Tag Archives: misunderstand

What You Might Misunderstand About Sexual Desire

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Sexual desire is frequently mistaken for sexual arousal, yet these three terms are often used interchangeably without full comprehension.

Though libido typically represents sexual desire, it’s often perceived as binary. The term “awakenings” refers to the physical changes that prepare the body for sexual activity, such as increased heart rate, altered breathing, and heightened blood flow to the genitals.

From a medical perspective, desire indicates a person’s inclination to engage in sexual activity. This is a fluid phenomenon.
Similar to many human behaviors, sexual activity can become a habit. However, the frequency, duration, and type of sexual engagement vary based on what each individual finds pleasurable.

Individuals seek and engage in sex for diverse reasons. Traditionally, sexual desire is viewed as a quantifiable trait, often categorized into low or high drives. This notion has been rooted in the belief that such drives are inherent. Many women have been mischaracterized as having low sexual desire, not because they lack it, but because they may not desire sex as much as their partners.

This view has evolved with the introduction of the dual-control model of sexual responses. This model posits two independent processes influencing our sexual responses: one is excitatory (activation), while the other is inhibitory (deactivation).

The interplay between these opposing processes dictates the overall sexual response at any given moment, akin to a vehicle’s accelerator (excitability) and brakes (inhibition).

In terms of sexual activity, the levels of acceleration and braking vary among individuals. While one may generally lean towards being an accelerator or brake, each circumstance can differ significantly. Thus, desires are intricate, personal, and dynamic.

A closer examination of the science surrounding sexual desire reveals two distinct types: spontaneous desire and responsive desire. Spontaneous desires can manifest suddenly and may arise with or without external stimulation. These are often heightened in younger individuals or during the initial phases of new relationships.

Conversely, responsive desires are reactions to external stimuli, like sharing a meal with a partner, and typically become more prevalent in long-term relationships where spontaneous desires may diminish.

These two desire types are woven into alternative models. The framework discussed in our examination of women’s sexual reactions recognizes both types of desire, illustrating that they can occur before or after awakening, thereby more accurately reflecting women’s experiences with sex.

Moreover, it acknowledges the significant role intimacy—both physical and emotional—plays in a woman’s inclination to engage in sexual activity.

Numerous biological, psychological, and social factors can also influence sexual desire.
For instance, physical conditions such as joint pain, vulvar discomfort, or menopausal genital symptoms can lead to a postponement of sexual engagement.

This can carry over to subsequent experiences, further delaying desire. As a result, inhibiting factors may overshadow arousal processes, dampening sexual interest.

This applies both psychologically and physically, as we naturally shy away from activities we don’t enjoy. For example, discomfort with body image or strains within a relationship can detract from the enjoyment of sexual experiences, ultimately impacting overall sexual desire.

External distractions can also obstruct desire. Everyday responsibilities—work commitments, meal preparation, child care, etc.—can interfere. With an unending to-do list and constant demands from others, it’s clear that physical and mental states affect the capacity to foster spontaneous desires.

Engaging in pleasurable, fulfilling sex is an endeavor that must be cultivated; it does not happen automatically. It’s a complex and evolving aspect requiring growth and nurturing. However, this reality is not fully recognized by many, leading to confusion about attitudes towards sex.

It doesn’t have to remain this way. A deeper understanding of the science behind desire can illuminate our motivations, contributing to a more satisfying and fulfilling sexual life.

Source: www.sciencefocus.com

Here’s what we often misunderstand about prostate cancer.

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Joe Biden’s recent prostate cancer diagnosis has brought awareness to these health issues within the public discourse.

Prostate cancer charities are urging men across the country to assess their cancer risk through signs and to seek medical advice if they experience symptoms like frequent and uncontrollable urination. Nevertheless, prostate cancer remains a nuanced and intricate condition.

The prostate gland is located beneath the bladder and typically enlarges with age. The urethra, which drains urine from the bladder, passes through the prostate. Consequently, when the prostate enlarges, it can compress the urethra, impeding urine flow and leading to symptoms such as dribbling and increased urgency to urinate. Overall, this is a prevalent condition.

Likewise, the incidence of cancers originating in the prostate is quite common. Autopsy studies indicate that 36% of white individuals and 51% of African Americans had unreported prostate cancer. In the 1970s, he was diagnosed with prostate cancer.

