Natural Aphrodisiacs

The Aphrodisiac Secret

Sometimes as you start to get over 35 as a woman, your sexual appetite can go down a lot. That is a bit of a sad thing, as you want to continue to love sex and that connection to your partner, but you just don't feel it anymore. However, this ebook shows that there are ways that you can bring your sex drive back up. Many times however, those methods are through dangerous chemicals or injections, and can have harmful side effects to your body. However, there IS a super fruit that can actually change ALL of this, and give you back the sex drive and the general good outlook on life that you have missed. These fruits are outlined in this guide, as well as how to prepare and serve them so that they taste their very best. All of these fruits are sure to bring back your sense of sex drive and get you feeling better than ever before. Continue reading...

The Aphrodisiac Secret Overview


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Hypoactive Sexual Desire Disorder

For women, low sexual drive is the most frequently reported sexual problem. Four in 10 women state they have low sexual drive. The lack of sexual desire may not be distressing for all women, with distress prevalence ranging in studies from 23 to 61 (Lindau et al., 2007 Shifren et al., 2008). Hypoactive sexual desire disorder (HSDD) may be general (a general lack of sexual desire), situational (previously present sexual desire is now absent), acquired (beginning after a period of normal sexual function), or lifelong (persistent no or low sexual desire). The cyclic model of sexual functioning postulates that arousal, not desire, may be the initial trigger for a woman's sexual encounter. Recently, therefore, experts suggest defining HSDD as a recurrent, consistent lack of ability to experience any desire or arousal (Basson et al., 2004). A brief questionnaire can be helpful to screen patients for HSDD (see eTable 43-1 online). Female sexual desire is a complex interaction among biologic,...

What happens if my sex drive libido is low What causes it can it be treated

Your interest in sex is governed by sex hormones, primarily testosterone, and by psychosocial factors. Low testosterone levels are associated with decreased libido. Stress, depression, or anxiety may also affect your libido. In men with erectile dysfunction, interest in sex may be diminished as a result of their inability to achieve an adequate erection. Any man with decreased libido should have his serum testosterone level checked. Normally, there is a feedback If you have decreased libido and your testosterone level is low then you may benefit from testosterone replacement therapy (see Question 76). Men with prostate cancer on LHRH agonist hormonal therapy will have a low testosterone level and may suffer from associated low libido. In these men, testosterone replacement therapy is con-traindicated, and there would need to be a conscious effort to think about sex. Similarly, individuals who are stressed or depressed may experience low libido, and if their testosterone level is...

Urine Formation In A Nephron

Puberty is the period during which sexual characteristics develop and sexual organs mature. In boys, puberty usually begins between the ages of about 12 and 15 and lasts for 3-4 years. The pituitary gland, at the base of the brain, starts to secrete hormones that stimulate the testes to produce the male sex hormone testosterone. This hormone stimulates changes such as enlargement of the genitals and the growth of body hair, and, later, sperm production and increased sex drive.

Conflict Between Different Motivational Systems

A prominent example of a conflict between different motivational systems in the psychoanalytic context is one between what Freud (1912) referred to as love and desire which he also referred to as the affectionate and sensual currents). Freud attributed the conflict between love and desire to the persistence of incestuous wishes so that the person one loves cannot also be the object of sexual desire. As Freud 1912 put it, W herc they love, they cannot desire and where they desire, they cannot love (p. 183). One consequence of this conflict, Freud observed is psychical impotence in men, sexual frigidity in women, and in both a failure to experience pleasure from the sexual act.

Inhibition of Gonadotropin Releasing Hormone GnRH

Numerous approaches to blocking the activity of Gn-RH, which is the key controlling hormone produced by the hypothalamic portion of the brain that ultimately leads to production of testosterone by the testes, have been examined for nearly two decades. While sperm production has been decreased, the undesirable side effects of decreased testosterone leading to decreased libido, loss of muscle mass, and alterations of male sexual characteristics have been highly problematic. Replacement testosterone has been the only solution to date of overcoming these negative effects.

Influence of testosterone on sexual behaviour in men

There is only limited evidence on the effects of testosterone administration to eugonadal men with or without sexual problems. In a controlled study of eugo-nadal men with diminished sexual desire O'Carroll and Bancroft (1984) produced a significant increase in sexual interest with injections of testosterone esters when compared to placebo injections. But in most of the men studied the increase in sexual interest was not translated into an improvement of their sexual relationship -perhaps because psychological problems with their partner had not been resolved with hormonal treatment only. When supraphysiological doses of testosterone used as potential hormonal male contraceptive agents were administered to healthy volunteers, this resulted in a significant increase in psychosexual stimulation or arousal during testosterone substitution, although there was no change in sexual activity or spontaneous erections (Anderson etal. 1992 Bagatell etal. 1994 Su etal. 1993).

Sexual Urges Regrets and Remedies

The AVP intensifies male sexual arousal partly by promoting sexual persistence in animals this is evident in sustained territorial marking behavior and elevations of sex-related aggression. In humans, plasma AVP levels surge during sexual arousal but decline sharply at orgasm (Murphy et al., 1990). Whether new drugs that can facilitate AVP activity in the brain might promote sexual desire remains a poorly developed line of inquiry that may have interesting therapeutic implications, as might AVP antagonists in the control of sexual aggression and jealousy (see Chapter 21). during pleasurable skin contact. However, these important neuropsychological events are surely not left to a single chemistry, for many neurochemicals, including opi-oids, contribute to the pleasure of sex as well as many other rewards (Van Ree et al., 2000). Another key player is the luteinizing hormone-releasing hormone, which can selectively increase female libido. Whether such manipulations could be deployed to...

