What is sexual dysfunction?

Special to the NNPA from the St. Louis American

My old school, Southern-bred mother was appalled to learn that my then 2-year-old used words like vagina and penis. She could not believe I had taught her such language because she of course had taught me to say “private parts” and use nicknames such as “pocket book.” Well, I suppose my liberating medical education had freed me from that type of sexual bondage and I dared to embrace body parts for what they were intended to be called.

As I matured even further in this journey, I began to see how so many adult women were still hindered by male-dominated social norms and old-fashioned myths about their bodies. I recall being taught not to bathe/shower or wash my hair while menstruating because this would cause illness. And let us not venture into the bedroom. I’m sure women in my mother’s generation thought it was normal to be directed in sexual intercourse by their partners and would have never considered telling their partners what was actually pleasurable to them. I know women even today who have never actually explored their bodies to learn what pleases them. Where did such practices originate? Were these behaviors part of the reason why medical advances for women in regards to their sexual health lagged so far behind those for men?

When drugs such as Viagra and Levitra hit the market, men across the world rejoiced because they could now continue to experience sexual satisfaction even though they were advancing in age. And please don’t get me wrong, sexual health is an extremely important aspect of a man’s mental well-being. However, fewer men have issues as compared to women, 31 percent versus 43 percent respectively. So, when I learned that there was a possible solution to some of the concerns women face as it relates to their sexual enjoyment, I was excited. No pun intended!

Sexual dysfunction can occur at any age and is defined as a disruption in the sexual response cycle that inhibits a couple from experiencing sexual satisfaction. Excitement (desire and arousal), plateau, orgasm and resolution comprise the sexual response cycle. Problems at any one of these levels interferes with overall satisfaction.

Sexual dysfunction is classified in four different categories:

Desire disorders-lack of sexual desire or interest

Arousal disorders-inability to become physically aroused or excited during sexual activity

Orgasm disorders-delay or absence of climax or orgasm

Pain disorders-pain during intercourse

Although the research suggests that more women have problems with sexual dysfunction than men, very few women, for example, in my practice have complained. Embarrassment has always been my assumption for this hesitancy in reporting this important medical problem. For instance, only a small percentage of women experience orgasm during intercourse yet rarely do women mention this to me during their exams.

There are many causes of sexual dysfunction and they can be divided into physical and psychological. Conditions such as heart disease, diabetes, neurological disorders, hormonal imbalances and a host of other health problems can all cause sexual dysfunction. Stress as it relates to work, marital relationship or finances also contribute to sexual dysfunction. Past history of sexual trauma/abuse is a common reason for women to experience problems in their sexual relationships. Both women and men may also have issues with body image.

By now, many of you have been listening to all of the dialogue about the “female Viagra” pill, flibanserin, recently approved by the FDA for premenopausal women with sexual dysfunction. However, the first misconception to correct is that flibanserin is NOT Viagra and its exact mechanism of action is unknown, but it is believed to correct an imbalance of a chemical in the brain which is responsible for sexual desire.

Per the manufacturer, Addyi, the brand name for flibanserin, is billed to be a remedy for women with hypoactive sexual desire disorder. The drug’s effectiveness ranges anywhere from 8 to 13 percent. Side effects include low blood pressure, dizziness and fainting. Furthermore, many of these side effects are exacerbated by alcohol thereby prompting the FDA to require a boxed warning label inside the package advising against alcohol use while on the medication.

This is not the first time this drug has attempted FDA approval and with such a low efficacy rate it makes you wonder why it was approved. Only certified pharmacies and providers will have access to this medication, but only after special training has been completed.

Therefore, my excitement for a substantial therapeutic option for women was slightly premature. Again, no pun intended. Both providers and patients will have to wait and see if Addyi is all that it is cracked up to be.

Yours in Service,

Denise Hooks-Anderson, M.D.

Assistant Professor

SLUCare Family Medicine

yourhealthmatters@stlamerican.com

Tips for a safe, healthy summer

Special to the NNPA from the St. Louis American

Nothing says summer like flip-flops, bathing suits, ice-cream cones and concerts in the park. After Spring Break, kids along with teachers and administrators start the countdown to summer vacation. In contrast, parents are stressed out trying to figure out what they will do with those kids for 10-11 weeks and they are secretly wishing school was in session year round.

However, the merriment of the long-awaited warm weather cannot lessen the importance of summer safety. Having a less rigid schedule should not be synonymous with emergency room and urgent care visits. Injuries and illnesses are not uncommon during this time of year and can definitely transform what was planned as a tranquil experience to a disaster. So, to launch summer into the right direction, here are some simple tips to follow.

Tip #1: Everyone needs sunscreen— No matter your complexion or ethnicity, your skin can be damaged by those intense rays from the sun especially between the hours of 10 a.m. – 3 p.m. Ideally, skin should be protected with a hat, clothing and sunscreen with an SPF of 30. Furthermore, per the American Academy of Dermatologists, the sunscreen should be broad-spectrum and waterproof. Repeated episodes of sun damage will increase the likelihood of developing skin cancer in the future.

Tip #2: Respect the water— About one in five drowning victims is younger than age 14. Per the CDC, 80 percent of the people who die from drowning are male. Children between the ages of one and four are more likely to die in a home pool. The fatal drowning rates of African American children between the ages of five and 14 are almost three times that of whites.

It is imperative that children be supervised around bodies of water and follow general safety guidelines such as not running on the slippery surfaces next to the pool, obeying the directions of the lifeguards and wearing life vests when appropriate. One of the main factors involved in drowning injuries is lack of swimming ability. Participation in formal swimming lessons can decrease the risk of drowning in children ages one and four.

Tip #3: Listen to your body— After surviving a brutal winter, it is understandable that when summer arrives being outdoors as much as possible is a major priority. But, excessive heat can cause a variety of heat-related illnesses such as heat rashes, heat exhaustion, heat cramps and heat strokes. The body normally controls internal temperatures by sweating however during excessive heat, this mechanism is insufficient and body temperatures can reach dangerously high levels. Seniors, children, and people who are ill or overweight are most at risk. Feeling clammy, dizzy, or nauseated are all symptoms of being overheated and should alert you to seek shade, rehydrate with cool water-not ice water, and elevate feet.

Heat strokes occur when temperatures reach 104 or higher either by excessive exercise or inappropriately treated heat exhaustion. Internal temperatures that reach such levels can cause multiple organ damage and is an extremely dangerous condition. On average, over 600 people die each year in the United States from heat related illness, which is more than tornadoes, hurricanes, floods and lightning combined.

Tip #4: Obey the rules— Although highway deaths have declined about 25 percent since 2004, the National Highway Safety Administration reported 32,719 deaths in 2013 from crashes. On the other hand injuries caused by distracted drivers, increased by one percent. During that same time, about a third of the people between the ages of 21-34 involved in a fatal crash had blood alcohol levels above the legal limit. Furthermore, a large percentage of the pediatric fatalities were unrestrained occupants.

Speed limits are recommended for your safety. Wet roads, curves, and construction are all hazards that not only endanger you but the surrounding drivers as well.

Reducing your speed during those road conditions will enable you to more effectively handle your vehicle. In addition, medications, fatigue, and illicit substances like marijuana can delay your reaction time and contribute to driver errors.

Therefore, the bottom line about summer is that it should be a time of fellowship, friendship and fun! Let’s make summer 2015 one of the best vacation times ever!

Denise Hooks-Anderson, M.D. is an Assistant Professor at SLUCare Family Medicine.