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Alcohol and impotence.

Alcohol and Impotence from The Doctor's Casebook

Q: My husband is 53 years old and is unable to obtain an erection. He consumes several shots of whiskey daily when he is home. I have told him there is a connection between his drinking and impotence, but he ridicules this idea. Who is right? A: Ethyl alcohol is the world's most abused drug if we consider the economic and behavioral implications on society and the family. There are more than 14 million alcoholics living in the United States. Ethyl alcohol is chemically related to methyl alcohol, which is distilled from wood instead of grain, and its consumption can lead to blindness and death. Ethyl alcohol, generally believed to be a stimulant, is actually a depressant of the central nervous system (CNS), brain and spinal cord in any quantity. It is because alcohol, like cocaine, marijuana, and other narcotics, suppresses our inhibitions and leads someone to believe he's the world's best lover.

Masters and Johnson, in their monumental work on human sexual inadequacy, identified alcohol as a common factor in impotence. Alcohol can damage the CNS and destroy brain cells, and if the damage is prolonged enough, it can result in irreversible sexual impotence even while a person is sober. Alcohol is also a factor in loss of sexual control or premature ejaculation. Even a couple of beers before sex can spoil a man's erection and ruin his ejaculatory control. Up to 80 percent of men who drink heavily are believed to have serious sexual side effects, including impotence, sterility, or loss of sexual desire. Heavy drinking over a long period of time can irreversibly destroy testicular cells, leaving men with shrunken testicles. Both sexual drive and sexual capacity can be damaged. Alcohol also suppresses testosterone levels even in social drinkers by suppressing the secretory activity of the Leydig cells.

Women, too, suffer sexually from alcohol. Alcohol has many of the undesirable pharmacologic and physiologic effects on a woman as nicotine. The female alcoholic may have difficulty in reaching orgasm or may damage her ovaries, causing menstrual and ovulatory dysfunction and a lack of estrogen production, which often leads to early menopause and associated signs of premature aging. Alcohol, even in small doses, sharply reduces a woman's sexual responsiveness as measured by photoplethysomographic recordings of vaginal pulse and blood volume. Alcohol taken simultaneously with tranquilizers, sedatives, or barbiturates is deadly.

Q: What are the most common causes of infertility in women? A: There can be many causes, but the most common are ovulatory failure or defect, tubal obstructions or adhesions, endometriosis, and uterine myomas. A physician often has to be like a Sherlock Holmes and eliminate the improbable or impossible causes, leaving what is left as probable or possible causes. For example, a woman who suffers from premenstrual syndrome (PMS) usually ovulates every month so a gynecologist would probably look elsewhere first for the cause. The journey of the ovum through the fallopian tube and finally into the uterus after fertilization is extremely hazardous. Many events must work in precise synchronization in order for successful pregnancy to occur.

Q: Is there an ointment that can be applied to remedy temporary impotence? A: According to the Journal of Urology (141) (3):546, 1989), applying 2 percent nitroglycerin paste to the penile shaft is the latest therapy for erectile dysfunction no matter what the etiology. In a study involving 26 men with various degrees of impotency, 18 responded to the topical vasodilator with increased blood flow in the deep penile arteries with firmer erections after erotic stimulation. Only one patient showed side effects of headache and hypotension. It is still unknown what side effects on the sex partners may be caused by vaginal absorption of the drug. This potential side effect may be avoided by use of a condom.

Q: I recently entered a new sexual relationship and shortly therafter developed what my doctor called "honeymoon cystitis." It seems every time I enter a new sexual relationship I develop this condition. What can be done to prevent it? A: This is a fairly common condition, and apparently the new bacteria introduced by a new sex partner are believed to cause the reaction. After the initial intercourse, the reaction of the vaginal bacteria seems to prevent a recurrence by perhaps building up an immunity. Here is a tip given by Angela Kilmartin in her book, Understanding Cystitis (London, Heinemann). "One superb and vital piece of self-help in the incidence of cystitis related to intercourse. It is: Always pass an effective amount of urine within fifteen minutes of intercourse ending...".

Q: How does exercise affect a woman's sexuality? A: A recent survey by a fitness magazine reported on 8,145 female readers; over three-fourths exercised regularly for at least one-half hour three times a week. Since starting their exercise regimen, 31 percent reported an increase in frequency of sexual activity with their partners. Almost 27 percent reported an increase in their ability to achieve climax and 40 percent reported an increase in their ability to be aroused. However, at very high levels of exercise, sexual interest and performance decreased. Moderation in exercise seems to be the key to improving sexual performance.

Q: I recently remarried, and since I started having intercourse with my new husband my vagina itches and burns every time we have sex. Both my husband and I have been tested for Candidiasis and other sexual diseases, and results all are negative. Could I be allergic to my husband's ejaculate? A: Yes, you could be. According to the July 1989 issue of the American Journal of Obstetrics and Gynecology, several cases of recurrent vaginitis in the women were traced to the male ejaculate, which caused symptoms every time the couple had intercourse. Your partner should have his semen checked for immunoglobulin (IgE) antibodies. If it is shown that his semen is transmitting antibodies causing the reaction, use of a condom should resolve the problem.

Q: Do sexual relations prevent the vagina from drying out in an older woman? A: There is strong evidence that an ongoing sexual relationship in older women helps to maintain and restore the lubrication that may be lacking in later years. Masters and Johnson in 1966 reported that they found sexual activity in older women after menopause correlated with better vaginal lubrication, especially when compared with women in similar age brackets who were sexually inactive. Since then, other investigators have reported that a continued active sexual life helped preserve the vaginal elasticity and better vaginal health, preventing vaginal atrophy.
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Title Annotation:from The Doctor's Casebook; causes of infertility; exercise and sexuality; allergy-induced vaginitis
Author:Flatto, Edwin
Publication:Nutrition Health Review
Article Type:column
Date:Jan 1, 1990
Previous Article:Grandparents as role models.
Next Article:A tale of two regulators.

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