Logic would suggest that women with low sexual desire do not acquire sexually transmitted infections. However, this may not be the case. Until recently, it has been considered that sexual activity in women is initiated by desire, which produces arousal. This leads to orgasm and resolution.1, 2 In practice, sexual desire and arousal are not isolated psychological and physiological states but interdigitate and feed back on each other. In a new relationship a woman’s sexual desire is often spontaneous.3 In effect this means that thoughts of her partner or seeing him are sufficient to produce an urge to want sexual relations to take place. This produces both mental excitement and bodily arousal (for example, vaginal lubrication, uterine “tenting,” breast enlargement). These sensations (arousal) feed back to produce a greater desire for intercourse. However, it is also well recognised that women are less attentive to genital sensations than men, and indeed may lubricate and vasocongest in the vulva and vagina in the absence of mental sexual excitement.
The DSM IV definition of low sexual desire, or to be more precise, hypoactive sexual desire disorder is “persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity. The judgement of the deficiencies or absence is made by the clinician, taking into account factors that affect sexual function, such as age and context of the person’s life. The disturbance causes distress and interpersonal difficulty and is not accounted for by another axis I diagnosis.”4
In 1992 Laumann and colleagues in the United States conducted a large non-biased survey of sexual norms in men and women between the ages of 18 and 59.5 They also asked a number of simple questions relating to sexual dysfunction which the probands answered in dichotomous fashion. In all, 1749 women took part in the study. They responded in the affirmative if they had had such a problem “for one or more months over the previous year.” The commonest problem was low sexual desire in women, which affected 31% of those surveyed. Sixty four per cent of these women with low desire were under 39 years of age. There was a positive correlation between low sexual desire and ever having had an STI (OR 1.44 (1.02–2.03) (p ≤0.05).
In our genitourinary medicine unit a recent survey suggested that 20 out of 100 consecutively seen women were sexually dysfunctional. Seven of them complained of low sexual desire over the past year.6 All of these women were in long term relationships (≥9 months), and five of the seven were diagnosed with an STI (genital herpes (one), pelvic inflammatory disease (one), trichomoniasis (one), cervicitis (one), genital warts (one)). The remaining two were appropriately concerned that they might have picked up an STI from their partner, although in fact none was found. Six of the seven women had only had sex with their long term partners, whereas one, in spite of complaining of low sexual desire for her regular partner, had had casual sex with another man in the recent past. These data might suggest that some women with low sexual desire do not want intercourse but agree to have sex with the regular partner (they didn’t admit to sexual assault). It is possible that male partners of such woman need a sexual outlet outside the relationship, and that a sexually transmitted infection is later acquired by the women with low sexual desire. An alternative hypothesis is that the STI acquisition leads to low sexual desire (for example, the psychological effect of acquiring genital herpes).
How can these women with low sexual desire be helped? Initially they need to be screened for physical and psychological illness, and inquiries made of the current relationship to exclude interpersonal conflicts. However, it is likely that a large proportion of women with low sexual desire in long term relationships don’t fall into any of the above categories. Both Leiblum7 and Teifer8 feel that traditional notions of female sexual desire (for example, spontaneous fantasies) ignore many major components of women’s sexual satisfaction that lead to desire—trust, intimacy, ability to be vulnerable, non-sexual touching, communication, and affection.
Rosemary Basson3 has recently redefined low sexual desire in women and has pointed out that in long term relationships women may neither have spontaneous sexual desire, nor respond mentally to genital stimulation (although they may make a genital response). These women in long term relationships have sexual desire that is responsive to emotional closeness. As she puts it “the rewards of emotional closeness—the increased commitment, bonding and tolerance of imperfections in the relationship—together with an appreciation of the subsequent wellbeing of the partner all serve as motivational factors that all activate the (desire/arousal) cycle next time.” Basson’s new definition of hypoactive sexual desire disorder would be “ . . . the persistent or recurrent deficiency (or absence) of sexual fantasies, thoughts, desire for sexual activity (alone or with a partner) and inability to respond to sexual cues that would be expected to trigger responsive sexual desire. The symptoms need to be causing personal distress.” In other words, women who have responsive sexual desire are not perceived as abnormal. This often comes as a revelation and relief to these woman and their partners.
