoner ones are:
  • Alcohol, tobacco & drug abuse
  • Diabetes
  • Heart diseases, high B.P. & its drugs, Dyslipidemia & high cholesterol
  • Kidney, thyroid & liver diseases
  • Hormonal imbalance
  • Urinary infections
  • Prostate diseases
  • Few cancers
  • Some surgeries
  • Certain drugs
  • Certain injuries- especially SPINAL.

33. Does Alcohol enhance sexual pleasure?

As against the popular belief that alcohol increases excitement & therefore enhances the sexual performance, the scientific fact is that alcohol is a Central Nervous System depressant & decreases the arousability. It however still has enhancing effect in sex in most people- even if transient, by making them bolder in their sexual approach. With alcohol, the inhibitions diminish resulting in wilder sexual fantasies, uninhibited sex & sexual (mis)adventures in terms of sexual exploration & experimentation. This short term enhancing effect is possible only if quantity of liquor consumed is small; else it takes away the performance. The old saying that alcohol when taken ‘provoketh the desire, but taketh away the performance’ still holds good.

It is important however to understand that alcohol when consumed for long, damages the lining of the penile blood vessels leading to Impotence in men & Frigidity in women.

34. How does smoking affect sex life?

Smoking too like liquor, damages the small delicate blood vessels of penis leading to Impotence, besides affecting the quality of sperms. It may also cause Cervical cancer in women leading to sex problem. In fact smoking spares no system of the body, has 42 cancer producing substances & is the leading cause of cancers especially Lungs & mouth.

35. What is the difference between smoking & suicide?

Smoking takes longer to kill.

36. How does stress affect sexual efficiency?

There can not be a bigger killer of libido (sexual desire) than the stress. It also affects the arousal/excitability by inhibiting the release of sex hormones. Even if present in abundance in the body, the bio-availability of sex hormones is jeopardized at the time when they are needed the most, thus leading to a failed or poor performance. Stress is notorious to play spoilsport in brain-body connect, an indispensable ingredient of sexual interaction.

Stress often leads to relationship blues & thus again affects sexual performance as relationship & intimacy are at the core of sex.

Besides, stress is the cause of whole lot of psycho-somatic diseases- notably Hypertension, Heart diseases, ulcers, Irritating Bowel, certain cancers. These too adversely affect sexual health indirectly.

37. Has corporate lifestyle led to shift in the sexual practices of the people?

Long Corporate hours especially odd hours, night shifts, eating together, frequent partying to meet corporate social/client obligations, client cultivation outings etc., provide ample opportunities to employees to mingle & be intimate. In fact, more awake hours are spent with colleagues than with spouse.

In addition ambitions, competitiveness, rivalry, revenge, seeking favors from colleagues/bosses/clients; make people more vulnerable to offering sex in return. Less quality time & setting-in of sexual monotony with a regular partner (spouse) encourages sex at workplace. Out-of-marriage sex seems adventurous, has thrill of tasting forbidden fruit, gives illusion of greener pastures across fence, is sometimes perceived as symbol of sexuality (manliness/feminity), gives sought after feeling & satisfies attention seeking urge.

This all however, often leads to stress called ‘Corporate Stress’. Stressed mind is a leading cause of sexual disorders, brain being the biggest sex organ of the body. Brain is not only the initiator of sex but is the sustainer too. Chemicals released during stress, kill sexual drive & also interfere with the functioning of sex hormones. The resultant sexual inadequacy deprives an employee of benefits of sex like de-stressing, intimacy & a sense of fulfillment. The sexual inadequacy is also a known cause of relationship/matrimonial discord & is perceived to be the biggest ever conceivable humiliation meted out to a human being. It is especially true for a man though women are not excluded. Sex problems are also unique in the sense that, while only one partner may harbor the disorder, the suffering is equal, resulting in unhappiness of both.

The above has led to shift in sexual practices.

38. What sexual problems are caused due to poor & sedentary lifestyle?

Poor & sedentary lifestyle decreases stamina, causes obesity & other metabolic disorders associated with obesity. It increases proneness to diseases like Diabetes, High blood pressure, Heart diseases, bone diseases etc. These diseases form the biggest chunk of organic causes responsible for Sexual dysfunctions like Impotence in men & Frigidity in women, reduced genital sensations, many male ejaculatory disorders like absent/scanty/delayed discharge, and semen discharge in urine. It can even cause total absence of orgasm in both the sexes. Obesity also acts as a physical barrier during sexual interactions. Psychologically, it affects the body image & the feel-good feeling- so essential for the sex, as sex is as much if not more, between the two ears as between the two thighs.

39. What is the relation between ED (Erectile Dysfunction)- also called Impotence, and other diseases?

  • ED usually coexists with Heart disease (CVD i.e. cardio-vascular disease). In fact, impotence may be the first sign of an impending heart disease.
  • ED often unmasks undiagnosed or hidden Diabetes.
  • A study by the Columbian Presbyterian Medical Center showed that almost 70% of the hypertensive (high Blood Pressure) patients had some form of ED.
  • Around 68-70% of men with ED were found to have high cholesterol. 52% of High cholesterol cases however did not have ED.
  • 75% of people suffering from Diabetes, Hypertension and Heart diseases have ED.

