Pallavi Joshi, the psychiatrist spoke to us about common sexual problems faced by couples and the top misconceptions attached to sex. In our second part, she tells us about when to seek professional advice and shares some simple tips that’ll help couples keep their sex life healthy.
By Mdhil | Mdhil Q. What would be your advice, about when one should seek professional help in cases of sexual disorders?
A. When the difficulties in sexual practice in the form of problems with desire and or performance are present for 6 months, I’d say it’s time to see a professional. And if these problems are present for almost all occasions, causing significant difficulty in the social and occupational spheres, thus increasing the stress on the relationship. At such a time, one should consult with a psychiatrist, rather than wait for the distress to increase in the relationship.
Q. Is it true that 60 – 70% of women suffer from anorgasmia, or the inability to achieve an orgasm?
A. Surprisingly, the answer is yes, in the Indian scenario. Many possible causes for anorgasmia have been proposed, but all are inconclusive or inadequate at explaining the problem as a whole. Proposed explanations have included lack of sexual education, strong religious upbringing, lack of strength in the woman’s pubococcygeus muscle (muscle stretching from the pubic bone to the tailbone), past sexual abuse, impotence or early ejaculation on the part of the male partner, and high levels of anxiety associated with sex.
Q. Can you share with us your approach to treatment in cases related to common sexual health problems and associated distress?
A. The first step in dealing with common sexual health problems is recognition, in terms of the effects and symptoms that mental illness may have brought to the relationship.
The next step is adopting and maintaining a healthy lifestyle. A good diet, adequate sleep and regular exercise can make a big difference to both, mental health and a healthy libido.
Some people may not have enough symptoms for a specific diagnosis, but they face significant stress associated with an unsatisfactory sex life. Usually, these problems are related to difficulties around timing, frequency and unclear knowledge about sexual activity. It’s important to reassure them about the fact that no one’s sexual life is always on a high and while problems like theirs are common, they do require timely attention.
Sex education is key in explaining the anatomy and physiology of male and female reproductive systems and normal sexual cycle.
I encourage my patients to opt for deep breathing and recommend relaxation exercises for both partners together to reduce sexual anxiety. Reducing any “conflict” or “grudge” about each other at a mental level is also helpful in bonding two people.
We advocate modest use of medicines in reducing anxiety and fear related to sexual cycle when the problem is more psychological, and use of specific medicines and other methods in more severe problems.
Q. Are there any tips you’d like to share with our readers that’ll help improve their sexual life?
A. There are definitely simple things all couples can do to improve their sex lives:
1. Free communication between partners - This is the cornerstone of a healthy sexual relationship. It requires many years of togetherness to understand your partner’s non-verbal communication – what you like, what you don’t like in the act; what more you want from your partner for better arousal; what is expected from you by your partner and the things which you don’t like but can perform for your partner’s satisfaction, and the things you simply cannot stand. Simple turn offs like body odour or bad breath can be put in proper words for betterment in sexual life.
2. Respecting your partner in the public as well as in private space - There cannot be a healthy relationship if one does not respect his or her partner’s wishes. Overt criticism in public or constant conflicts on various issues can adversely affect sexual life by losing affection towards each other. In fact appreciating your partner’s efforts for taking care of you can strengthen the bonds.
3. Showing love in non-sexual context - This can be done by taking care of each other, bringing gifts even without it being a special occasion, writing letters to each other or talking to each other about how he or she is important in your life, helping each other in day to day matters, boosting each other in respective careers.
4. Bringing changes in the bedroom – These range from changing bed sheets to vibrant colours, changing curtains, using different room fresheners to trying out new sexual positions. The message is change helps in decreasing the boredom.
5. Make the time - Finding time for intimacy when you are mentally free and without hindrance from external sources.
6. Change your perspective - Getting rid of the compulsion that foreplay should always lead to complete sex and orgasm. One should try to enjoy the non-penetrative part of sex also, as there is lot of pleasure is simple caressing, hugging and holding hands also.
Have a happy and healthy sex life!
Dr Pallavi Joshi has an MD in Psychiatry and currently practices at Vydehi Medical College, Bangalore
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