Influence of testosterone on sexual behaviour in women

The positive relationship between testosterone and various measures of sexual interest and behaviour is intriguing on the other hand, most studies failed to provide evidence of a peak of sexual behaviour at the time of the midcycle peak in testosterone. However, this is no argument against any testosterone-sexuality relationship in females, as an increase in testosterone does not have to produce an immediate behavioural response. For instance, the latency between androgen administration and increases in sexual desire in hypogonadal men ranges from days to several weeks. Although there is converging evidence from these correlational and experimental investigations that testosterone enhances male and female sexual behaviour, such as sexual desire or sexual phantasies, the underlying behavioural mechanism is not fully understood. Testosterone might have direct effects on cognitive behaviour, e.g., influence the awareness of sexual cues (Alexander and Sherwin 1993), or may act...

Background The Ancient Indian Texts The Ayurvedic Texts

Ayurveda deals with life (human and animal) in all its aspects including hygiene, ethics, medical education, and rules of behavior. Dietetics, geographic pathology, and even the philosophical basis of existence are also treated. Both the Sushruta and the Caraka divide medicine into eight broad areas (1) Surgery (Salya) (2) Diseases of the Ear, Nose, Throat, and Eye (Salakya) (3) Internal Medicine (Kayachikitsa) (4) Mental Diseases (Bhutavidya) (5) Pediatrics Including Pregnancy and Its Complications (Kaumara-bhrtya) (6) Chemicals Used in Treatment (Rasa-yana) (7) Rejuvenation and (8) Aphrodisiacs (Vajikarana). The Astangahrdaya also mentions eight divisions of the Ayurveda, which are similar but not identical to the previous sections.

Bone density in men with disorders of androgen action

A clinical model of androgen effects on bone tissue is represented by the cohort of men undergoing therapeutic orchiectomy for the treatment of prostate cancer or sexual delinquency. In 12 men of the latter group, bone mineral density of the lumbar spine decreased after bilateral orchiectomy (Stepan etal. 1989). Corresponding effects were seen in men treated with surgical or chemical castration for prostate cancer as a consequence, osteoporotic fractures were significantly increased in comparison to controls (14 vs. 1 ) (Daniell 1997 2000). This has been recently confirmed by a study involving 429 men who underwent bilateral orchiectomy for treatment of prostate cancer. Fractures were ascertained from medical records and compared with expected numbers based on local incidence rates this demonstrated a three-fold increase of fractures accounted for by moderate trauma of the hip, spine and distal forearm, locations traditionally linked with osteoporosis (Melton etal. 2003). The...

New Narrative of Sexuality

As clinical practice attests, patients have sexual problems (Green 19961, but the paths to and outcomes of sexual development are multiple, not unitary (Breen 1993). Desire itself is, to put it in different language, idiomatic. What Bollas (1989) wrote ol the personal idiom altogether must hold true for sexual desire in particular a set of unique person possibilities specific to this individual and subject in its articulation to the nature of lived experience in the actual world p. 9J. These possibilities may include heterosexual object choice as a solution to the conflicts of the oedipal and pre-oedipal passages. However, they may also include sadomasochism and other practices formerly dubbed perversions as adaptive solutions to disorders of self The oedipal narrative, as classically told, is useful but is, after all, a story and only one, at that of how a person becomes heterosexual, not only of how that person becomes sexually and psychically mature. According to recent...

Nutrients to Neutralize Mucus

You've spent all this time clearing your lungs of mounds of mucus. Now you need to practice avoiding sugary foods or dairy products that often gunk them up again. Even something as simple as drinking too much fruit juice translates into ingesting sugar (fructose). Try supplementing with vitamin C, which cuts the mucus without the sugar, and coenzyme Q10, which helps get rid of toxins. Black radish, mullein, chick-weed, fenugreek, and gingko biloba are used to further clean mucus from your lungs. Consult an herbalist if you have any questions. He or she can guide you in your choices or create a custom prescription for your particular needs.

Side effects of androgen replacementablation in the aging male

Besides its effects upon normal and abnormal growth and physiology ofthe prostate, testosterone is also critical for maintenance of bone and muscle metabolism, as well as libido. For this reason, aging males who have an insufficient level of serum testosterone (i.e. hypogonadal males) suffer clinically from loss of bone and muscle mass as well as a decreased libido. Such aging hypogonadal males are candidates for exogenous testosterone replacement. Due to its growth-promoting effects on the prostate, however, such hormonal replacement therapy could enhance the

Surveillance of testosterone substitution therapy

The presence and frequency of sexual thoughts and fantasies correlate with appropriate testosterone substitution, while loss of libido and sexual desire are a sign of subnormal testosterone values. Spontaneous erections such as those during sleep will not occur if testosterone replacement is inadequate however, erections due to visual erotic stimuli maybe present even with low testosterone levels. The frequency of ejaculations and sexual intercourse correlate with serum testosterone levels in the normal to subnormal range. Therefore, detailed psychological exploration or a diary on sexual activity are useful adjuncts in assessing testosterone substitution. For objective evaluation of psychosexual effects weekly questionnaires on sexual thoughts and fantasies, sexual interest and desire, satisfaction with sexuality,

What is sexual dysfunction

The term sexual dysfunction broadly encompasses trouble with any component of the sexual response cycle. The sexual response cycle in men consists of sexual desire interest (libido), sexual arousal (erection), orgasm (including emission involuntary discharge of semen from the ejaculatory duct into the urethra and ejaculation), and detumescence (return of the penis to the flaccid, nonerect state). An abnormality in one component of the sexual response cycle may not affect the remainder of the components of the cycle. For example, one may still be able to climax and ejaculate without achieving a rigid erection. Common sexual dysfunctions include problems with libido, ejaculation, and orgasm. Lack of interest in sex is often called decreased libido or decreased desire. Libido is governed by psychogenic factors and involves all five senses (sight, smell, taste, touch, and hearing) as well as hormonal factors. Low libido, or hypoactive sexual desire, occurs in about 15 of men and in about...