In the United Kingdom many genitourinary medicine clinics now offer a service for patients with sexual dysfunction.9 Many women with classic sexual desire problems as well as the normal but variant responsive sexual desire patients can be helped. By doing so, STI acquisition in these patients might be prevented, although this hypothesis needs to be tested in rigorous fashion. A necessary prerequisite is government acceptance that sexual dysfunction is as much part of sexual health as STI prevention, treatment, and family planning. This would enable sexual function clinics to be properly financed and managed. Women with sexual desire problems are distressed and may have a poor quality of life, as has been shown for men with erectile dysfunction.10–12 They deserve a sympathetic hearing and optimal treatment.
- ↵ Masters WH, Johnson VE. Human sexual response. Boston. Little Brown, 1966.
- ↵ Kaplan HS. Hypoactive sexual desire. J Sex Marital Therapy 1979;3:3–9.
- ↵ Basson R. The female sexual response: a different model. J Sex Marital Therapy 2000;26:51–65.
- ↵ American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington DC: APA, 1994.
- ↵ Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States. Prevalence and predictions. JAMA 1999;281:537–44.
- ↵ Goldmeier D, Judd A, Schroeder K. Prevalence of sexual dysfunction in new partner sexual attenders at a central London genitourinary medicine clinic in 1998. Sex Transm Inf 2000;76:208–9.
- ↵ Leiblum SR. Definition and classification of female sexual disorders. Int J Impotence Research 1998;10:S102–6.
- ↵ Teifer L. Historical, scientific and feminist criticisms of the “human sexual response cycle.” Annu Rev Sex Res 1991;2:1–23.
- ↵ Keane FEA, Carter P, Goldmeier D, et al. The provision of psychosexual services by genitourinary medicine physicians in the United Kingdom. Int J STD AIDS 1997;8:402–4.
- ↵ Aroujo AB, Durante R, Feldman HA, et al. The relationship between depressive symptoms and male erectile dysfunction; cross sectional results from the Massachusetts male aging study. Psychosom Med 1998;60:458–65.
- Shabsigh R, Klein LT, Seidman S, et al. Increased incidence of depressive symptoms in men with erectile dysfunction. Urology 1998;52:848–52.
- ↵ Litwin Ms, Nied RJ, Dhanani N. Health related quality of life in men with erectile dysfunction. J Gen Intern Med 1998;13:159–66.
- Can Chlamydia Cause Erectile Dysfunction?
- Taking drugs for hair loss or an enlarged prostate
- Gum Disease
- Your Wife Befriending Your Buddies
- High Blood Pressure
- 8 Surprising causes of erectile dysfunction
- Erectile dysfunction (impotence)
- Psychological treatments
- Pelvic floor muscle exercises
- Complementary therapies
- Erectile Dysfunction (ED)
Can Chlamydia Cause Erectile Dysfunction?
Term and Conditions
Chlamydia affects around 2 million Americans every year – so if you think it’s not a common diseases, you might be wrong. It’s a sexually transmitted disease (STD) which affects millions of men and women around world. While it is a curable medical condition, it often goes undiagnosed as its symptoms do not appear in its early stage. If chlamydia is left untreated, it can cause serious, life-threatening health issues.
BUT CAN CHLAMYDIA CAUSE ERECTILE DYSFUNCTION? LET’S FIND OUT. BUT BEFORE THAT, LET’S MAKE SURE YOU UNDERSTAND WHAT THIS THING IS.
As the name suggests, it is difficulty or inability to keep your penis erect at all or not get an erection hard enough to enjoy sexual intercourse. It is also seen as a sign of impotence. But just because you can’t get it up occasionally doesn’t mean you are impotent – it’s a very common thing. Many factors such as stress, fatigue or lack of sexual stimulation can cause erectile dysfunction.