Photo credit: Getty

Another study suggested that five percent of men under 30 lived with prostate cancer. This may seem surprising, but these cancers were identified during autopsies of men who passed away from other causes. Medical professionals have long maintained certain sayings, such as “That’s how I die from prostate cancer.”

This presents a significant challenge concerning prostate cancer. It can manifest in a form that causes minimal harm while also possessing a variant that is potentially lethal and can metastasize to nearby organs and bones.

How Dangerous Is Prostate Cancer?

Currently, prostate cancer accounts for approximately 35,000 deaths in the U.S. each year, with over 313,000 men diagnosed annually.

The key to addressing this issue lies in identifying which cases pose a threat, as treatments like surgery, radiation therapy, and hormone therapy may have side effects such as long-term erectile dysfunction and incontinence.

It is essential that patients avoid unnecessary treatments that do not benefit them.

Unfortunately, there is currently no straightforward method to differentiate between aggressive tumors and those that are indolent. A blood test known as the PSA (prostate-specific antigen) test was created in the 1990s to monitor men’s responses to prostate cancer treatments.

Following its introduction, the number of diagnosed prostate cancer cases surged, yet there was no corresponding decrease in mortality rates.

This led Richard Alvin, the researcher who developed the PSA test, to remark, “The widespread use has resulted in a costly public health crisis.” This is due to the PSA test potentially generating false positives caused by factors aside from prostate cancer, including infections and benign prostate enlargement.

In the U.S., the Preventive Services Task Force reviews research independently and issues recommendations regarding screening.

They state that PSA screening can marginally lower the risk of death from prostate cancer in some men. However, many men may experience harm from the screening, including false positives leading to unnecessary tests and diagnoses of non-threatening issues.

In short, increased screening rates in the U.S. may have contributed to deteriorating health outcomes for men, as they pursued treatments for conditions detected through positive test results that were not life-threatening.

Despite a reduction in testing rates since their peak in the ’90s, prostate cancer mortality rates in the U.S. have gradually decreased over the years. This might be attributed to improved treatment protocols, rather than indicating benign prostate enlargement. Limiting trials to men who exhibit symptoms of prostate enlargement could prevent unnecessary cancer treatments.

In other regions, such as in Sweden, prostate cancer screening cut mortality rates from 1.7% to 0.98%, although this required diagnosing 13 men to prevent a single death.

What is the Solution?

To mitigate this issue and avoid unnecessary treatments, a “watchful waiting” approach has shown efficacy. A recent 15-year British study indicated that localized prostate cancer with low mortality rates whether treatment included radiation, prostate removal, hormone therapy, or observation. This underscores the futility of invasive treatments offering no significant benefits.

So, what steps can we take? In the UK, the National Screening Committee regularly reviews the recommendation for PSA screening for prostate cancer. Recent research has identified harmful cancers through MRI screenings, but there is still insufficient evidence regarding whether this can reduce death rates while minimizing excessive treatments.

Meanwhile, straightforward messages regarding the benefits of screening are being communicated to men without adequately addressing the potential drawbacks. Numerous screening events are organized by well-meaning charities during sports events. Advocates argue that informed consent is critical; otherwise, we risk offering false promises and ensuring minimal progress in men’s health.

This article was published in 2024

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Source: www.sciencefocus.com

I’m a Female Health Doctor: Here’s What We Misunderstand About Perimenopause

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Menopause marks a significant transition in a woman’s life when the ovaries cease hormone production, but the journey leading up to this milestone can span several years. This extended phase is known as perimenopause.

On average, menopause occurs around age 51, meaning many women begin noticing symptoms of perimenopause in their mid-40s. These symptoms can vary greatly from one individual to another. While hot flashes and irregular heavy periods are commonly cited, not everyone experiences them.

Additionally, even within the same person, symptoms can differ in type, frequency, and intensity.

More than 75% of women report experiencing a range of symptoms, with about 25% indicating that these symptoms significantly impact their quality of life. Common issues include sleep disturbances, anxiety, and weight gain.

Unfortunately, these symptoms are often overlooked or dismissed by professionals as resulting from other medical conditions.

Symptoms and Treatment

Insomnia is often one of the earliest symptoms, potentially starting in one’s late 30s or early 40s. Research shows up to 60% of women over 40 are affected by sleep problems.