Implicit learning accounts for the knowledge of skills

Children must also learn how to deal with hunger, thirst, sexual desire, exploratory behavior and other biological needs, which are the primary engines that generate behavior. Desires and emotions can be conceptualized as states of disequilibrium that must be resolved by an appropriate action, which is naturally the satisfaction of the specific need. Feedback mechanisms check hedonic behavior, suggesting that satiation consists in the restoration of an internal equilibrium. When the behavior results in the satisfaction of the need, it becomes reinforcing, which is to say that reinforcement promotes the learning of the satisfactory behavior. Once the behavior is learned, the animal can easily repeat it, whenever the same need arises again. The reinforcement of the learned behavior is an essential characteristic of the process, because the behavior is initially a random or automatic exploratory response. Thus, the positive reinforcement of behavior is one of the key mechanisms for...

Presence of animal tissue

For example, the ingredients of Nu Bao have been found to include human placenta, deer antler, and donkey skin, which are all potential sources of bacteria and viruses. Secondly, some constituents that are used medicinally are toxins themselves, for example the venom extracted from the skin glands of certain species of toads (Bufo marinus, Bufo alvarius) used in some Chinese aphrodisiacs. The venom contains bufotoxins, which have similar molecular structure and pharmacological effects to digoxin. These preparations can cause symptoms and clinical findings very similar to digitalis overdose and toxicity, and have led to dangerous alterations in heart rhythm and even death.

Listing Your Prodromal Signs Of Depression

Describe changes in your activity and energy levels as your depressive episodes develop (examples feeling slowed down, withdrawing from people, moving more slowly, talking more slowly, doing fewer things, having little or no sex drive, feeling fatigued, feeling tired but wired).

Who should be considered for treatment

As to the objective signs of relative androgen deficiency, although a decrease of muscle mass and strength and a concomitant increase in central body fat and osteoporosis can most easily be objectified, they are not specific signs. Decreased libido and sexual desire, loss of memory, difficulty in concentration, forgetfulness, insomnia, irritability, depressed mood as well as decreased sense of well-being, are rather subjective feelings or impressions, less easily objectified and certainly difficult to differentiate from hormone-independent aging. Complaints of excessive sweating are not uncommon, whereas true hot flushes do occur in elderly men, although they are mainly prevalent in severe acquired hypogonadism such as under hormonal treatment for prostate cancer.

Possible benefits of androgen replacement in women

Multiple studies demonstrate clear evidence that testosterone replacement enhances sexual function in hypogonadal men. In women, there is also strong data in this regard. The best-known study demonstrating a beneficial effect of androgen replacement on sexual function in women was published in 1987 (Sherwin and Gelfand 1987). This trial, although non-randomized and unblinded, did demonstrate increased arousal, fantasy, coitus and orgasm in postmenopausal women given monthly intra-muscular testosterone enanthate (150 mg) and 10 mg of E2 valerate. However, mean serum testosterone levels noted in this study were well over 200 ng dl, at least five times the physiological range seen in naturally post-menopausal women. Accordingly, a later study reported that prolonged use of this preparation resulted in virulizing effects in a number of women (Urman et al. 1991). Oral testosterone androgenic preparations have also been assessed in terms of sexual function in postmenopausal women. A...

Disturbances of sexual functioning

One common effect of traumatic brain injury (TBI) that has received only limited investigation to date is the alteration in sexual desire and performance associated with the injury (Elliott & Biever, 1996). It is estimated that TBI affects approximately 7 million people per year throughout the world. These injuries primarily affect men, with over 25 of TBIs occurring prior to age 25 (Ducharme & Gill, 1990). Independence and sexuality are crucial developmental tasks that need to be addressed during these early adult years and TBI, with its complex and interacting sequelae, can have a seriously detrimental effect on the development and nurtur-ance of normal sexual behaviour. The cognitive, behavioural, and physical impairments as well as the hormonal changes and psychological reactions to the cognitive and other deficits can combine to result in a lethal cocktail of sexual and emotional maladaptation. Often in the rehabilitation setting, the only time when the sexuality of the...

Neurohormonal influences

It appears that androgen levels are closely linked to seminal emission and sex drive in the human male, and that there is a requirement for a certain minimal level of androgen to be available for sexual function to take place however, excess amounts of androgen above these levels has minimum effect (Segraves, 1996). In the case of the female subject, current evidence suggests the oestrogen levels are essential to maintain vaginal epithelial integrity and lubrication whereas androgen levels may be related to libido (Segraves, 1996). Hyperprolactinaemia has been associated with decreased libido in both sexes (Segraves, 1988).

Methodological issues

For example, in their study of self-reported sexual difficulties in a sample of 322 patients with TBI (193 men and 129 women), Hibbard Gordon, Flanagan, Haddad, and Labinsky (2000) noted that their TBIs reported more frequent physiological difficulties influencing sex drive (i.e., decreased energy, sex drive, ability to initiate sexual activities, or achieve orgasm) physical difficulties (i.e., problems with body positioning, movement, and sensation) and body-image difficulties (i.e., feeling attractive and comfortable having the partner view one's body during sexual activities). Yet in men with TBI and without disability the most sensitive predictor of sexual dysfunction was level of depression, whereas for women endocrine disorders were the best predictor. Due to the complex interacting forces of the organic, cognitive, and psychosocial consequences of brain injury, specific delineation of the nature of these effects can often be difficult to ascertain.

Female Sexual Arousal Disorder

With the exception of persistent sexual arousal disorder, evaluation should include assessment for hypoactive sexual desire disorder. Neurologic and vascular causes should be considered when adequate genital vasocongestion and swelling do not occur but subjective arousal and lubrication are intact.