In most cases, you don’t even need treatment – all you need to do is relax. But if your erectile dysfunction is caused by a STD, you may need to see a doctor and start a treatment to cure the underlying medical condition as soon as possible.
YES. CHLAMYDIA CAN CAUSE ERECTILE DYSFUNCTION.
Yes, Chlamydia can cause erectile dysfunction. But, it is important to understand that it doesn’t directly affect your erections – the erectile dysfunction is a result of the disease infecting your prostate. It is actually prostatitis which causes ED.
As stated earlier, you could have chlamydia for weeks without noticing any major symptoms. Like most sexually transmitted diseases, when the symptoms finally appear, they are quite obvious. Here are some of things that can help you diagnose chlamydia at early stages and prevent getting erectile dysfunction due to it:
- Burning or pain while peeing
- Swollen or painful testicles
- Weird, unusual discharge from the penis
If you notice any of these symptoms, rush to your doctor. By getting treatment for chlamydia, you can avoid erectile dysfunction. Even better, by practicing safe sex practices you can protect yourself from all types of sexually transmitted diseases and enjoy a pleasurable, safe sexual life. With the help of safe sex kits, you can make your sex life safer and far more enjoyable.
As many 30 million men in the United States experience erectile dysfunction (ED) the inability to get or maintain an erection firm enough for intercourse.
Age may be the most common denominator of men with ED. About four percent of men in their 50s experience erectile dysfunction, while nearly half of men older than 75 do, according to the National Institutes of Health.
Here are seven other surprising factors that may raise your risk of developing ED.
Taking drugs for hair loss or an enlarged prostate
(Image credit: Neil Gould | Stock Xchng)
Medications, such as finasteride (known by its brand names Propecia and Proscar) and dutasteride (Avodart), used to treat male pattern hair loss and enlarged prostate may produce side effects such as erectile dysfunction and loss of libido in some men, according to a January study in the Journal of Sexual Medicine.
“These drugs work by reducing the amount of dihydrotestosterone circulating in the blood,” said Dr. Andrew Kramer, a surgeon and ED expert at the University of Maryland Medical Center. Dihydrotestosterone is the male sex hormone that helps maintain sex drive.
While the drugs may help with hair loss and alleviate urinary tract symptoms due to an enlarged prostate, the hormonal changes can also lead to the inability to get an erection.
(Image credit: Dreamstime)
What do the gums and the penis have in common? Having periodontitis chronically inflamed and infected gums may increase your risk of erectile dysfunction, according to a study published in June in the Journal of Sexual Medicine. The study, performed in mice, suggests , but the connection in humans and the mechanism by which periodontitis may lead to ED is still unclear.
Gum disease is an indicator of overall poor health, and has been linked to an increased risk of heart disease, another risk factor for erectile dysfunction, the researchers said.
“Gum disease may result from an underlying problem with blood flow in the gums. It’s possible that someone with it also experiences problems with blood flow in other parts of the body such as the penis, as well,” said Dr. Bruce Kava, acting chairman of urology at the University of Miami Miller School of Medicine.
Your Wife Befriending Your Buddies
(Image credit: Dreamstime)
It’s well-known that psychological factors can play a major role in sexual performance, but here’s a new one: your wife spending more time with your male friends than you do may put you at increased risk for erectile dysfunction, according to new research in the American Journal of Sociology.
The researchers, who surveyed more than 3,000 men ages 57 to 85, found that a man whose female partner got too close to his friends was 92 percent more likely to experience difficulty getting or maintaining an erection than one whose partner didn’t.
Researchers said this might be due to social perceptions of masculinity in younger and middle-aged men. In men in their 70s and 80s, the association all but disappeared, possibly because older men have different perceptions of masculinity.
(Image credit: Kirill Kleykov | Dreamstime)
The Scythians, who were iron-age Iranian horsemen, identified a link between horseback riding and impotence in the 9th century B.C.
