A taboo is a behavior or practice that is vetoed or frowned upon by society. Is sex taboo? On European Sexual Health Day, Dr. Mariano Rosselló Barbará, Director of the Institute of Sexual Medicine, answers this and other questions about sexuality.
Surely nowadays sex is no longer taboo in most social groups but it clearly suffers from a curious paradox: we are constantly exposed to images of high erotic content in the media or in the cinema and society praises those people who come close to the ideal of sexual attractiveness; but on the other hand, few talk openly about their intimate life and even fewer acknowledge suffering from problems related to their sexual function. Why this contradiction? If it is so important to aspire to be sexually attractive, why don’t we also take care of our sexual health?
Perhaps part of the responsibility lies with the restrictive education of yesteryear in which sex was identified as a sin and the genitals as a part of the body to be hidden and ignored. In addition, it is possible that the problem is due to the fact that for years medicine has not had answers for the most common sexual dysfunctions. In fact, it is only relatively recently that the disciplines of andrology and sexual medicine have been known, although fortunately this is changing and there are now clinics dedicated to these areas of health.
When there is pain in any part of the body or loss of function or mobility, most people go to the doctor to find out the causes and remedy the problem. However, when it comes to discomfort in the genitals or difficulty in achieving sexual satisfaction, we tend to ignore the problem, thinking that it is just a bad patch. Sometimes this is the case because the desire and sexual performance suffers during a period of low mood or stress, but if the problem persists 2-3 months and / or fails in 40% of intimate encounters it is time to face it, corner the feeling of shame and seek professional help.
We are going to give answers to 7 problems or situations that usually provoke a lot of anguish in those who suffer from them but that nevertheless have a solution in the hands of experts in urology, andrology and sexual medicine.
- Curvature of the penis, to what extent is it normal? A slight curve to one side in an erect penis is not a problem, but when the curvature appears suddenly (in a few weeks) and is accompanied by pain, it is necessary to see a specialist, since it could be Peyronie’s disease. Unknown to many, it affects 7% of the male population, so its prevalence is remarkable and should not be overlooked.
- Vaginismus, when penetration is not possible. Vaginismus is not an anatomical problem or a small or narrow vagina, as has been erroneously given to understand. There are women who suffer from a problem that prevents them from having penetrative sex, against their will! It is not related to lack of desire but to the involuntary contraction of the muscles of the vagina, which strongly contract the orifice preventing intercourse. This dysfunction manifests itself at an early age since it can be a problem during a gynecological check-up or simply trying to use tampons for menstruation. The good news is that, in the hands of experts, it has a very high resolution rate, over 90%. Once an anatomical problem has been ruled out and the diagnosis has been confirmed, treatment is usually based on psychotherapy and sexual medicine.
- Premature ejaculation, is it possible to regain control? Lack of ejaculatory control is the most commonly consulted sexual problem in patients between 18 and 40 years of age. It can be easily solved but it is necessary to follow the treatment to the letter, since it is a matter of re-educating the perception of pre-orgasmic sensations in order to learn to detect them in advance and thus be able to control the ejaculatory reflex before the point of non-return is reached. In some cases it is advisable to combine treatment with specific prescription medication, but the ultimate goal of treatment at the Institute of Sexual Medicine is to restore control without pharmacological dependence. In fact, we have been offering online treatment since 1998 with a high rate of satisfaction.
- Erectile dysfunction, is there a solution if pills fail? The famous blue pills to solve erectile dysfunction problems appeared in 2000 and since then there are others that have proven to be effective. But what happens if these pills fail? There are intracavernous injections and vacuum systems as a second line of treatment, but the former have adverse side effects and are only recommended for a very small group of patients. We should bear in mind that only 40% of those suffering from erectile dysfunction of physical origin do not respond satisfactorily to these drugs. For the remaining 60%, after an exhaustive diagnosis, the most viable option is penile prosthesis implant surgery. This option, very frequent in diabetic patients or those with coronary problems, is as unknown as it is effective; it restores erectile capacity, giving back to the patient and his partner a higher satisfaction index than that obtained with oral or injectable drugs.
- Does size matter? Aesthetics and size of the genitals. We can affirm that there is a lot of confusion and uneasiness surrounding this subject. Many men come for consultation concerned mainly about the size of their penis and, to a lesser degree, there are also consultations about the volume of the testicles or the general aesthetics of the whole. Just as the nose can be wider, thinner or protruding, we must also accept that the penis varies greatly from one person to another. Aesthetic improvements are possible but very few cases are considered pathological (less than 2% of people who come to consultation have a micropenis) and yet there are many men who want to improve their aesthetics to improve their self-image and, at the same time, their self-esteem. In our center we perform a previous psychological evaluation and in case they manifest an altered psycho-emotional state that requires psychological treatment instead of surgery. For those who do require surgery, a volumetric augmentation is proposed, either in length, thickness or both, depending on the case.
The European Sexual Health Day is the ideal occasion to remember that sex is not only life but also health. We are all here because of sex and maintaining an active and satisfying sex life is not only pleasurable but also strengthens the intimate bond with the partner, and is also healthy. Taking care of it is essential for our physical and emotional well-being!