Prevalence and incidence of disturbances of sexual functioning

Walker and Jablon (1961) report that in a large sample of World War II veterans with head injury (739 men) the vast majority (87 ) had no complaint about their sexual functioning subsequent to the injury. Eight percent complained of impotence or reduced libido, four reported an increase in sexual desire, and 14 reported other problems regarding their sexual appetites. The frontally injured subjects tended to have more sexual complaints than individuals injured in other brain regions. At the 25-year follow-up (Walker, 1972), an unspecified number of wives complained of diminution of sexual functioning in their spouses and wondered whether anything might be done to enhance his sexual interest (p. 8). De Morsier and Gronek (1971) found that 47 of their 49 male patients reported impotence following TBI, and only two of their male patients reported increased sexual desire there was no mention of decreased sexual desire. noted postconcussive symptoms that endured for a minimum of six months...

Today he presents to the clinic with bone pain and a serum PSA of 67 ngmL 67 mcglX

The combination of estramustine (280 mg three times a day, days 1-5) and do-cetaxel 60 mg m on day 2 every 3 weeks also improves survival in hormone-refractory metastatic prostate cancer.50 Estramustine causes a decrease in testosterone and a corresponding increase in estrogen therefore, the adverse effects of estramustine include an increase in thromboembolic events, gynecomastia, and decreased libido

Lesion location and mechanism of sexual dysfunction

Griffith, Cole, and Cole (1990) propose that diffuse frontal injury with the involvement of the neural and endocrine systems is responsible for diminished sex drive. Garden (1991) proposes that medial temporal lesions account for hypersexuality whereas bilateral temporal lesions with lesions of the limbic system cause hypo-sexuality. Zasler (1998) contends that the frontal temporal areas, adjacent to the limbic structures of the right hemisphere, are responsible for arousal and sexual function. Lundberg (1992) concurs with Zasler and emphasises the contribution of the basal hypothalamus and the adjacent areas of the temporal lobe in regulating sexual desire. Rosenbaum and Hoggs (1989) note a drastic reduction in sexual relations, but no clear-cut relationship with locus of injury while Sandel et al. (1996) noted that most of their group were not experiencing major sexual dysfunction and not surprisingly observed that there was no relationship between sexual functioning and indices of...

Contract For Preventing Mania

Together they developed a list of his prodromal symptoms, which included mild irritability, mistrustfulness, standing too close to people and talking too loud, a sudden disinterest in his job, an increase in his sex drive, and a subjective feeling of mental clarity. They made a distinction between these early warning signs and signs of his full-blown manias, such as feeling elated or expansive, socially inappropriate outbursts of anger, spending excessively and impulsively, grandiose beliefs about his musical talents, severe loss of sleep, and a firm denial that anything was wrong. They also agreed on the environmental circumstances associated with his escalations an excessive workload, family arguments, and financial problems.

Antiandrogens Bicalutamide Flutamide and Nilutamide

Flashes, gynecomastia, and decreased libido. Flutamide tends to be associated with more diarrhea and requires three-times-daily administration, whereas bicalutamide is dosed once daily. Nilutamide may cause interstitial pneumonia and is associated with the visual disturbance of delayed adaptation to darkness. Initially, luteinizing hormone-releasing hormone (LHRH) agonists increase levels of leutinizing hormone and follicle-stimulating hormone, but testosterone and estrogen levels are decreased because of continuous negative-feedback inhibition. Major side effects are testicular atrophy, decreased libido, gynecomastia, and hot flashes. Leuprolide is well absorbed, with a terminal half-life of 2.9 hours, whereas goserelin has a terminal half-life of 4.9 hours. Goserelin is injected as a pellet under the skin, so subcutaneous injection of lidocaine prior to administration helps to decrease the pain associated with goserelin administration. Numerous dosage forms are available for...

Growth Hormone Hypersecretion Museuloskeletal Increas

Other Arthralgias, slight kyphosis, visceromegaly, reproductive problems (women amenorrhea, galactorrhea, anovulatory problems men decreased libido, hypogonadism), hyperprolactinemia, adenomatous polyps and colon cancer, esophageal and gastric cancer, parathyroid and pancreatic islet cell adenomas (MEN-I syndrome)

The Autoerotic Factor In Religion

Even when there is absolute physical suppression on the sexual side, it seems probable that thereby a greater intensity of spiritual fervor is caused. Many eminent thinkers seem to have been without sexual desire. Already, however, in a rudimentary form appeared contrary tendencies strictly speaking they were not contrary, but related, tendencies . Beneath the mystic passion which concealed it sexual desire was sometimes felt. At sixteen she experienced emotions which she could not master, when thinking of a priest who, she said, loved her. In spite of all remorse she would have been willing to have relations with him. Notwithstanding these passing weaknesses, the idea of purity always possessed her. The nuns, however, were concerned about her exaltation. She was sent away from the convent, became discouraged, and took a place as a servant, but her fervor continued. Her confessor inspired her with great affection she sends him tender letters. She would be willing to have relations...

LIIRII agonist medical castrations or surgical aie equivalent

The most common adverse effects reported with LHRH agonist therapy include a disease flare-up during the first week of therapy, hot flashes, erectile impotence, decreased libido, and injection-site reactions.26 The disease flare-up is caused by an initial induction of LH and FSH by the LHRH agonist, leading to an initial phase of increased testosterone production, and manifests clinically as either increased bone pain or increased urinary symptoms.26 This flare reaction usually resolves after 2 weeks and has a similar onset and duration pattern for the depot LHRH products.39,40 Initiating an antiandrogen prior to the administration of the LHRH agonist and continuing for 2 to 4 weeks is a frequently employed strategy to minimize this initial tumor flare.27

Ascites In Pathophysiology In Book

Portal Vein Anatomy

Changes in steroid hormone production, as well as changes in the conversion and handling of steroids are also prominent features of cirrhosis. These changes can result in decreased libido, gynecomastia (development of breast tissue in men), testicular atrophy, and features of feminization in male patients. Another deleterious effect of changes in sex hormone metabolism is the development of spider angiomata (nevi). Spider angiomata are vascular lesions found mainly on the trunk. The lesion has a central arteriole (body) surrounded by radiating legs. When blanched, the lesions fill from the center body outward toward the legs. Spider angiomata are not specific to cirrhosis, but the number and size do correlate with disease severity, and their presence relates to risk of variceal hemorrhage.12