And it turns out that a similar modern-day activity, long-distance bicycling, may also increase your risk of erectile dysfunction. A 2005 review article published in the Journal of Sexual Medicine found that 4 percent of male bicyclists who spent at least three hours per week in the saddle experienced moderate to severe erectile dysfunction, while only about 1 percent of runners who were the same age experienced ED.
When you sit on a bike seat, you bear weight on the nerves and arteries that carry blood to the penis. “Over time, these vessels can become damaged, resulting in decreased blood flow to the penis and risk of ED,” Kava said.
(Image credit: Jim Delillo | Dreamstime)
Men who have diabetes are two to three times more likely to also have erectile dysfunction than men without diabetes, according to the National Institutes of Health.
Poorly regulated blood sugar can damage the nerves and small blood vessels that control erections and allow blood flow to the penis, Kramer said.
High Blood Pressure
(Image credit: Michael Gray | Dreamstime)
Healthy blood vessels and sufficient blood flow are essential to getting and keeping an erection. Uncontrolled hypertension damages blood vessels in the body, making them less elastic and less able to transport blood the same volume of blood quickly.
But some medications used to treat high blood pressure, such as beta blockers and diuretics, can also increase your risk of erectile dysfunction. While no one should stop taking blood pressure medicine without speaking to their doctor, making lifestyle changes, such as maintaining a healthy diet and getting more exercise may help lower your blood pressure so you don’t need the drugs, Kramer said.
(Image credit: stockxpert)
As many as 61 percent of people with severe depression may experience sexual problems, according to the Cleveland Clinic Foundation. Depression may do more than just lessen your interest in sex.
“There’s a biochemical component to depression that may make it difficult to get and keep an erection,” Kava said. Chemicals help brain cells communicate to stimulate blood flow to the penis. And not being able to participate in and enjoy sex can worsen depression symptoms, Kramer said.
Some antidepressants, namely selective serotonin reuptake inhibitors (SSRIs ) can cause sexual problems too nearly half of all men and women on SSRIs may experience sexual dysfunction, according to the National Institute of Mental Health. In men, this can mean having erectile dysfunction, loss of libido and delayed ejaculation.
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Erectile dysfunction (ED) is highly prevalent among men with newly diagnosed inflammatory bowel disease (IBD), according to a recent prospective incidence cohort study.
Eugenia Shmidt, MD, of the University of Minnesota in Minneapolis, and colleagues studied 69 men with IBD who completed the International Index of Erectile Function (IIEF), which measures 5 dimensions of sexual function over the most recent 4 weeks. The group included 41 men with Crohn’s diseases and 28 with ulcerative colitis. The cohort had a mean age at diagnosis of 43.4 years. The men had a minimum follow-up of 2 years.
At baseline, 39% of men had global sexual dysfunction and 94% had ED, Dr Shmidt’s team reported in Inflammatory Bowel Disease. Over the 2-year course of the study, the investigators observed no significant change in mean IIEF score, despite improvement in disease activity and quality of life measures. Older age and lower physical and mental component summary scores on the Short Form Health Survey (SF-36) were independently associated with ED.
“Clinicians should be aware of the high prevalence and risk factors of sexual dysfunction in men with IBD,” the investigators concluded. “We recommend screening for sexual dysfunction in male patients with IBD and considering referral for treatment using pharmacotherapy and behavioral techniques when appropriate.”
The study is the first to examine sexual function in men with newly diagnosed IBD, according to the authors. Another strength of the study was its prospective, longitudinal design. In a discussion of study limitations, Dr Shmidt’s team noted that about one third of patients in their cohort did not have sufficient data for analysis. Although they found no difference in demographics or disease activity scores between completers and noncompleters of the IIEF questionnaires, the study still may be susceptible to response bias, the investigators stated.
Shmidt E, Suárez-Fariñas M, Mallette M, et al. Erectile dysfunction is highly prevalent in men with newly diagnosed inflammatory bowel disease. Inflamm Bowel Dis. 2019; published online ahead of print.