40. Does Diabetes affect sex?

Diabetes is the biggest enemy of Sex.
  • Some changes in sexual functions are normal as people age, as a result of diminished hormones & usual body wear & tear. Diabetes hastens these changes leading to premature occurrence and increased severity of sexual dysfunction. Onset of ED in Diabetics may be 10 to 15 years earlier than non-diabetics.
  • Diabetic men are three times more likely to have (ED) Erectile Dysfunction compared to non-diabetics.
  • Over 50 percent of the estimated 10 million men with diagnosed type 2 Diabetes, experience impotence in USA.
  • In India, the estimates of the prevalence of erectile dysfunction in men with diabetes range from 20 to 85 percent averaging 52%.
  • In fact, in up to 12% of men with diabetes, ED is the first sign that leads to the diagnosis of diabetes.
  • In Diabetic men even if the diabetes is well controlled, the rate of impotence is about 30 %.
  • Approximately 35 % women with diabetes may experience some form of established sexual dysfunction related to their disease.

41. What are the sex problems caused by Diabetes?

52% of Diabetic men suffer from
  • Loss of sexual desire
  • Impotence (also known as erectile dysfunction)
  • Retrograde Ejaculation (semen in urine)


35% of Diabetic women suffer from
  • Decreased or total lack of interest in sexual relations
  • Decreased or no sensation in the genital area
  • Constant or occasional inability to reach orgasm
  • Dryness in vagina, leading to pain during sexual relations
So

If you have Diabetes, get checked for sex problems.
                                    If you have sex problems, get checked for Diabetes.

42. Why & how does Diabetes cause sex problems?

  • Diabetes causes damage to the walls of the blood vessels, which affects circulation and blood flow to the penis.
  • It causes nerve damage that affects the quality of erection.
  • In addition, urological complications of Diabetes may also lead to sexual problems e.g. Urinary tract infections and bladder problems.

43. Does Heart disease mean end of road to sex?

  • Heart attack or a heart surgery at any age & stage is a mental trauma, not accepted well. To most people, a heart attack or a heart surgery means, the end of road to sex.
  • While many heart patients are physically capable of resuming sexual activities including the intercourse, they are unable to sexually perform because of emotional & psychological barriers.
  • If you can climb 2 flights of stairs, without getting too breathless, you can perform normal/near normal sexual activities even if you suffer from heart disease.

44. Is it true that Impotence is a warning of the future heart attack?

Yes, it is true. The vascular cause of Heart attack & the Impotence (ED) is exactly the same i.e. diminution of blood supply as a result of damage to the inner wall (endothelium) of arteries. Since, heart arteries are bigger in diameter than Penile, one should be on guard for Heart attack if he develops ED. It is seen that a person may get heart attack 1.5 – 2 yrs after developing ED.

Size of Arteries of Penis, Heart, Neck & legs; and the diseases caused by obstruction in them are enumerated below.

Artery Size (mm) Diseases caused
Penile 1-2 Impotence
Coronary 3-4 Heart Attack
Carotid (neck) 5-7 TIA/Stroke
Femoral (legs) 6-8 Claudication


"The recognition of ED as a warning sign of silent vascular disease has led to the concept that a man with ED and no cardiac symptoms, is a Heart (or vascular) patient until proven otherwise."

SOURCE- Princeton II: Jackson G et al. 2006. J Sex Med 3:28-36
  • Diabetes causes damage to the walls of the blood vessels, which affects circulation and blood flow to the penis.
  • It causes nerve damage that affects the quality of erection.
  • In addition, urological complications of Diabetes may also lead to sexual problems e.g. Urinary tract infections and bladder problems.

45. What are the effects of Heart diseases on Sex?

In Men
  • Decreased sexual desire.
  • Difficulty achieving or maintaining an erection (Impotence). (This may come as the 1st warning of future heart attack).
  • Occasionally rapid or premature ejaculation.
  • Fear of rejection.
  • Feelings of inadequacy.


In Women
  • Decreased sexual desire.
  • Decreased sexual arousal (swelling/wetting response).
  • Difficulty in achieving orgasm (Anorgasmia).
  • Sexual pain (Disparunia).
  • Feelings of inadequacy.
So

If heart disease, get checked for sex problems.
                                                    If sex problem, get checked for heart diseases.

46. Are all sexual disorders curable?

  • Most are. Since mind-set & psyche plays a major role in sex, these disorders are highly amenable to Counseling. The results are excellent if Counseling is combined with the regular treatment.
  • Sophisticated investigations like Penile Doppler besides the semen analysis, the hormonal assays, the USG & other radiological tests etc., have made the diagnosis highly accurate.
  • The time tested techniques like Sensate focus exercises, Masters & Johnson’s Techniques, Eros Therapy (for women) etc ensure a good outcome. With a wide variety of available drugs & modalities like Testosterone, Sildenafil, Verdanafil, Tadalafil, Yohimbine, SSRIs, Dopexitine, Clomipramine; various sprays; penile injections; vacuum devices; sexual enhancers, surgeries (penile implantation, vascularisation etc), the cure is almost assured in the right hands.


  • ALL SEX PROBLEMS ARE TREATABLE IF NOT CURABLE