What are some of the side effects of hormonal therapy and how are they treated

LHRH analogues and antagonists have side effects that may affect your quality of life over the short and long term (Table 9). Some of the side effects related to these medications, such as hot flashes, erectile dysfunction, anemia, and osteoporosis, can be treated. Erectile dysfunction occurs in about 80 of men taking LHRH analogues and antagonists and is associated with decreased libido (sexual desire). The widely prescribed drug silde-nafil (Viagra) as well as the other oral therapies for erectile dysfunction, vardenafil (Levitra) and tadalafil (Cialis) are effective in most of these men if they had normal erectile function before starting hormone therapy. Unfortunately, there is no medication to restore libido.

Impulse Control Disorders in Parkinson s Disease

There have been very few studies that examine the impact of PD on sexual functioning in women with PD. What little evidence that exists suggests that women with PD often experience a decline in sexual desire and a reduced ability to experience orgasm during sex. Sex can be uncomfortable due to lack of lubrication and desire. For women with PD who have experienced menopause, the decline in sexual interest may be due to both menopause and to PD.

Ironically it is the anorexia that cloaks you with a kind of invisibility the 44essence of your personality becomes

Since sex is a form of communication, and since anorexia alters how you communicate all aspects of your self, physically intimate experiences are often transformed from occasionally awkward to frightening. Many anorexics report completely losing their sexual feelings and sex drive. This may be a result of hormonal deficiencies but also may be due to a psychological walling-off of emotions, a profound lack of trust in interpersonal relationships, a fear of being naked, a literal fear of being touched and of touching someone else. Sexual dysfunction is a complicated and serious side-effect of this disorder.

Sexual Experiences Following Treatment for Penile Cancer

Was 52 years, and all had been sexually active prior to surgical treatment. All had a minimum residual penile stump length of at least 2.5 cm following surgery and the median time from surgery was 23.5 months. Patients were asked to retrospectively assess their sexual function before surgery and to then assess their function at the time of interview. Significant reductions in erectile function, orgasmic function, sexual desire, and intercourse satisfaction were identified. These two studies, taken together have led to a view that the more radical the penile surgery, the greater the effect on sexual function, with even partial penectomy having significant adverse effects. The traditional view that surgery for penile cancer requires a 2-cm tumor-free margin in all cases has been challenged.8,9 Recently a more conservative approach using treatment modalities such as laser therapy, brachytherapy, or by conservative surgery such as glans resurfacing or glansectomy has been advocated.9...

H6 Prevalence of testosterone deficiency in patients with erectile dysfunction

More recently, endocrine screening of 1022 men with erectile dysfunction detected serum concentrations of testosterone < 3 ng ml in 8.0 of men. However, 40 of these patients had normal serum levels at repeated determination (Buvat and Lemaire 1997). Pituitary tumors were discovered in two men with low testosterone. Determination of testosterone only in cases of low sexual desire or abnormal physical examination would have overlooked 40 of men with low testosterone, and 37 of men subsequently improving during testosterone substitution therapy (Buvat and Lemaire 1997). The largest study involving 3547 men with erectile dysfunction revealed a prevalence of testosterone deficiency (serum concentration less than 2.8 ng ml) of 18.7 (Bodie etal. 2003).

What are the 5alpha reductase inhibitors

What are the side effects of 5-alpha reductase inhibitors Side effects found in the first year of 5-alpha reductase inhibitor use include decreased sexual drive (libido), increased ejaculatory dysfunction (such as smaller amount of semen ejaculated), difficulty getting an erection, breast tenderness or enlargement. One large study demonstrated that after a year of treatment, finasteride resulted in the same level of decreased sex drive and inability to get an erection as placebo. Ejaculatory dysfunction was higher with finasteride than with placebo.

Electromagnetic Therapies

By the eleventh and twelfth centuries, lodestones were thought to have curative powers and were used to treat gout, arthritis, baldness and other ailments, as described by medieval writers. Scholars of the time also believed that magnets could cause and cure melancholy. Aphrodisiac powers were attributed to lodestones probably because of their magnetic ability to attract.

Clinical studies with finasteride in men with androgenetic alopecia

In studies of finasteride 1 mg in young men with AGA, side-effects related to finasteride treatment were confined to transient impairment of sexual function (decreased libido, erectile dysfunction, and decreased ejaculate volume) in a small number of men. In aggregate, in studies in younger men, 3.8 of patients receiving finasteride compared to 2.1 receiving placebo reported these side-effects, yielding a treatment group difference of < 2 (US Product Circular for Propecia 2002). In the two-year placebo-controlled study of finasteride 1 mg in older men with AGA, more patients reported side-effects related to sexual function in each treatment group, as expected 8.7 for finasteride and 5.1 for placebo, yielding a treatment group difference of 3.6 (Whiting etal. 2003). Few patients discontinued the studies because of these side-effects, and the incidence of reported side-effects declined with continued treatment.

Exchange Relationshipspostmarital Depression And Divorce Culture

Sexual desire disorders have also been increasing at a very rapid rate over the past two decades.35 The most common disorder is classified as hypoactive sexual desire disorder, a deficiency or total absence of sexual urges, which currently affects over 20 percent of the adult population. Different causes have been suggested, such as fear of loss of control, fear of pregnancy, depression, and a history of sexual trauma. Of these factors, depression is the only one that could account for the sharp increases in sexual desire disorders, but we probably need to go beyond depression as a causal agent and to look at the shifting focus of our desires. Passion that normally would be directed to the social realm is drained off as culture imbues members with the type of desire, including sexual desire, that does not promote self-transcendence or human interest.