8 Surprising causes of erectile dysfunction
Erectile dysfunction, also known as impotence, is defined as not being able to get or keep an erection firm enough for sex. Remember, occasional erectile dysfunction is not uncommon, but if it’s persistent, erectile dysfunction can be the sign of a more serious health issue, and so you should visit your doctor.
Here are 8 surprising causes of erectile dysfunction:
- High cholesterol. Having a raised cholesterol increases the risk of atherosclerosis where the arteries become narrowed and clogged, resulting in impaired blood flow. When this happens to the arteries in the penis, it can prevent enough blood to create an erection from reaching the penis.
- Depression. This can cause a lack of interest in sex. See your doctor if this happens to you.
- Smoking. Smoking causes damage to blood vessels, including those that supply the penis which can result in difficulty in achieving an erection.
- Cycling. Long hours in the saddle without changing position can cause compression of the perineal nerves and blood vessels, resulting in nerve damage which causes erectile dysfunction. Some saddles are worse than others. If cycling is causing you symptoms of tingling or numbness in your penis, adjust your riding position and take a break. You might want to look at a different saddle, too. Rodeo riding can have the same effect.
- Medicines. Erectile dysfunction can be a side-effect of many medicines, including some antipsychotics and antidepressants, cholesterol-lowering medicines, high blood pressure medicines, and epilepsy medicines.
- Stress. Feelings of stress and anxiety can overflow onto your sex life, and you may find you can’t perform as well as you normally could. ‘Performance anxiety’ is a common cause of erectile problems.
- Diabetes. Diabetes raises the risk of erectile dysfunction threefold by its effects on nerves and blood vessels.
- Peyronie’s disease. This disease causes curvature of the penis due to a hardened area of scar tissue, which results in pain when the man has an erection.
If you suffer from erectile dysfunction, don’t be embarrassed – it affects one in 5 men over 40. Remember your doctor can help identify the cause of your erectile dysfunction, and put you on the path to successful treatment. Read erectile dysfunction – visiting your doctor to find out what to expect when you visit your doctor.
Erectile dysfunction (impotence)
Hormones are chemicals produced by the body. Many hormonal conditions can be treated using injections of synthetic (man-made) hormones to restore normal hormone levels.
Surgery for erectile dysfunction is usually only recommended if all other treatment methods have failed. It may also be considered in:
- younger men who have experienced serious injury to their pelvic area – for example, in a car accident
- men with a significant anatomical problem with their penis
In the past, surgery was used if there was clear evidence of a blockage to the blood supply of the penis. The surgeon could unblock the blood vessels to restore a normal supply of blood. However, research now suggests that the long-term results of this type of surgery are poor, so it’s unlikely to be used.
Penile implants are a type of surgery that may be considered. These can be:
- semi-rigid implants – which may be suitable for older men who do not have sex regularly
- inflatable implants – which consist of two or three parts that can be inflated to give a more natural erection
Penile implants are not usually available on the NHS and inflatable implants may be very expensive. However, around three-quarters of men report being satisfied with the results of this type of surgery.
As with all types of surgery, having penile implants inserted carries a risk of infection. If you take preventative antibiotics, the rate of infection is around two or three in 100. Mechanical problems with the implants may occur within five years in five per cent of cases.
If your erectile dysfunction has an underlying psychological cause then you may benefit from a type of treatment called sensate focus.
If conditions such as anxiety or depression are causing your erectile dysfunction, you may benefit from counselling (a talking therapy).
Sensate focus is a type of sex therapy that you and your partner complete together. It starts with you both agreeing not to have sex for a number of weeks or months. During this time, you can still touch each other, but not in the genital area (or a woman’s breasts). The idea is to explore your bodies knowing that you will not have sex.
After the agreed period of time has passed, you can gradually begin touching each other’s genital areas. You can also begin to use your mouth to touch your partner, for example, licking or kissing, them. This can build up to include penetrative sex.
