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Smoking and sexuality.

Smoking and Sexuality From The Doctor's Casebook

Q: Can smoking cigarettes harm my sex life?

A: Suppose the Surgeon General would order cigarette manufacturers to print on their packages: "Warning: Use of this product can kill your sex life." It would certainly be much more effective in getting people to quit smoking than warning against cancer or a cardiac infarction. Tobacco advertisers portray "macho" type men in cigarette ads to imply that smoking is associated with virility. Just the opposite is true!

Pharmacologically, nicotine acts as a vasoconstrictor. It constricts the arteries and blood vessels supplying blood flow to the corpora cavernosa penis, or the two columns of erectile tissue on either side of the male sex organ. Nicotine also lowers testerone and other hormonal levels in the blood. It increases the concentrations of free fatty acids in the blood, a condition which helps bring about athereosclerosis of the arteries, further restricting blood to the genitals.

Tobacco can also ruin a woman's sex life. There is evidence that smoking can interfere with a woman's orgiastic ability. Nicotine can damage ovaries, causing menstrual and ovulatory abnormalities, and decrease estrogen production. It can also lead to early menopause and other signs of aging such as lessened lubrication in the vagina.

Women who are on the pill and smoke have a far greater risk of dying of cardiovascular disease than non-smokers. For example: In the 30-to-39 year-age bracket, of women who take the pill and smoke, the risk of developing a fatal coronary occlusion is ten times greater than the non-smokers. Nicotine excites the central nervous system at all levels and produces tremors throughout the extremities. If a woman is pregnant, smoking can damage the fetus resulting in impaired growth and low birth weight.

Q: There is a drug, Yohimex, that has gained great popularity for treatment of impotence. Do you recommend its use?

A: Yohimex (Kramer Pharmaceutical) or Yocon (Palisades Pharmaceutica) are trade names for Yohimbine, an alkaloid derived from the Rubaceae and related trees, is a tablet taken by mouth. Yohimbine has been identified by medical researchers as an alpha-2 adrenergic blocking agent useful in the treatment and diagnosis of some types of male erectile impotence. It also has been used as a mydriatic agent that dilates the pupil of the eye and as a sympathicolytic (agent that interferes with, opposes, or destroys impulses from the sympathetic nervous system). Its effect is to increase parasympathetic (cholinergic) activity which, in males, increases sexual performance, since erection is linked to cholinergic activity, which theoretically results in penile inflow of blood.

The main source of Yohimbine is the yohimbine bark from a tree that is indigenous to Africa. It is listed in The Pharmacist's Guide to the Most Misused and Abused Drugs in America. The substance has also been sold illegally as an aphrodisiac or "passion pill." I quote the following:

"Promoters cite a single Canadian hospital study in which 23 sexually unresponsive men were given yohimbine for ten weeks. Six of the 23 responded with arousal." Yohimbine readily penetrates the central nervous system, produces peripheral sympathetic nerve blockage including anti-diuresis (retaining of urine), elevation of blood pressure and heart rate, irritability and tremor. Sweating, nausea and vomiting are common after injection of the drug. Also dizziness, headache, and skin flushing were reported when orally used.

In experimental doses of the drug to treat impotence, 1 tablet (5.4 mg.) was given three times a day to adult males, taken orally. Occasional side effects reported at this dosage are nausea, dizziness or nervousness.

Q: Is there a link between impotence and atherosclerosis? A: It is now known that about half the men suffering from impotence have insufficient blood flow into the penile arteries to sustain an erection. Atherosclerosis is not a local condition, but is systemic, or found throughout the body. In studies at the Veterans Administration Medical Center in Sepulveda, California, it was found that men with impaired penile blood flow have a significantly greater likelihood of having a myocardial infarction or cerebrovascular. accident, compared with men of similar age bracket demonstrating normal penile blood flow.

Men who are impotent and over 40 should be evaluated for psychogenic causes and if findings are negative, a vascular study should follow.

Q: My wife has been having bouts of vaginal candidiasis, which keeps recurring. She was advised to use the pill or have me use a condom. Since I started using a condom, the infection cleared up, but I am still wondering if the diaphragm is really the culprit.

A: It could be that the spermicide used with the diaphragm caused an imbalance in the bacterial flora, permitting the candida to take over, or there could be an allergy to the chemicals. If the allergen is unknown, sometimes antihistamines may help suppress the symptoms. I would continue using the condom to prevent reinfection.
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Title Annotation:from The Doctor's Casebook; cigarettes and sex life; drug for impotence; treatment for vaginial candidiasis
Author:Flatto, Edwin
Publication:Nutrition Health Review
Article Type:column
Date:Jun 22, 1989
Previous Article:The joys of summer - and the annoyances; a review of pests and pitfalls.
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