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Reclaiming Desire

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When health problems sabotage your sex life

We all know that depression and the hormonal shifts of aging can lead libido to take a nosedive, but other, less-known health issues also can cause difficulties with sex drive and/or arousal. If you’re having problems in bed, consider the conditions below and discuss your situation with your doctor.

BLAME IT ON BLOOD FLOW

A flagging libido, limited arousal and trouble reaching orgasm often have the same root cause — reduced blood flow to genitals. Any health problem that interferes with blood flow throughout the body can impede genital blood flow. Culprits…

High cholesterol. Cholesterol is a fatlike substance that contributes to plaque formation in the arteries. As arteries become clogged and narrowed, blood flow is restricted. Total cholesterol above 200 milligrams per deciliter (mg/dL) can contribute to arousal problems.

Medication concern: No studies have shown that cholesterol-lowering statin drugs cause sexual dysfunction in women, but we do know that statins can lower men’s levels of testosterone, a hormone that strongly influences sex drive. Statins may have a similar effect in women (who also produce testosterone, though at lower levels than men do).

What helps: Regular exercise and a low-fat diet that includes cholesterol-lowering foods, such as ground flaxseeds, walnuts, and most fruits and vegetables. Also, talk to your doctor about cholesterol-lowering supplements, such as niacin, red yeast rice extract and/or fish oil.

Diabetes. The hormone insulin allows blood sugar (glucose) to move from the blood into the muscles and other cells for use as fuel. Type 1 diabetes occurs when the body does not produce enough insulin. Type 2 diabetes develops when cells cannot use insulin properly — often due to excess weight, a high-sugar diet and/or lack of exercise. One consequence of either type of diabetes is reduced blood flow, because blood vessels narrow and harden. Also, a condition called diabetic neuropathy, in which there is damage to nerves, can contribute to sexual dysfunction.

Note: A prediabetes condition called insulin resistance also can interfere with blood flow.

What helps: Catch the problem early, and sexual responsiveness will return — but if the condition progresses very far, sexual dysfunction may be irreversible. From age 45 onward, have your doctor give you an oral glucose-tolerance test every three years to screen for diabetes. To reduce your risk for diabetes or to keep it from worsening, stabilize blood glucose levels by adopting a low-sugar diet, losing excess weight and exercising regularly.

Hypertension. Blood pressure is the force of the blood pushing against the walls of the arteries whenever the heart beats.  Hypertension, or high blood pressure, means that the heart has to work harder, the arteries harden and blood flow is impaired. Blood pressure above 120/80 is cause for concern.

Medication concern: Hypertension drugs themselves can contribute to an inability to reach orgasm because they reduce blood pressure overall, including blood supply to the genitals. Beta-blockers and diuretics are more likely to cause sexual dysfunction than other drugs. If you need medication, work with your doctor to find one with a minimum of side effects.

What helps: For some people, a low-salt diet can lower blood pressure, so keep sodium intake below 1,500 mg per day. When possible, avoid over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), which can increase blood pressure. Talk to your doctor about natural supplements that can lower blood pressure, such as magnesium and coenzyme Q10 (CoQ10). Supplementing with the amino acid L-arginine can help, but it is not advisable for anyone with a history of heart attack.

Smoking. Obviously, smoking cigarettes is not a disease (although it can lead to a plethora of health problems) — but it is a primary cause of sexual dysfunction in both women and men. Smoking delivers a double whammy to blood flow — the toxins damage the smooth inner lining of blood vessels… and nicotine triggers the release of fats into the blood, which then stick to artery walls.

What helps: Easier said than done — stop smoking!

New approach: Women typically have a harder time giving up cigarettes than men do. However, a study from the University of Chicago found that smoking-cessation rates among women rose by almost 50% when nicotine patches or nasal sprays and behavioral therapy were used in combination with the oral medication naltrexone (Vivitrol), which blocks nicotine’s pleasurable chemical signals to the brain.

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Source: Barbara Bartlik, MD, assistant professor of psychiatry at New York Presbyterian Hospital/Weill Cornell Medical College in New York City and a member of the Bottom Line/Women’s Health advisory board. She is the medical advisor for the book Extraordinary Togetherness: A Woman’s Guide to Love, Sex and Intimacy (Rodale). A sex therapist for 22 years, Dr. Bartlik has treated more than 1,000 patients. Date: September 1, 2007 Publication: Bottom Line Health
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