You can find out more about sensate focus from the College of Sexual and Relationship Therapists (COSRT).
Psychosexual counselling is a form of relationship therapy where you and your partner can discuss any sexual or emotional issues that may be contributing to your erectile dysfunction. By talking about the issues, you may be able to reduce any anxiety that you have and overcome your erectile dysfunction.
The counsellor can also provide you with some practical advice about sex, such as how to make effective use of other treatments for erectile dysfunction to improve your sex life.
Psychosexual counselling may take time to work and the results achieved have been mixed.
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT) is another form of counselling that may be useful if you have erectile dysfunction. CBT is based on the principle that the way you feel is partly dependent on the way you think about things. CBT helps you realise that your problems are often created by your mindset. It is not the situation itself that is making you unhappy, but how you think about it and react to it.
Your CBT therapist can help you to identify any unhelpful or unrealistic thoughts that may be contributing to your erectile dysfunction – for example, to do with:
- your self-esteem (the way you feel about yourself)
- your sexuality
- your personal relationships
Your CBT therapist will be able to help you to adopt more realistic and helpful thoughts about these issues.
Pelvic floor muscle exercises
Some studies have suggested that, in a few cases, it may be beneficial to exercise your pelvic floor muscles. These are a group of muscles around the underside of the bladder and rectum, as well as at the base of the penis.
Pelvic floor muscle exercise involves strengthening and training the muscles used to control the anus (back passage) and urinate. If your GP feels this type of exercise could be beneficial, then you may want to discuss it with a physiotherapist to learn it correctly.
By strengthening and training these muscles, you may be able to reduce the symptoms of erectile dysfunction.
Some complementary therapies, such as acupuncture, have claimed to treat erectile dysfunction. However, there is little evidence they are useful.
In some cases, they may even include ingredients that could interact with other medications and cause side effects.
Always speak to your GP before using any complementary therapies.
Erectile Dysfunction (ED)
Not everyone can use these medicines. Your doctor may talk to you about alprostadil if oral medicines aren’t an option for you. Alprostadil is a synthetic version of prostaglandin E. It can be injected into the penis or inserted as a tiny suppository into the urethra (the hole at the end of the penis). Your doctor will help you decide which treatment is best for you.
How should I take ED medications?
Follow your doctor’s instructions. Usually, a man takes 1 tablet 30 minutes to 1 hour before he plans to have sex. Sildenafil works for 4-8 hours; vardenafil works for up to 8 hours; and tadalafil works for up to 36 hours.
You should not take more than 1 dose in 24 hours. Tadalfil and vardenafil come in tablets of 2.5 mg, 5 mg, 10 mg and 20 mg. Sildenafil comes in tablets of 25 mg, 50 mg and 100 mg.
Even if you take the medications, you still need physical and mental stimulation and desire to have an erection. If your first dose doesn’t help, call your doctor. Your doctor may want to change your tablet strength.
What are the side effects?
The side effects of ED medications are mostly the same. Sildenafil and vardenafil can cause these side effects:
- flushing (face and upper body turning red and warm)
- stomach upset
- runny nose (sniffles)
- vision changes (things look blue).
Tadalfil has the same side effects, except for the flushing and possible changes in vision. Instead, it can also cause back pain and muscle aches. For each of the medications, headache is the most common side effect. Vision changes are the least common. Talk to your doctor if you have any side effect that bothers you.
Call your doctor right away if you take one of these medications and have a prolonged erection that lasts 4 hours or longer. This condition may cause permanent impotence if not treated.
Can everyone use ED medications?
No. You shouldn’t use these medicines if you take nitroglycerin or any other nitrates for chest pain. If you have heart problems, tell your doctor before taking any ED medicines. These medicines can have serious side effects in people who have heart problems.
If you use sildenafil, tadalfil, or vardenafil and get chest pains, be sure to tell the paramedics, nurses or doctors at the hospital that you use it and when you used it last.