Hypoandrogenism of senescence and sexual activity

Several authors reported differences in parameters of sexual desire or activity according to endogenous serum testosterone levels (Davidson et al. 1983 Schiavi etal. 1988 1990 Tsitouras etal. 1982 Udry etal. 1985), but there is a broad overlap of serum testosterone levels in sexually less or more active elderly men in these studies. Moreover, other studies failed to find an association between androgen levels and the perception of sexual functioning (Perry etal. 2001 T'Sjoen etal. 2003) (see also Chapters 4 and 11). Although potency and nocturnal penile tumescence (NPT) require adequate testosterone levels and although several studies show that hormonal alterations might play some role in 6 to 45 of cases (Morley 1986), most frequently the cause of impotence in elderly males is non-hormonal.

Altered Sexuality Syndromes

Altered sexuality may take many forms. The loss of libido is the most common form and can present as inhibited excitement or orgasm. Hypoactive sexual desire may be due to a number of psychiatric, medical, and neurological disorders. Typically, the cause is functional and the condition occurs in the presence of anxiety or depression. Hyposexuality associated with hypergraphia, hyper-religiosity, irritability, and elation comprise the main features of the Gastaut-Geschwind syndrome. This syndrome has been described as an interictal syndrome in patients with epilepsy of temporal lobe origin. These patients may also demonstrate viscosity, which refers to a stickiness of thought processes and an interpersonal adhesiveness, and circumstantiality, which is manifest as a difficulty in terminating conversations.

Impact of Infertility on the Patient

Infertility is one of several important developmental crises of adult life. The impact of infertility on a woman can be severe. The influence of the higher nervous system on ovulation is well known but only partially understood. When a woman is told that she is infertile, she may be shocked and distressed about the loss of an important function of her body. This psychologic injury lasts for variable amounts of time. Often the woman feels defective or inadequate. This extends to her interactions with others, in addition to her sexual function. Her attitude toward her job may change her work productivity may decline. There is a significant decrease in sexual desire. Depression, loss of libido, and concern over whether conception will ever occur combine to make sex a less pleasurable activity and decrease the possibility of normal ovulation. A period of mourning and frustration usually occurs.

Classification And Clinical Presentation

These tumors do not secrete active hormones, and therefore signs of hormone excess are absent. Prolactin levels may be mildly elevated because of the stalk effect, resulting from loss of tonic inhibition from the hypothalamus caused by compression or distortion of the pituitary stalk. Varying degrees of hypopituitarism may also be seen, and a full panel of hormone levels should be drawn. Signs of hormone insufficiency include decreased libido, fatigue, weakness, and hypothyroidism. It is essential to draw thyroid hormone levels in addition to thyroid-stimulating hormone (TSH) levels, because the patient with hypothyroidism of pituitary etiology will likely have a low TSH. Prolactin-secreting tumors are the most common pituitary adenoma, responsible for approximately 27 of pituitary tumors.5 They occur more often in women by nearly 2 1, but autopsy studies reveal an almost equal prevalence of pro-lactinomas in both sexes. Prolactinomas often cause amenor-rhea or galactorrhea and...

Selection of Medication

Check for drug interactions in patients receiving complex polypharmacy regimens, because drug-drug interactions are constantly being updated and changing. For example, fluoxetine is a potent 2D6 inhibitor that can triple TCA and phenytoin levels or increase the anticoagulation associated with warfarin. Fluoxetine also has the longest half-life of any SSRI its active metabolite norfluoxetine has a half-life of 10 days. SSRIs have sexual side effects (decreased libido, delayed orgasm or anorgasmia) and GI side effects (nausea, diarrhea) (see Table 47-4). GI side effects likely will remit over time, but sexual effects typically do not attenuate and may require treatment with other agents, such as a phosphodiesterase inhibitor (e.g., sildenafil), or choosing an antidepressant less likely to cause sexual side effects. Gastrointestinal side effects (nausea, diarrhea, heartburn) sexual dysfunction (decreased libido, delayed orgasm) headache insomnia somnolence

Turn On Your Acu Points Shut Off the Ringer

The two most common oriental diagnoses of tinnitus that I see are rising liver and gallbladder fire, and kidney deficiency. Rising liver and gallbladder fire is characterized by sudden onset of a loud noise, emotional stress, headache, irritability, a bitter taste in the mouth, constipation, dizziness, reddish face, and thirst. Deficient kidney tinnitus comes on gradually with low, intermittent sounds, poor memory, blurred vision, sore back and knees, and reduced sexual desire or performance.

Side Effects of Antidepressants

Most likely to cause these side effects but TCAs, MAOIs, venlafaxine, lithium, and carbamazepine can also cause them. SSRIs, MAOIs, and venlafaxine are more prone to causing anorgasmia and decreased libido while TCAs are the most likely to cause difficulty maintaining erection.

Ego Psychology

With various offshoots, dissenters, and rivals, the codification of clinical practice and of the rules followed by psychoanalysis' growing number of practitioners was of concern to Freud. As the field gained new adherents, the importance of clarifying it both as a theory and as an organization became increasingly important. In spite of a difficult beginning, Berlin soon bccame the center of a flourishing psychoanalytic community, with Karl Abraham, who had left the Burgholzli in Zurich for Berlin, at its center. Karen Homey, Helene Deutsch, and Melanie Klein trained there, and all three were analyzed a second analysis for Klein) by Abraham, who had developed some ideas about the female libido that these three analysands would each, in different ways, challenge and modify. Sandor Rado and Franz Alexander arrived in 1921. Some of the basic precepts of analytic training, including the training analysis, the supervision, and the seminars, had been established in Berlin by 1930. The two...

