Dr. Irwin Goldstein shares three tips for a healthy sexual function.
I would like to share with you three tips to help maintain a very healthy sexual function. The first tip–tip number one is to be healthy. Diet, exercise are strategies that are very relevant to being awake and alert and to having responsivity and not being tired. We have data that on the diet, an excellent diet that’s associated with good sexual function is the Mediterranean diet.
We have data that people who exercise have better sexual function except for one exercise form: women should not ride bicycles with narrow-nosed seats because they will create sensation problems to their genitals and may even cause nerve damage to their genitals. So exercise and diet I would say are numero uno.
The obvious is a good relationship, but I am not even going to go into that. Let’s just go into staying in the concept of healthy, hormone-healthiness. I can’t think of anything more important than to be hormonally healthy, and the problem with being hormonally healthy is you don’t know about the specific hormones unless you do blood tests.
You could, if you are pre-menopausal, you could have your reproductive cycle. You could have a normal, regular cycle and still have hormonal problems. You could have hormonal problems with thyroid. You can have hormonal problems with testosterone.
Women who take birth control pills, for men who haven’t done contraception through vasectomy or condom, and the contraception focus is on the woman, a very common contraception strategy is a birth control pill. The dilemma of the birth control pill is it uses a form of estrogen called ethynylestradiol, not the native 17 beta-estradiol.
Ethynylestradiol has very, it’s a synthetic, so it’s not a natural product. It has a very strong affinity to the estrogen receptors in the pituitary, and what it does is it affects the liver in all women. I mean, not just some women, all women, to raise this protein called sex hormone-binding globulin, and without getting too confusing here, it makes women’s testosterones that are not bound. They are sort of free form of testosterone, very low.
So all women will have low testosterone when taking the birth control pill. So you can’t be hormonally healthy if you are on a birth control pill. So that’s a dilemma. There are other reasons for hormone healthy problems. After childbirth there can be hormone changes. There could be hormone changes with depression. There can be hormone changes with certain medications.
So I would say diet and exercise–number one. I would say hormonally healthy–absolutely critical. So what you are taking for medication, where you are in your cycle, and if you have any concerns, blood tests are needed.
For the third item I would say that, I’ll get back to the relationship. There can’t be anything more important than a great relationship and a great positive attitude. Not everybody is in a relationship, and that doesn’t mean you can’t be sexual if you are not in a relationship, but a great positive attitude, being not “woe is me; only I have the problem being late for the bus and always stressed with work,” and being… we call it emotionally intelligent. Being aware of where you are on the tone scale, being aware of your happiness, being grateful, being thankful, that’s very, very important.
So let’s review, number one is the diet and exercise and being healthy physically. Hormonally healthy, can’t emphasize how important that is. The sad point is there’s no way to figure that out unless you get blood test. You can have thyroid problems and testosterone problems and you menstruate normally, and that’s what confuses everybody.
Often the doctors say, “Well, your hormones have to be normal. You are having a regular cycle,” but that’s not true. And the third item is just being a positive person, being thankful, grateful, being, you know, “the glass is half full rather than the glass is half empty.”
About Dr. Goldstein, M.D.:
Dr. Irwin Goldstein is Director of San Diego Sexual Medicine at Alvarado Hospital, the Secretary of the International Society for the Study of Women’s Sexual Health, a former President of the Sexual Medicine Society of North America and a Clinical Professor of Surgery at University of California at San Diego.
Dr. Goldstein has been involved with sexual dysfunction research since the late 1970s. His specialties include penile microvascular bypass surgery, surgery for dyspareunia, physiologic investigation of sexual function in men and women, and diagnosis and treatment of sexual dysfunction in men and women.