Changes in mood are also common, with women experiencing feelings of anger, irritability, sadness, and depression.

Other possible symptoms include brain fog, memory lapses, difficulty concentrating, joint and muscle pain, vaginal dryness, decreased libido, and discomfort.

Many women hesitate to seek medical help due to embarrassment or a desire to avoid making a fuss. While consulting a healthcare provider is crucial, currently, there are no official menopause or perimenopause tests for women older than 45.

This highlights the importance of tracking symptoms and noting when they occur. By discussing these experiences with your doctor, women can collaboratively determine the best treatment options.

For instance, there is robust evidence supporting the benefits of hormone replacement therapy (HRT) as endorsed by the National Institute for Health and Care Excellence, particularly for alleviating hot flashes and night sweats.

HRT has also been shown to help some women achieve better sleep and may alleviate negative cognitive symptoms. Additionally, cognitive behavioral therapy (CBT) can assist with management and stabilize mood and sleep patterns.

However, prescribing clonidine and antidepressants as first-line treatments is considered outdated.

Other studies indicate that HRT may also help maintain bone mineral density and reduce the risk of osteoporotic fractures later in life.

HRT encompasses various medications, including estrogen, combinations of estrogen and progestogen (another female hormone), and testosterone. These can be administered through patches or gels.

The type and dosage of HRT depend on the specific condition being managed, individual risks, and personal preferences. There is no definitive cutoff for starting HRT; the benefits must outweigh perceived risks.

New Research

Women undergoing HRT also experience a reduced risk of colorectal cancer and type 2 diabetes. Studies have indicated that starting estrogens as part of HRT early in the perimenopausal phase may further lower the risk of coronary heart disease and Alzheimer’s disease.

Specifically, the cardiovascular disease prevention benefits are notable for women who begin HRT in their 50s as compared to those who start after age 60.

However, initiating HRT solely for the prevention of cardiovascular disease or dementia is not recommended. There are known risks associated with certain types of HRT, including an elevated risk of uterine cancer when estrogen-only HRT is used without progestogens, as well as an increased risk of blood clots.

Osteoporosis generally affects older adults and postmenopausal women. HRT can help treat it. – Image credits: Science Photo Library

The primary concern remains breast cancer. This area is complex due to variable risks linked to historical clinical trial data, along with personal and family health histories, and lifestyle factors such as alcohol intake and obesity.

This variability can impact the clinical significance of the data for each individual.

Current evidence suggests that estrogen-only HRTs have little to no correlation with breast cancer risk, while combined HRTs may increase the risk by 3-4 cases per 1,000 women.

Alternative Treatment

Local estrogen HRT, applied topically, has proven very effective for managing vulvar and vaginal pain and dryness, as well as recurrent urinary tract infections.

Moreover, testosterone treatments paired with estrogens may benefit some women with low sexual desire.

Unfortunately, HRT isn’t a panacea. A review of current clinical trials shows no significant improvements in cognitive function, bone density, body composition, strength, or psychological health for women undergoing treatment.

Many women may opt against HRT, particularly those with a history of breast cancer.

Previously, alternative treatments were limited, primarily focusing on antidepressants and clonidine. These options have shown limited effectiveness and significant side effects. Recently, the new non-hormonal medication Fezolinetant has received approval for managing blood flow issues.

Natural Relief

In addition to medication, lifestyle and behavioral modifications—like improving sleep, increasing physical activity, and adopting better nutrition—carry no associated risks and can yield significant benefits.

Starting with sleep is often beneficial. When well-rested, focusing on enhancing activity and diet becomes more manageable.

Implementing good sleep hygiene practices, avoiding screens before bedtime, maintaining a consistent sleep routine, and utilizing CBT have all been shown to mitigate insomnia and other sleep disorders in women undergoing menopause.

Increasing activity levels can also be incredibly beneficial. Strength training exercises help build and maintain muscle and bone density, which helps prevent osteoporosis, enhances flexibility, and reduces insulin resistance.

Aerobic activities such as running, swimming, and cycling can improve long-term heart and brain health. Maintaining a balanced diet rich in fresh foods while limiting ultra-processed items is advantageous at any life stage.

Although menopause can be challenging, various proven interventions can assist in making this transition smoother.

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Source: www.sciencefocus.com