Clinical History

In one eye or in the optic nerve should be considered. Painful monocular visual loss is characteristic of an inflammatory or demyelinating optic neuropathy. With binocular visual loss, a lesion of both eyes or optic nerves, or of the chiasm, tract, radiations, or occipital lobe should be investigated. Associated neurological deficits, such as motor or sensory abnormalities, also assist in localization and often indicate a hemispheric abnormality. Medical conditions should always be investigated in the review of systems. Hypertension and diabetes, for instance, predispose the patient to vascular disease, and a history of coronary artery disease should alert the examiner to the possibility of carotid artery insufficiency as well. Visual loss accompanied by endocrine symptoms, such as those consistent with hypopituitarism (e.g., amenorrhea, decreased libido, impotence) or pituitary hypersecretion (e.g., galactorrhea, acromegaly), suggests a chiasmal disorder.

Key thinkerstheories

Freud believed gender identity is acquired through identification with the same-sex parent. According to Freud, boys develop an Oedipal complex by which they experience sexual desire for their mother but because they fear that their father will find out about this and castrate them, they instead try to identify with their father to avoid discovery. Thus, resolution of the Oedipus conflict, in part, involves gender identity, adopted from the example set by the father. For girls identification with the mother derives from a similar process but instead of the fear of castration girls experience the Electra complex, identifying with the mother for fear of her finding out that she actually feels penis envy towards the father. Thus, these identification processes in the phallic stage of development (3-6 years) play a major role in the development of gender stereotypes.


Snakes, heal dog-bites, and bruises raw garlic was given to asthmatics fresh garlic and coriander in wine was a purgative and an aphrodisiac Juniper mixed with honey and beer was used orally to encourage defecation and origanum was boiled with hyssop for a sick ear (Manniche, 1989).

Sexual Function

Most men and women who had been sexually active will experience dysfunction after a stroke.121 Sexual desire often persists. Subtle premorbid problems associated with diabetes, cardiovascular medications, and vascular disease can be exacerbated by poststroke neural dysfunction, decreased mobility, pain, and new medications. These can produce impotence, which is also an age-related disorder that increases to over 25 in men after age 65 years. Some patients benefit from eliminating or switching drugs, particularly cardiovascular, antispasticity, and antidepressant types. The patient and his her partner can be encouraged to explore different sexual techniques. However, clinical factors may play less of a role than maladjustments related to psychologic and in-terpersonel difficulties.122 Counseling is especially important, for example, for those who lose self-esteem or fear rejection, because the partner is now a caretaker.

History And Overview

Individual cases of lead poisoning were reported as early as 200 bc. However, it was not until the twentieth century that industrialization and modernization resulted in a need for medical evaluation and treatment of health effects caused by exposure to harmful chemicals. To meet this need, a new medical specialty was developed called occupational and environmental medicine. Unfortunately, the number of physicians in this specialty is too few to treat the number of patients requiring evaluation and treatment. Even in academic and workplace settings that offer this expertise, neurological input is paramount because many of the health effects due to chemical exposure are related to the central and peripheral nervous systems. Whereas some health effects such as pulmonary distress and gastrointestinal symptoms are noticed easily by the affected individual, some nervous system effects may be unrecognized. Acute, high-level exposure to a toxicant often results in clearly identifiable signs...

Mixed Solvents

Chronic low-level exposure is generally seen in industrial settings. In these cases, development of symptoms is insidious. Headaches are the most commonly reported symptom. Characteristically, these begin shortly after arriving at work and disappear at night, on weekends, and during vacations when patients are not in the vicinity of the organic solvents. Other complaints include irritability, personality changes, depression, memory loss, poor attention or concentration, sleep difficulties, decreased libido, and pain and numbness starting in the feet and then progressing to the hands (peripheral neuropathy). Neurobehavioral findings are most notable in activities demanding manual dexterity, executive or motor functioning, and olfaction. y


Use This aphrodisiac dilates blood vessels of the skin and mucus membranes (including those of the sexual organs). It is a monoamine oxidase inhibitor, which means that you should strictly avoid nasal decongestants, foods containing tyramine (such as liver, cheese, and red wine), and certain diet aids containing phenylpropanolamine. The drug should not be taken by anyone suffering from hypotension (low blood pressure), Dosage Usually administered in 5.4 mg doses, it is available as a prescription drug in many combinations with other so-called sexual stimulants such as strychnine, thyroid, and methyltestosterone.

Sexual Difficulties

Hormone insufficiency can affect not only the physiology of sex but the psychology as well sexual desire or libido. Adequate hormone replacement with estrogen is often all that is needed. If estrogen alone does not improve your libido, then your doctor may prescribe a combination of estrogen and an androgen such as testosterone. There is one combination medication, called Estratest, that is approved for this specific use. Or, with your doctor's instructions, a compounding pharmacist can make up a combination of estrogen and testosterone in capsule form for you to take orally or as a vaginal suppository. Soon testosterone-containing patches may be approved to increase libido in postmenopausal women. If taking replacement hormones is not an option for you, or if these measures do not help to increase sexual desire, then take a close look at your relationship and stresses in your life for clues about changes you can make that may result in your being more receptive and...

Social Networking

Many have noted the Internet's value for enhancing social communication and connecting people who suffer from alienation or discrimination in their offline lives. However, the formation of identity groups and communities online may also lead to an increase in social capital and empowerment among people with extremist and harmful beliefs. For example, street gangs have begun using social networking sites such as Facebook and YouTube to recruit new members, often at very young ages (Vazquez 2008). The Internet's versatility for social networking has been exploited by extremist religious groups (e.g., terrorist organizations and the Heaven's Gate cult), hate groups (e.g., neo-Nazi social communities online), and individuals with deviant sexual desires, such as pedophilia (Durkin and Bryant 1999). Commenting on self-disclosure in cyberspace, Ben-Ze'ev makes the following observation considered as immoral, such as hate and sexual desire, are likely to be more prevalent and more intense in...

Adrenal Disorders

Clinical Features and Associated Disorders. The clinical features of adrenal insufficiency are influenced by the site of dysfunction, because PAI affects all of the adrenocortical hormones, whereas SAI only affects glucocorticoids. Thus, hyperpigmentation, salt craving, and hyperkalemia are unique to patients with PAI. Patients with adrenal insufficiency may present acutely or as a chronic condition. Acute adrenal insufficiency is a medical emergency (so-called addisonian crisis) characterized by mental status changes, fever, hypotension, volume depletion, arthralgias, myalgias, and abdominal pain that may mimic an acute abdomen. yi Chronic adrenal insufficiency may present more insidiously with fatigue, weakness, GI symptoms, amenorrhea, decreased libido, salt craving, arthralgias, and hypoglycemic symptoms. Neurological manifestations can include confusion, apathy, depression, psychosis, paranoia, and myalgias, as well as hypoglycemic symptoms. 102 In addition, a past medical...

Sexual Subjectivity

If the oedipal narrative historically organizes and creates sex and gender, the new narrative generates the question of sexual self-states. Sexuality itself is no longer taken for granted as a self-evident drive, affect, or set of behaviors. Sexual desire is no longer a unisex model of tension, discharge, relief. Not only must femininity as well as masculinity, homosexuality as well as heterosexuality and biscxuality, be taken into account when it comes to desire. There may be as many sorts of desire as there are individuals who desire (Chodorow 19941 individual sexuality, manifesting as compromise formation Chodorow 2003), comprises linked, interacting elements that are universally occurring but idiosyncratically combined. Finally, desire itself changes throughout life, to extend a point insisted on by the classical narrative. Recent work (e.g , Dimen 1999 Laplanche 1976 Stein 1998 Stoller 1979) has begun to address the dilemmas of sexual experience. Freud, we have seen, found the...

Dopamine and Food

Figure 6-1 Brain dopamine (DA) systems. Three major systems contribute to sexual arousal and desire, including the mesolimbic and mesocortical DA system. This system has DA-containing cell bodies in the ventral tegmental area (VTA) with terminals in the nucleus accumbens (NAcc) (and other limbic regions) and medial prefrontal cortex (mPFC), respectively. Other DA systems shown include the diencephalic system and the nigrostriatal system. The tuberoinfundibular DA system controls hormone release from the anterior pituitary gland. These systems control attention and motivation related to sexual and feeding stimuli and are also involved in the regulation of mood and emotions, attention, motivation, reward and reinforcement, and the actions of cocaine. SN substantia nigra mPOA medial preoptic area. (From Figure 3 from Pfaus, James G., Reviews Pathways of Sexual Desire, Journal of Sexual Medicine, Copyright 2009. Reprinted with permission of John Wiley & Sons, Inc.) Figure 6-1 Brain...


It is common to experience a temporary lack of sexual desire or inability to perform sexually (see Low sex drive in men, p.250, and Low sex drive in women, p.272). Such problems are often due to stress or emotional difficulties, or to the use of alcohol, recreational drugs, or certain medications. Disorders such as diabetes mellitus can cause longer-term sexual problems. It is important to discuss concerns with your partner. Talk to your doctor if the problem is persistent.


It has long been recognized that androgens play a critical role in human male sexual behaviour. Prepubescent boys do not engage in sexual activity outside the context of play. After puberty, when the testes begin to secrete androgens, sex drive and the motivation to seek sexual contact become powerful and are overtly expressed. Sexual performance and copulatory ability increase as well. The general pattern of age-dependent rise and decline of androgen levels in men corresponds to average levels of male sexual activity throughout the cycle of life. When blood levels of testosterone, especially non SHBG-bound testosterone, diminish as men age, this mirrors their usually declining sexual interest and potency (Davidson etal. 1983). These observations suggest, but do not prove, that male sexual behaviour is influenced by androgens. Less obvious and difficult to infer from everyday observation is the role of testosterone in female sexual behaviour. Physiological testosterone levels in...

Nonmotor Symptoms

As the autonomic system is disturbed in patients with PD, orthostatic hypotension and GI, urinary, sexual, and dermatologic symptoms are common. Patients with orthostatic hypotension may experience dizziness, lightheadedness, fainting upon standing, or fall-related injuries. GI symptoms include constipation and dysphagia due to a slowing of the automatic pattern of contraction and relaxation of the throat muscles. These swallowing difficulties may lead to weight loss, sialorrhea, and aspiration. Genitourinary symptoms include urinary incontinence, urgency, and frequency related to over activity of the bladder emptying reflex. Symptoms may be worse at night, causing nocturia. Sexual dysfunction includes decreased libido, erectile dysfunction, and delayed ejaculation. Skin symptoms include sweating and intolerance to heat and cold.6-8,11,12

S ex and S exuality

A woman's sexual desire depends on both psychological and physiological components. Physiologically, testosterone is a key hormone that influences sexual drive, and the amount of circulating testosterone affects sexual responses. Both the ovaries and the adrenal glands produce testosterone. The ovaries produce about half of all the testosterone made in a woman's body. Removal of the ovaries, therefore, lowers a woman's total testosterone level and can lead to alterations in sexual drive for some women. Even when the ovaries are not removed, the surgical procedure involved in removing the uterus may sometimes cause changes in the blood flow to the ovaries, which can lead to reduced hormonal production, including decreases in testosterone production. So even women who still have their ovaries may notice a difference in their sexual desire. Another way pelvic surgery can adversely affect sexual desire is by making you afraid that intercourse will hurt or will injure you in some way. Your...

Inorganic Lead

Currently, acute lead encephalopathy due to industrial lead exposure is rare. Symptoms generally include delirium, combative irrational behavior, and seizures. Early signs of lead exposure include sleep disturbances, decreased libido, increased distractibility, increased irritability, and mental status changes marked by psychomotor slowing and memory dysfunction.

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